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Mother’s and father’s perceived experiences of breastfeeding a preterm infant in a neonatal intensive care unit 母亲和父亲对新生儿重症监护病房早产儿母乳喂养的感知体验
Pub Date : 2026-01-01 DOI: 10.1016/j.enfie.2025.500571
Èlia Santiveri-Camacho RN, MSc , Alejandro Bosch-Alcaraz RN, PNP, MSc, PhD , Mariela Patricia Aguayo-González RN, MSc, PhD , M. Ángeles Saz-Roy RN, PNP, MSc, PhD

Introduction

A premature birth involves stress derived from the context of the NICU where the baby is cared for. In addition, the separation between mother and father/couple and child involves an interruption of the biological process of breastfeeding. The experiences lived in this process between mother and father/couple are unequal, which entails different care needs to be covered by the health professional through informative and educational activities.

Objective

To explore the experiences of mothers and fathers/couple breastfeeding PTNB during their stay in the NICU.

Design and methods

A qualitative phenomenological study was carried out. The population studied were mothers and fathers/couple of PTNB in a neonatal unit who were breastfeeding. Using purposive convenience sampling and the principle of information saturation, the participants were 5 mothers and 4 fathers. Semi-structured interviews were conducted and organised into the following thematic areas: knowledge, environment, feelings, coping strategies and challenges.

Results

The mothers' and fathers'/couples’ experiences are grouped into four themes: previous lack of knowledge about the breastfeeding process, BF as a personal challenge, barriers and facilitators during the process of breastfeeding a PTNB, and the feelings of the families.

Conclusions

From the perceptions and feelings reported by breastfeeding mothers and fathers/couples of PTNB, changes can be made to improve nursing care in the NICU. Improving early expressing within the first hour, developing specific protocols for breastfeeding in PTNB and updated training for nursing staff are aspects that emerge from the study and could help to priorities and meet the expressed needs for breastfeeding support in the NICU.
早产涉及来自新生儿重症监护室照顾婴儿的环境的压力。此外,母亲和父亲/夫妇和孩子之间的分离涉及到母乳喂养生物学过程的中断。在这一过程中,母亲和父亲/夫妇之间的经历是不平等的,这就需要保健专业人员通过宣传和教育活动来满足不同的护理需求。目的探讨父母/夫妻在新生儿重症监护病房期间母乳喂养PTNB的经验。设计与方法进行定性现象学研究。研究的人群是在新生儿病房中母乳喂养的母亲和父亲/ PTNB夫妇。采用有目的的方便抽样和信息饱和原则,调查对象为5名母亲和4名父亲。半结构式访谈是按照以下主题进行的:知识、环境、感受、应对策略和挑战。结果将母亲和父亲/夫妇的经历分为四个主题:先前对母乳喂养过程缺乏了解,BF作为个人挑战,PTNB母乳喂养过程中的障碍和促进因素,以及家庭的感受。结论从母乳喂养的父母/夫妇对PTNB的认知和感受来看,可以改善新生儿重症监护病房的护理。改善新生儿在第一个小时内的早期表达,制定PTNB母乳喂养的具体方案,以及对护理人员进行更新培训,这些都是研究中出现的方面,可以帮助确定新生儿重症监护室母乳喂养支持的优先事项并满足已表达的需求。
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引用次数: 0
Occurrence of adverse events with arterial catheters and their contributing factors: A cross-sectional study 动脉导管不良事件的发生及其影响因素:一项横断面研究
Pub Date : 2026-01-01 DOI: 10.1016/j.enfie.2025.500575
Patriny Marcelle Mariano-Gomes MSc , Adriana Ouverney-Braz RN, PhD , Graciele Oroski-Paes RN, PhD

Introduction

The insertion of an arterial line is one of the most important invasive procedures in intensive care, but it may still pose risks to patients.

Objectives

To determine the prevalence and analyze the association of contributing factors with the occurrence of adverse events related to the use of arterial catheters.

Method

Cross-sectional, retrospective, analytical and quantitative study. The sample included all reports of adverse events involving arterial catheters over the past five years. The hospital's electronic and physical medical records were used to supplement the patients' clinical data. Descriptive and inferential analysis was carried out using frequency calculations and association tests, including chi-square and Fisher's exact test. A significance level of up to 10% (p-value < 0.1) was used for all analyses. The study adhered to the STROBE Checklist guidelines (a checklist of items recommended for reports of cross-sectional studies).

