Department of Cardiovascular Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan City, Shandong Province, China.
Department of Intensive Care Unit, Affiliated Hospital of Jining Medical University, Jining City, Shandong Province, China.
Heart Lung. 2024 Nov-Dec;68:367-372. doi: 10.1016/j.hrtlng.2024.09.006. Epub 2024 Sep 10.
Frailty is prevalent among older patients in intensive care units (ICUs) and poses significant challenges to recovery. Despite its importance, there is limited research on effective nurse-led frailty management strategies in this context.
The purpose of this qualitative study was to explore nurses' perceptions of frailty management in cardiac ICUs through the lens of the Wuli-Shili-Renli (WSR) system approach.
Sixteen nurses from two tertiary hospitals in Shandong province, China, participated in semi-structured interviews. Participants were selected based on their involvement in frailty training, educational background, and cardiac ICU work experience. Thematic analysis was conducted to identify key themes and sub-themes.
Analysis in three categories revealed the need for foundational support, including the need for appropriate screening tools, updated evidence-based practices, and institutional support. Closed-loop management involved frailty screening, personalized program implementation, information management, and follow-up assessment. Personnel training and coordination emphasized enhancing nurses' professionalism, multidisciplinary teamwork, and cooperation from patients and their caregivers.
The insights gained can inform evidence-based practices and improve the quality of care provided to frail patients in cardiac ICUs. There is a need for future research to empirically investigate these strategies.
在重症监护病房（ICU）中，虚弱是老年患者中普遍存在的问题，对康复构成了重大挑战。尽管虚弱问题很重要，但在这方面，针对有效的护士主导的虚弱管理策略的研究还很有限。
本定性研究旨在通过吴理-事理-人理（WSR）系统方法的视角，探讨护士对心脏 ICU 中虚弱管理的看法。
来自中国山东省两家三级医院的 16 名护士参加了半结构式访谈。参与者是根据他们参与虚弱培训、教育背景和心脏 ICU 工作经验选择的。采用主题分析方法来确定关键主题和子主题。
通过三个类别的分析揭示了基础性支持的必要性，包括需要适当的筛查工具、更新的基于证据的实践以及机构支持。闭环管理涉及虚弱筛查、个性化方案实施、信息管理和随访评估。人员培训和协调强调了提高护士的专业性、多学科团队合作以及患者及其照顾者的合作。
这些见解可以为心脏 ICU 中虚弱患者提供循证实践，并提高护理质量。需要进一步的研究来实证检验这些策略。
