ICU患者黏膜压力性损伤预防与管理的障碍及促进因素分析

doi:10.3761/j.issn.2096-7446.2026.08.001

摘要/Abstract

摘要：

目的探讨ICU护士在黏膜压力性损伤（mucous membrane pressure injuries，MMPI）预防及管理过程中遇到的障碍和促进因素。方法采用描述性质性研究设计，对南京市某三级甲等医院的ICU护士进行半结构式访谈，采用主题分析法对资料进行整理、编码和分析，并将提炼的结果映射到理论领域框架，以确定MMPI预防与管理的障碍和促进因素。结果对12名ICU护士进行了访谈，访谈结果编码后共映射至14个理论域，形成8个主题和23个亚主题，其中实施MMPI的促进因素包括“医护合作及管理者支持”“知晓MMPI管理的意义”“管理监督与个人特质”3个主题；障碍因素主题包括“MMPI认知及技能不足”“多重后果信念导致的决策困境”“对预防管理效果缺乏信心”“MMPI的易忽略性”4个主题，主题“人力资源与预防材料”既是障碍因素也是促进因素。结论影响护士进行MMPI预防管理的因素较为复杂，可根据研究结果为临床MMPI的预防管理提供尽可能多的促进因素，并避免障碍因素，降低重症患者MMPI发生率。

关键词: 黏膜压力性损伤, 障碍因素, 促进因素, 质性研究, 重症监护

Abstract:

Objective To explore the barriers and facilitators encountered by intensive care unit（ICU） nurses in the prevention and management of mucous membrane pressure injuries（MMPI）. Methods A descriptive qualitative study design was employed. Semi-structured interviews were conducted with ICU nurses from a tertiary Grade A hospital in Nanjing. Thematic analysis was used to organize，code，and analyze the data. The identified themes were then mapped onto the Theoretical Domains Framework（TDF） to systematically identify barriers and facilitators influencing MMPI prevention and management. Results Interviews were conducted with 12 ICU nurses. The coded interview data mapped to 14 theoretical domains，yielding 8 main themes and 23 sub-themes. The promoting factors for the implementation of MMPI included three themes，including physician-nurse cooperation and manager support，knowing the significance of MMPI management，management supervision and personal characteristics. The theme of barriers included four themes，including insufficient cognition and skills of MMPI，decision-making dilemma caused by multiple consequences beliefs，lack of confidence in the effect of prevention management，and negligibility of MMPI. The theme of human resources and prevention materials was not only a barrier factor but also a promoting factor. Conclusion The factors influencing nurses’ prevention and management of MMPI are complex. The findings of this study can inform clinical practice by leveraging facilitators while mitigating barriers，ultimately aiming to reduce the incidence of MMPI in critically ill patients.

Key words: Mucous Membrane Pressure Injury, Barriers, Facilitators, Qualitative Research, Intensive Care

何静静, 付逸超, 陶金, 曹阳洋, 乔力, 李慧, 黄萍. ICU患者黏膜压力性损伤预防与管理的障碍及促进因素分析[J]. 中华急危重症护理杂志, 2026, 7(8): 901-907.

HE Jingjing, FU Yichao, TAO Jin, CAO Yangyang, QIAO Li, LI Hui, HUANG Ping. Barriers and facilitators to mucose membrane pressure injury prevention and management in intensive care units[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(8): 901-907.

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