Results

Between 2019 and 2023, 3104 arterial catheters were inserted in the hospital's intensive care units. 39 reports of adverse events with these catheters were included, with an occurrence rate of 1.25% (95% confidence interval). The most prevalent incident was inadvertent loss (41%), followed by pseudoaneurysm and/or hematoma formation (25.6%), and obstruction (20.51%). Human resources (p-value 0.069), need for sedation (p-value 0.011) and insertion site (p-value 0.074) were factors that were associated with accidental device loss. Factors related to the patient (p-value 0.079) and the puncture method (p-value 0.079) were related to the formation of pseudoaneurysms and hematomas. Human resources (p-value 0.001), the use of vasoactive amines (p-value 0.032) and the insertion site (p-value 0.012) were associated with system obstruction.

Conclusion

The results elucidated potential weaknesses that could compromise the safety of critically ill patients using blood pressure monitoring, such as the method of puncture, circuit management and the clinical characteristics of the patients. In addition to the negative impact on patients and costs, litigation can also result from failures in healthcare safety.
动脉线的插入是重症监护中最重要的侵入性手术之一,但它仍然可能给患者带来风险。目的了解动脉导管使用不良事件发生率,分析影响因素与不良事件发生的关系。方法横断面、回顾性、分析定量研究。样本包括过去五年中所有涉及动脉导管不良事件的报告。利用医院的电子病历和实物病历来补充患者的临床资料。使用频率计算和关联检验(包括卡方检验和Fisher精确检验)进行描述性和推断性分析。所有分析均采用高达10%的显著性水平(p值<; 0.1)。该研究遵循STROBE清单指南(一份推荐用于横断面研究报告的项目清单)。结果2019年至2023年,该院重症监护室共插入动脉导管3104根。纳入39例不良事件报告,发生率为1.25%(95%可信区间)。最常见的事故是意外丢失(41%),其次是假性动脉瘤和/或血肿形成(25.6%)和梗阻(20.51%)。人力资源(p值为0.069)、镇静需求(p值为0.011)和插入位置(p值为0.074)是与意外器械丢失相关的因素。假性动脉瘤和血肿的形成与患者相关因素(p值为0.079)和穿刺方法相关因素(p值为0.079)有关。人力资源(p值0.001)、血管活性胺的使用(p值0.032)和插入部位(p值0.012)与系统阻塞有关。结论分析了危重患者血压监测在穿刺方法、回路管理及患者临床特点等方面存在的可能危及危重患者安全的薄弱环节。除了对患者和成本的负面影响外,医疗安全方面的失败也可能导致诉讼。
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引用次数: 0
Lung collapse during postural repositioning in a mechanically ventilated patient, could it have been avoided? A case report 机械通气患者体位复位时肺塌陷是否可以避免?一份病例报告。
Pub Date : 2026-01-01 DOI: 10.1016/j.enfie.2025.500583
María Dolores Rodríguez-Huerta RN, MSc , Ana Díez-Fernández RN, MSc, PhD , María Jesús Rodríguez-Alonso RN , María Martín-Rodríguez RN , Mario Fernández-Izquierdo RN

Objective

To analyse through a clinical case the need for comprehensive management of bronchial secretions by nurses, with a proactive and preventive character to improve mechanically ventilated patients’ safety.

Clinical case presentation

A 76-year-old man under invasive mechanical ventilation admitted to the ICU due to pulmonary infection, who presented subtotal left lung collapse during routine postural changes. Trying to recover the left lung ventilation, the patient was repositioned, an endotracheal suctioning and two recruitment manoeuvres were made without any ventilation improvement. The previous level of left ventilation was not achieved until secretions were completely eliminated after three more suctioning manoeuvres.

Discussion and implications for practice

Critically ill patient care is complex, requiring general basic attention and monitoring, including the assessment of the risks that certain interventions and nursing care may entail for each individual patient. Both, postural repositioning and endotracheal suctioning constitutes tow integral parts of routine care for all mechanically ventilated patients. This case shows how the presence of deep secretions during postural repositioning can greatly affect the respiratory function, with no significant immediate or short-term changes observed on routine monitoring, as electrical impedance monitoring is not standard practice, so the changes described in this case would not have been observed in short term.

