Liu Hong-Mei, Jin Jing-Yi, Ji Jian-Hong, Zhang Yun, Cui Zhi-Ming
School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu Province, 226001, People's Republic of China.
Department of Critical Care Medicine, Nantong First People's Hospital, Nantong, Jiangsu Province, 226006, People's Republic of China.
J Multidiscip Healthc. 2025 Sep 10;18:5677-5689. doi: 10.2147/JMDH.S531771. eCollection 2025.
This study aimed to develop a structured narrative nursing log, grounded in narrative nursing theory, for use with conscious patients in the intensive care unit (ICU), and to conduct a preliminary clinical evaluation of its effectiveness.
A structured narrative nursing log was developed through literature review, group brainstorming, and expert consultation. A quasi-experimental design was adopted. The study included 90 conscious ICU patients from a Class III Grade A hospital in Nantong, Jiangsu Province, selected via convenience sampling. Participants were assigned to either the control group (n = 46), in which nurses documented care using a blank nursing log, or the intervention group (n = 44), in which nurses utilized the structured narrative nursing log developed in this study. Primary outcome measures included patient-reported anxiety levels, perceived caring, time spent by ICU nurses on narrative nursing, and nurses' sense of professional fulfillment.
Patients in the intervention group exhibited significantly lower anxiety levels and significantly higher perceived caring compared to those in the control group ( < 0.05; 95% CI, 2.33-3.72). The average time spent on narrative nursing was also significantly lower in the intervention group (25.05 ± 1.94 minutes) than in the control group (34.07 ± 3.93 minutes) ( < 0.05; 95% CI, 7.71-10.33). Among the 43 participating ICU nurses, a statistically significant increase in self-reported professional fulfillment was observed following implementation of the structured log ( < 0.05; 95% CI, -10.95 to -6.40).
The structured narrative nursing log shows promise in reducing anxiety-related symptoms, improving patients' perception of care, and enhancing nurses' sense of professional accomplishment. These findings suggest its potential value in refining nursing practices for conscious patients in intensive care settings.
本研究旨在基于叙事护理理论开发一种结构化的叙事护理日志，供重症监护病房（ICU）的清醒患者使用，并对其有效性进行初步临床评估。
通过文献回顾、小组头脑风暴和专家咨询，开发了一种结构化的叙事护理日志。采用准实验设计。本研究纳入了江苏省南通市某三甲医院的90例清醒ICU患者，采用方便抽样法选取。参与者被分为对照组（n = 46），护士使用空白护理日志记录护理情况；干预组（n = 44），护士使用本研究开发的结构化叙事护理日志。主要结局指标包括患者报告的焦虑水平、感知关怀、ICU护士进行叙事护理的时间以及护士的职业成就感。
与对照组相比，干预组患者的焦虑水平显著降低，感知关怀显著提高（<0.05；95%可信区间，2.33 - 3.72）。干预组叙事护理的平均时间（25.05±1.94分钟）也显著低于对照组（34.07±3.93分钟）（<0.05；95%可信区间，7.71 - 10.33）。在43名参与研究的ICU护士中，实施结构化日志后，自我报告的职业成就感有统计学意义的提高（<0.05；95%可信区间，-10.95至-6.40）。
结构化叙事护理日志在减轻焦虑相关症状、改善患者对护理的感知以及增强护士的职业成就感方面显示出前景。这些发现表明其在优化重症监护环境中清醒患者的护理实践方面具有潜在价值。
