Intensive Care Unit, Galway University Hospitals, Galway, Ireland.
Intensive Crit Care Nurs. 2011 Oct;27(5):244-52. doi: 10.1016/j.iccn.2011.06.002. Epub 2011 Jul 23.
The aim of the study was to describe the factors that influence critical care nurses when deciding to wean patients from mechanical ventilation. The study adopted a qualitative methodology, using semi-structured interviews and a vignette. An invited sample of critical care nurses (n=24) from one Irish intensive care unit was employed. Each nurse was interviewed once and a vignette was used to structure the interview questioning. The findings were analysed using thematic content analysis. Six major themes influencing nurses' decision to wean emerged, as follows: physiological influences; clinical reassessment and decision making; the nurse's experience, confidence and education; the patient's medical history and current ventilation; the intensive care working environment; and use of protocols. The findings highlight the complex nature of weaning patients from mechanical ventilation and the major role of the nurse in this process.
本研究旨在描述影响重症监护护士决定为机械通气患者撤机的因素。该研究采用了定性方法，使用半结构化访谈和病例描述。从爱尔兰的一家重症监护病房邀请了 24 名重症监护护士作为样本，每位护士接受一次访谈，病例描述用于构建访谈问题。使用主题内容分析法分析研究结果。研究结果得出了影响护士撤机决策的 6 个主要因素，分别为：生理影响；临床再评估和决策；护士的经验、信心和教育；患者的病史和当前通气情况；重症监护工作环境；以及使用协议。研究结果强调了为机械通气患者撤机的复杂性，以及护士在这一过程中的重要作用。