Conclusions

The implementation of a nursing integral care protocol for the management of secretions in mechanically ventilated patients, could be very useful in preventing adverse events, ineffective multiple endotracheal suctioning, which are not free of potential complications, and in reducing the need for deep airway clearance by fibrobronchoscopy.
目的:通过一个临床病例分析护士对支气管分泌物进行综合管理的必要性,以积极预防的态度提高机械通气患者的安全性。临床病例介绍:一名76岁男性患者在有创机械通气下因肺部感染入住ICU,在常规体位改变时出现左肺大部萎陷。试图恢复左肺通气,患者重新定位,气管内吸痰和两次复吸手法,没有任何通气改善。在三次以上的抽吸操作后分泌物完全消除后,才达到先前的左侧通气水平。对实践的讨论和影响:危重病人护理是复杂的,需要一般的基本关注和监测,包括评估某些干预措施和护理可能给每个病人带来的风险。体位复位和气管内吸引是所有机械通气患者常规护理的两个组成部分。本病例显示体位重定位过程中深层分泌物的存在如何极大地影响呼吸功能,常规监测没有观察到明显的即时或短期变化,因为电阻抗监测不是标准做法,因此本病例中描述的变化不会在短期内观察到。结论:机械通气患者分泌物管理的护理整体护理方案的实施,可以非常有效地预防不良事件,无效的气管内多次吸引,这并非没有潜在的并发症,并减少纤维支气管镜下深度气道清除率的需要。
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引用次数: 0
Associations between ICU nursing care and functional outcomes in survivors of critical COVID-19: Longitudinal study 重症COVID-19幸存者ICU护理与功能结局的关系:纵向研究
Pub Date : 2026-01-01 DOI: 10.1016/j.enfie.2025.500579
Raví P. Pereira RN, MSN , Vanessa F. Bonatto RN, MSN , Luísa B. Santana RN , Isis M. Severo RN, PhD , Michele D. Santarem RN, PhD , Augusto Savi PT, PhD , Cassiano Teixeira MD, PhD , Karina de O. Azzolin RN, PhD

Introduction

The evaluation of long-term functional disabilities and factors associated with decline following COVID-19-related critical illness in low- and middle-income countries remains underexplored in current literature. Addressing this gap is essential for healthcare professionals, particularly nurses, to develop targeted interventions aimed at reducing the risk of functional decline after critical illness during pandemics.

Objectives

To analyze ICU nursing care factors associated with functional outcomes in survivors of critical illness due to COVID-19, six months after ICU discharge.

Methods

A prospective longitudinal study was conducted. Adults (≥18 years) discharged from the ICU after viral pneumonia, confirmed by RT-PCR for SARS-CoV-2, with a minimum ICU stay of 72 h, were included. Follow-up was conducted via telephone interviews at one, three, and six months to collect sociodemographic data and assess functional status using the Barthel Index. Data were analyzed using Generalized Estimating Equations.

Results

The study included 400 participants (mean age: 52.41 ± 13.680 years; median ICU stay: 15.0 days, IQR: 8.0–26.0). Functional decline was observed in 43% of patients at one month, 28.4% at three months, and 20.4% at six months. Delirium and skin ulcers during ICU stay were modifiable factors associated with post-critical care functional disability.

Conclusions

Exploring targeted nursing interventions, such as delirium and pressure ulcer prevention, is essential to promote recovery and prevent long-term disability after critical illness.
目前的文献中,对低收入和中等收入国家covid -19相关危重疾病后长期功能残疾和衰退相关因素的评估仍未得到充分探讨。解决这一差距对于卫生保健专业人员,特别是护士,制定有针对性的干预措施,以减少大流行期间重症后功能下降的风险至关重要。目的分析COVID-19危重症患者出院后6个月ICU护理因素与功能结局的关系。方法采用前瞻性纵向研究。纳入经RT-PCR确诊为SARS-CoV-2的病毒性肺炎后出院的成人(≥18岁),至少在ICU住院72小时。随访时间为1个月、3个月和6个月,通过电话访谈收集社会人口统计数据,并使用Barthel指数评估功能状态。使用广义估计方程对数据进行分析。结果共纳入400例患者,平均年龄52.41±13.680岁,中位ICU住院时间15.0天,IQR: 8.0 ~ 26.0。43%的患者在1个月时出现功能下降,28.4%在3个月时,20.4%在6个月时。重症监护期间谵妄和皮肤溃疡是重症监护后功能障碍的可改变因素。结论探索有针对性的护理干预措施,如预防谵妄和压疮,是促进重症患者康复和预防长期残疾的必要措施。
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引用次数: 0
Effect of mobility at ICU discharge on mortality and length of post-ICU stay: A retrospective analysis ICU出院时活动能力对死亡率和ICU后住院时间的影响:回顾性分析
Pub Date : 2026-01-01 DOI: 10.1016/j.enfie.2025.500572
Roberto Mendes MSN , André Novo PhD , Manuel Nunes PhD , Miguel Castelo-Branco PhD

Background

Admission to intensive care can be accompanied by significant adverse effects for patients, which last beyond their stay in the unit. Early mobilisation is part of a set of a bundle to minimize these effects and is now unanimously considered to be safe and beneficial. It is therefore important to understand how it is being implemented in practice and what its real benefits are.

Aim/Objective

To characterise mobility in the ICU and correlate the level of mobility at discharge from the ICU with the results of post-intensive care, namely: length of stay after intensive care and hospital mortality.

Methods

This was an observational, retrospective study carried out in the Intensive Care Department of a Local Health Unit located in the portuguese countryside. A quantitative research methodology was used.

Results

Of the 244 patients included in the sample, 54.5% achieved orthostatism during the ICU stay and 36.5% achieved deambulation. The average length of stay between leaving the ICU and hospital discharge was 8.0 ± 7.5 days. Patients who remained at bed rest at discharge had longer hospital stays than patients who were ambulating (p = 0.014); and patients who performed activities in bed also had longer hospital stays than those who were orthostatic or ambulating (p = 0.026 and 0.002 respectively). Post-ICU mortality was 5.7%, and there was a strong correlation with mobility on discharge from the ICU (p < 0.001), with less mobile patients having a higher mortality rate than expected (Odds ratio = 5.13).

Conclusions

The mobility levels founded in this study are in line with international reality. Patients who achieve higher levels of mobility during their stay in intensive care have shorter hospital stays and lower mortality.
对患者来说,前往重症监护室可能伴随着严重的不良反应,这些不良反应会持续到他们住院后。早期动员是尽量减少这些影响的一揽子措施的一部分,现在被一致认为是安全和有益的。因此,重要的是要了解它是如何在实践中实施的,以及它的真正好处是什么。目的/目的描述ICU的活动能力特征,并将ICU出院时的活动水平与重症监护后的结果(即重症监护后的住院时间和住院死亡率)联系起来。方法:这是一项观察性、回顾性研究,在葡萄牙农村当地卫生单位的重症监护室进行。采用定量研究方法。结果244例患者中,54.5%的患者在ICU住院期间实现了直立,36.5%的患者实现了下床。出院至平均住院时间为8.0±7.5天。出院时卧床休息的患者比走动的患者住院时间更长(p = 0.014);在床上进行活动的患者也比站立或走动的患者住院时间更长(p分别= 0.026和0.002)。ICU后死亡率为5.7%,与出院时的活动能力有很强的相关性(p < 0.001),活动能力较差的患者死亡率高于预期(优势比= 5.13)。结论本研究建立的人员流动水平符合国际实际。在重症监护期间活动能力较高的患者住院时间较短,死亡率较低。
{"title":"Effect of mobility at ICU discharge on mortality and length of post-ICU stay: A retrospective analysis","authors":"Roberto Mendes MSN ,&nbsp;André Novo PhD ,&nbsp;Manuel Nunes PhD ,&nbsp;Miguel Castelo-Branco PhD","doi":"10.1016/j.enfie.2025.500572","DOIUrl":"10.1016/j.enfie.2025.500572","url":null,"abstract":"<div><h3>Background</h3><div>Admission to intensive care can be accompanied by significant adverse effects for patients, which last beyond their stay in the unit. Early mobilisation is part of a set of a bundle to minimize these effects and is now unanimously considered to be safe and beneficial. It is therefore important to understand how it is being implemented in practice and what its real benefits are.</div></div><div><h3>Aim/Objective</h3><div>To characterise mobility in the ICU and correlate the level of mobility at discharge from the ICU with the results of post-intensive care, namely: length of stay after intensive care and hospital mortality.</div></div><div><h3>Methods</h3><div>This was an observational, retrospective study carried out in the Intensive Care Department of a Local Health Unit located in the portuguese countryside. A quantitative research methodology was used.</div></div><div><h3>Results</h3><div>Of the 244 patients included in the sample, 54.5% achieved orthostatism during the ICU stay and 36.5% achieved deambulation. The average length of stay between leaving the ICU and hospital discharge was 8.0 ± 7.5 days. Patients who remained at bed rest at discharge had longer hospital stays than patients who were ambulating (<em>p</em> = 0.014); and patients who performed activities in bed also had longer hospital stays than those who were orthostatic or ambulating (<em>p</em> = 0.026 and 0.002 respectively). Post-ICU mortality was 5.7%, and there was a strong correlation with mobility on discharge from the ICU (<em>p</em> &lt; 0.001), with less mobile patients having a higher mortality rate than expected (Odds ratio = 5.13).</div></div><div><h3>Conclusions</h3><div>The mobility levels founded in this study are in line with international reality. Patients who achieve higher levels of mobility during their stay in intensive care have shorter hospital stays and lower mortality.</div></div>","PeriodicalId":93991,"journal":{"name":"Enfermeria intensiva","volume":"37 1","pages":"Article 500572"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Experience of care of caregivers and children between 12 and 17 years of age provided by health personnel during hospitalization in pediatric intensive care 儿童重症监护室住院期间卫生人员对护理人员和12至17岁儿童的护理经验
Pub Date : 2026-01-01 DOI: 10.1016/j.enfie.2026.500582
Herly Ruth Alvarado-Romero RN, MSc , Carlos Yecid Bernal-Cárdenas RN, PhD , Diana Norella Córdoba-Rojas RN, MSc , Alba Deyanira Quiñonez-López MD , Camila Yesenia Ruiz-Matore RN , Paola Torres-Giraldo RN, MSN

Introduction

Caring for children hospitalised in Pediatric Intensive Care Units is a complex and multidimensional process. This process includes specialised care, as well as emotional and psychological support for both patients and their caregivers. These caregivers play an essential role in the hospitalisation experience, facing a range of emotions due to the severity of the children’s illness and the connotations of being hospitalised.

Objective

Describe the caregiving experience of caregivers and children between the ages of 12 and 17 provided by healthcare personnel during hospitalisation in the unit at an institution in Bogotá in 2023.

Methodology

Qualitative study with a phenomenological design, using in-depth semi-structured interviews with caregivers and children hospitalised in an Intensive Care Unit in Bogotá in 2023.

Results

Twenty-seven interviews were conducted to achieve data saturation. Most of the caregivers were women. The predominant socioeconomic status was 3 and the educational level was high school. Four categories and thirteen subcategories were identified: Environment and dynamics, interaction with healthcare personnel, recognition of healthcare personnel, and feelings and experience upon admission to the unit.

Conclusion

Nurses working in Pediatric Intensive Care Units play a fundamental role, as they are in constant contact with children and their caregivers, who often experience high levels of anxiety and fear due to the seriousness of the environment. To provide comprehensive and humanised care, it is essential that these professionals have specific scientific knowledge about children’s health, as well as disciplinary skills to guide their interventions. In this way, they contribute to the child's recovery and the creation of a more humane care environment, even in a highly technical context.
在儿科重症监护病房住院的儿童的护理是一个复杂和多维的过程。这一过程包括专门护理,以及对患者及其护理人员的情感和心理支持。这些护理人员在住院经历中发挥着至关重要的作用,他们面临着由于儿童疾病的严重程度和住院的内涵而产生的一系列情绪。目的描述2023年波哥大一家机构住院期间医护人员提供的护理人员和12至17岁儿童的护理经验。方法:采用现象学设计的定性研究,对2023年波哥大重症监护室的护理人员和住院儿童进行了深入的半结构化访谈。结果共进行了27次访谈,达到数据饱和。大多数看护人都是女性。社会经济地位为3,文化程度为高中。确定了四个类别和十三个子类别:环境和动态,与医护人员的互动,对医护人员的认可,以及入院时的感受和体验。结论儿科重症监护室的护士工作起着至关重要的作用,因为他们经常与儿童及其照顾者接触,由于环境的严重性,他们经常经历高度的焦虑和恐惧。为了提供全面和人性化的护理,这些专业人员必须具备有关儿童健康的具体科学知识,以及指导其干预措施的学科技能。这样,它们有助于儿童的康复和创造一个更人道的照料环境,即使在高度技术性的环境中也是如此。
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引用次数: 0
Exploring patients’ experiences in intensive care units (ICU): A cross-sectional study in Pakistan 探索重症监护病房(ICU)患者的经验:巴基斯坦的横断面研究。
Pub Date : 2026-01-01 DOI: 10.1016/j.enfie.2025.500578
Tawseef Ahmad MS, Pharm-D , Sirima Sitaruno Pharm-D, BCPS , Sutthiporn Pattharachayakul Pharm-D, BCPS , Faiz Ullah Khan Pharm-D, PhD , Muhammad Kiddeer Pharm-D, M. Phil. , Shujaat Ali Khan Pharm-D, PhD

Background

Intensive Care Unit (ICU) stays are often traumatic, impacting patients psychologically, physically, and emotionally. However, patient experiences in ICU settings remain underexplored, particularly in developing countries like Pakistan.

Objective

This study aimed to assess the experiences of ICU patients in a tertiary care hospital in Pakistan, with a focus on psychological distress, emotional responses, and perceived quality of care.

Methods

A descriptive cross-sectional study was conducted at Ayub Teaching Hospital, Abbottabad. A total of 102 post-ICU patients meeting the inclusion criteria were interviewed within 72 h of transfer to medical wards. Data were collected using the validated Intensive Care Experience Questionnaire (ICEQ), and analyzed to evaluate patient perceptions and associated factors.

Results

Of the participants, 93.13% expressed relief upon discharge from the ICU, while 42.15% reported experiencing blurred memories during their stay. Despite this, 77.45% expressed satisfaction with the care received. Notably, only 23.52% of patients felt involved in decision-making processes regarding their care, indicating a communication gap. Statistical analysis revealed a significant negative correlation between patient age and satisfaction with care (r = −0.199, p < 0.05), suggesting older patients experienced reduced satisfaction. Gender also negatively correlated with memory of experience (r = −0.236, p < 0.05) and satisfaction with care (r = −0.208, p < 0.05), with women reporting more negative experiences. Length of ICU stay was significantly associated with reduced environmental awareness (r = −0.230, p < 0.001).

Conclusion

The findings highlight significant psychological and emotional challenges faced by ICU patients in Pakistan. Enhanced patient-centered communication, psychological support, and greater involvement in care decisions are critical to improving ICU experiences. Nursing staff play a pivotal role in creating a supportive and therapeutic ICU environment that fosters trust and improves patient outcomes.
背景:重症监护室(ICU)的住院往往是创伤性的,对患者的心理、身体和情感都有影响。然而,ICU环境中的患者体验仍未得到充分探索,特别是在巴基斯坦等发展中国家。目的:本研究旨在评估巴基斯坦一家三级护理医院ICU患者的经历,重点关注心理困扰、情绪反应和感知护理质量。方法:在阿伯塔巴德Ayub教学医院进行描述性横断面研究。在转入内科病房72小时内,对102例符合纳入标准的icu后患者进行了访谈。使用经过验证的重症监护体验问卷(ICEQ)收集数据,并分析以评估患者的感知和相关因素。结果:在参与者中,93.13%的人在出院时表示缓解,而42.15%的人报告在住院期间记忆模糊。尽管如此,77.45%的人对所得到的护理表示满意。值得注意的是,只有23.52%的患者感觉自己参与了有关其护理的决策过程,这表明存在沟通差距。统计分析显示,患者年龄与护理满意度呈显著负相关(r = -0.199, p)。结论:研究结果突出了巴基斯坦ICU患者面临的重大心理和情感挑战。加强以患者为中心的沟通、心理支持和更多地参与护理决策对改善ICU体验至关重要。护理人员在创造支持性和治疗性ICU环境中发挥关键作用,促进信任并改善患者预后。
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引用次数: 0
Clinical judgment and self-efficacy of nurses in sepsis management: The use of clinical simulation 护士在脓毒症管理中的临床判断和自我效能:临床模拟的应用
Pub Date : 2026-01-01 DOI: 10.1016/j.enfie.2025.500577
Lilian Regina-de-Carvalho RN, MSc, PhD , Ursula Marcondes-Westin RN, MSc, PhD , Renata Elizabete-Pagotti-da-Fonseca RN, MSc, PhD , Rafael Bressani-Lino RN, MSc, PhD , João Paulo Victorino RN , Silvia Helena-Zem-Mascarenhas RN, PhD

Introduction

Sepsis has high mortality and demands prompt intervention. Nurses are key in its management, but knowledge gaps persist. Enhancing clinical judgment and self-efficacy is crucial, and clinical simulation offers a safe, effective strategy for developing these skills, supporting education in healthcare.

Objective

To evaluate the responses related to self-efficacy and clinical judgment of nurses in the management of sepsis through high-fidelity clinical simulation.

Methods

A quasi-experimental, pre-and post-test study design was adopted. Self-efficacy, clinical judgment, and knowledge were considered dependent variables, while time and participant role (scenario participant/observer) were treated as covariates. The sample consisted of 28 nurses. Data were transcribed into Microsoft Excel® spreadsheets and analyzed using SAS version 9.4 software.

Results

After the debriefing session, the mean scores for knowledge, clinical judgment, and self-efficacy increased compared to baseline. Knowledge scores improved from a mean of 9.71 (SD = 2.02) to 12.75 (SD = 1.24). Clinical judgment scores increased from 31.75 (SD = 4.88) to 36.5 (SD = 5.5), and self-efficacy rose from 4.05 (SD = 0.44) to 4.19 (SD = 0.55). Statistically significant differences were found in clinical judgment (p < 0.0001) and knowledge (p < 0.0001) across time points. Participants who actively engaged in the simulation had significantly higher post-simulation clinical judgment (mean = 39.5 vs. 34.83; p = 0.0252) and self-efficacy scores (mean = 4.51 vs. 4.01; p = 0.0269) compared to observers. However, there was no significant difference in post-test knowledge scores between the groups (p = 0.6012). A strong correlation was identified between self-efficacy and clinical judgment. These findings support the effectiveness of simulation-based education in enhancing both clinical judgment and self-efficacy among nurses.

Conclusions

High-fidelity clinical simulation contributed to the development of nurses' clinical judgment, self-efficacy, and knowledge regarding sepsis management.
败血症死亡率高,需要及时干预。护士是其管理的关键,但知识差距仍然存在。增强临床判断和自我效能是至关重要的,临床模拟为发展这些技能提供了一种安全、有效的策略,支持医疗保健教育。目的通过高保真临床模拟,评价护士在脓毒症处理过程中自我效能感和临床判断的反应。方法采用准实验、测试前和测试后研究设计。自我效能、临床判断和知识作为因变量,时间和参与者角色(情景参与者/观察者)作为协变量。样本包括28名护士。将数据转录到Microsoft Excel®电子表格中,使用SAS version 9.4软件进行分析。结果报告后,知识、临床判断和自我效能的平均得分较基线有所提高。知识得分从平均9.71分(SD = 2.02)提高到12.75分(SD = 1.24)。临床判断评分从31.75分(SD = 4.88)提高到36.5分(SD = 5.5),自我效能从4.05分(SD = 0.44)提高到4.19分(SD = 0.55)。不同时间点的临床判断(p < 0.0001)和知识(p < 0.0001)差异有统计学意义。积极参与模拟的受试者在模拟后的临床判断(平均= 39.5 vs. 34.83, p = 0.0252)和自我效能评分(平均= 4.51 vs. 4.01, p = 0.0269)均显著高于观察者。但两组间测验后知识得分差异无统计学意义(p = 0.6012)。自我效能感与临床判断之间存在很强的相关性。这些发现支持了模拟教育在提高护士临床判断和自我效能方面的有效性。结论高保真度临床模拟有助于提高护士的临床判断、自我效能感和脓毒症管理知识。
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引用次数: 0
Prevalence, characteristics, and associated factors of dyskalemia in Moroccan intensive care units over a 28-month period: A cross-sectional correlational study 摩洛哥重症监护病房28个月期间钾血症的患病率、特征和相关因素:一项横断面相关性研究。
Pub Date : 2026-01-01 DOI: 10.1016/j.enfie.2025.500570
Kamal Takhdat RAN, PhD , Salma El Hamdou REN, BSN , Houda El Bannaoui REN, BSN , Ahmed Rhassane El Adib MD

Introduction

Dyskalemia disturbs electrophysiological homeostasis and even cause several life-threatening conditions. Improved understanding of dyskalemia risk factors is clinically relevant for prompt and effective dyskalemia treatment. This study aims to analyze dyskalemia prevalence and risk factors in two adult medical and surgical intensive care units (ICUs) in a Moroccan university hospital.

Methods

A retrospective cross-sectional study was conducted from January 1st 2022 to April 30, 2024. A total of 1274 patients’ medical records were examined, yielding for 549 dyskalemic patients. Single-factor and multi-factor logistic regression analyses were conducted to investigate associations between dyskalemia and the risk factors related to patients’ characteristics, comorbidities, and therapeutic agents.

Results

The prevalence of dyskalemia was found at 43%, with a dyskalemic patients’ mean age of 48,3 (±18,6). Over 62% of them developed dyskalemia during ICU stay. Multivariable analyses showed that the risk of hypokalemia was associated to female gender, diabetic ketoacidosis, anticancer drugs, heparin (LMWH), and insulin. However, the risk of hyperkalemia was associated with male gender, chronic kidney failure, metabolic acidosis, burns, blood transfusion, and propofol as a sedative agent.

Conclusion

Several associated factors of the risk of dyskalemia were identified. Critical care nurses should pay particular attention to high-risk patients of dyskalemia and be proactive in identifying early signs of dyskalemia in order to achieve targeted risk assessment, improve early diagnosis, and management of the patients’ conditions.
钾血症会扰乱电生理稳态,甚至导致一些危及生命的疾病。提高对血钾障碍危险因素的认识,对及时有效地治疗血钾障碍具有临床意义。本研究旨在分析血钾异常的患病率和危险因素在两个成人内科和外科重症监护病房(icu)在摩洛哥大学医院。方法:于2022年1月1日至2024年4月30日进行回顾性横断面研究。共检查了1274例患者的医疗记录,其中549例为钾血症患者。进行单因素和多因素logistic回归分析,以调查血钾异常与患者特征、合并症和治疗药物相关的危险因素之间的关系。结果:钾血症的患病率为43%,钾血症患者的平均年龄为48.3岁(±18.6岁)。超过62%的患者在ICU期间出现血钾异常。多变量分析显示,低钾血症的风险与女性、糖尿病酮症酸中毒、抗癌药物、肝素(LMWH)和胰岛素有关。然而,高钾血症的风险与男性、慢性肾衰竭、代谢性酸中毒、烧伤、输血和异丙酚作为镇静剂有关。结论:确定了血钾异常危险的几个相关因素。重症监护护士应特别关注钾血症高危患者,积极识别钾血症的早期体征,以实现有针对性的风险评估,提高患者的早期诊断和病情管理。
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引用次数: 0
Risk factors and preventive measures for corneal injury in the intensive care unit: Scoping review 重症监护病房角膜损伤的危险因素和预防措施:范围审查
Pub Date : 2025-12-19 DOI: 10.1016/j.enfie.2025.500580
Felicialle Pereira-da-Silva RN, PhD , Joana Estefanny de França-Oliveira RN , Raphael Alves da-Silva RN , Emanuela Batista Ferreira-e-Pereira RN, PhD , Maria Eduarda Ximenes-do-Rego RN , Yure Rodrigues-Silva RN , Beatriz Mendonça Morais-Alves RN , Camilla Ribeiro Lima-de-Farias RN, PhD , Isabel Cristina Ramos Vieira-Santos RN, PhD

Objective

To identify the risk factors and the main preventive measures in scientific literature related to the development of corneal injury in critically ill patients.

Methods

This is a scoping review, with a protocol previously registered on the Open Science Framework platform. The study was guided by the methodological guidelines of the Joanna Briggs Institute and followed the PRISMA-ScR framework. The research question was developed based on the PCC strategy. The search was conducted in the LILACS, PubMed, and SciELO databases, and in the grey literature via the CAPES Periodicals portal, with no language or time restrictions. The following descriptors were used: Corneal Injuries, Patient Care, Nursing, and Intensive Care Units. Two independent reviewers, with a third reviewer involved in case of disagreements, performed Screening and selection of studies. The steps followed the methodological recommendations for scoping reviews, aiming to map evidence on risk factors and preventive measures for corneal injuries in patients hospitalized in intensive care units.

Results

The studies analyzed indicate that the main risk factors for the development of ophthalmological injuries are higher among critically ill patients on mechanical ventilation, those under sedation and those with a decreased level of consciousness. Simple, effective nursing interventions are essential to the prevention of corneal injuries, contributing to the maintenance of ocular integrity of the patient.

Conclusion

Increasing the knowledge and training of nurses concerning ophthalmological care can contribute to greater awareness of the relevance of corneal injuries in critically ill patients, which is a crucial aspect of nursing care.
目的探讨危重患者角膜损伤发生的相关危险因素及主要预防措施。方法:这是一项范围审查,使用先前在开放科学框架平台上注册的协议。本研究以乔安娜布里格斯研究所的方法指南为指导,并遵循PRISMA-ScR框架。本研究问题是基于PCC战略而展开的。检索在LILACS、PubMed和SciELO数据库中进行,并通过CAPES期刊门户网站在灰色文献中进行,没有语言或时间限制。使用了以下描述符:角膜损伤、患者护理、护理和重症监护病房。两名独立审稿人对研究进行筛选和选择,第三名审稿人在有分歧的情况下参与其中。这些步骤遵循范围审查的方法学建议,旨在绘制重症监护病房住院患者角膜损伤的危险因素和预防措施的证据。结果分析表明,机械通气、镇静和意识水平下降的危重患者发生眼部损伤的主要危险因素较高。简单有效的护理干预对于预防角膜损伤至关重要,有助于维护患者的眼部完整性。结论加强护理人员的眼科护理知识和培训,有助于提高危重患者角膜损伤相关性的认识,这是护理的重要方面。
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引用次数: 0
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Enfermeria intensiva
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