ICU护士维护老年患者尊严影响因素的质性研究

doi:10.3761/j.issn.2096-7446.2025.07.003

中华急危重症护理杂志 ›› 2025, Vol. 6 ›› Issue (7): 786-791.doi: 10.3761/j.issn.2096-7446.2025.07.003

ICU护士维护老年患者尊严影响因素的质性研究

谢婉婷(), 朱海利(), 朱冬, 傅涵, 陈必慧

410208 长沙市湖南中医药大学护理学院（谢婉婷，朱冬，傅涵）;湖南省中西医结合医院护理部（朱海利）;长沙市中医医院内分泌科（陈必慧）

收稿日期:2024-11-22 出版日期:2025-07-10 发布日期:2025-07-04
通讯作者: 朱海利 E-mail:1018561798@qq.com;zhuhaili09@126.com
作者简介:谢婉婷：女，本科（硕士在读），E-mail：1018561798@qq.com
基金资助:
湖南省自然科学基金课题(2024JJ8200);湖南中医药大学研究生创新课题(2024CX184);湖南省中医药科研计划重点项目(C2022023)

The influencing factors of ICU nurses maintaining the dignity of elderly patients：a qualitative study

XIE Wanting(), ZHU Haili(), ZHU Dong, FU Han, CHEN Bihui

School of Nursing，Hunan University of Traditional Chinese Medicine，Changsha，410208，China

Received:2024-11-22 Online:2025-07-10 Published:2025-07-04
Contact: ZHU Haili E-mail:1018561798@qq.com;zhuhaili09@126.com

摘要/Abstract

摘要：

目的探究ICU护士维护老年患者尊严的影响因素，构建概念框架，为改进护理实践提供参考。方法采用程序化扎根理论方法，于2024年3月—5月，在长沙市3所三级甲等医院与15名ICU护士进行半结构化访谈，并运用NVivo软件对资料进行三级编码。结果共提炼出29个初始概念，形成9个主轴编码，最终归纳出4个核心范畴：护士因素、患者因素、文化因素和管理因素。基于范畴之间的内在逻辑关系，构建了ICU护士维护老年患者尊严影响因素的概念框架。结论 ICU老年患者尊严的维护需要通过加强护士培训、优化资源配置、推动多学科协作并提升文化敏感性，进而建立有利于尊严护理的环境。

关键词: 重症监护病房, 护士, 老年人, 尊严, 扎根理论

Abstract:

Objective To explore the influencing factors of ICU nurses maintaining the dignity of elderly patients， to construct a conceptual framework and provide evidence for improving nursing practice. Methods A programmatic grounded theory approach was adopted. From March to May 2024，semi-structured interviews were conducted with 15 ICU nurses from three tertiary class A hospitals in Changsha. Data were analyzed using Nvivo software through three levels of coding. Results A total of 29 initial concepts were extracted，forming 9 axial codes，and ultimately 4 core categories were summarized，including nurse factors，patient factors，cultural factors，and management factors. A conceptual framework was constructed based on the intrinsic logical relationships among these categories. Conclusion Maintaining elderly patient dignity in the ICU requires strengthening nurse training，optimizing resource allocation，promoting multidisciplinary collaboration，and enhancing cultural sensitivity to establish a dignity-centered care environment.

Key words: Intensive Care Units, Nurses, Aged, Dignity, Grounded Theory

谢婉婷, 朱海利, 朱冬, 傅涵, 陈必慧. ICU护士维护老年患者尊严影响因素的质性研究[J]. 中华急危重症护理杂志, 2025, 6(7): 786-791.

XIE Wanting, ZHU Haili, ZHU Dong, FU Han, CHEN Bihui. The influencing factors of ICU nurses maintaining the dignity of elderly patients：a qualitative study[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(7): 786-791.

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参考文献 18

[1]	World Health Organization. World mental health day 2015:dignity and mental health[EB/OL]. (2021-03-13)[2024-10-05]. https://www.who.int/docs/default-source/mental-health/quality-rights/update-2020-infosheet-dignity-final-01.pdf.
[2]	International Council of Nurses. The ICN code of ethics for nurses[EB/OL]. (2021-10-20)[2024-10-05]. https://www.icn.ch/sites/default/files/2024-12/ICN_Code-of-Ethics_EN_Web.pdf.
[3]	Sun XH, Zhang GY, Yu ZC, et al. The meaning of respect and dignity for intensive care unit patients:a meta-synthesis of qualitative researches[J]. Nurs Ethics, 2023, 31(4):652-669.
[4]	United Nations Department of Economic and Social Affairs. World population ageing 2019:highlights[EB/OL]. (2019-12-30)[2024-10-05]. https://digitallibrary.un.org/record/3846855?v=pdf.
[5]	Brunker LB, Boncyk CS, Rengel KF, et al. Elderly patients and management in intensive care units(ICU):clinical challenges[J]. Clin Interv Aging, 2023,18:93-112.
[6]	Fuseini AG, Rawson H, Redley B, et al. Self-reported dignity and factors that influence dignity in hospitalised older adults:a cross-sectional survey[J]. J Clin Nurs, 2023, 32(21/22):7791-7801.
[7]	陈向明. 扎根理论的思路和方法[J]. 教育研究与实验, 1999(4):58-63.
	Chen XM. Grounded theory:its train of thought and methods[J]. Educ Res Exp, 1999(4):58-63.
[8]	Liang AD, Gao CC, Xu WX, et al. Individual factors in dignified care:a cross-sectional study of critical care nurses[J]. J Nurs Manag, 2022, 30(7):3286-3294.
[9]	李娇悦, 杨黎, 苏爱华, 等. 护士同情心的影响因素及训练方法的研究进展[J]. 中华护理杂志, 2024, 59(3):371-377. doi: 10.3761/j.issn.0254-1769.2024.03.017
	Li JY, Yang L, Su AH, et al. Research progress on influencing factors and training of nurses’ compassion[J]. Chin J Nurs, 2024, 59(3):371-377. doi: 10.3761/j.issn.0254-1769.2024.03.017
[10]	Xie WQ, Chen LM, Feng F, et al. The prevalence of compassion satisfaction and compassion fatigue among nurses:a systematic review and meta-analysis[J]. Int J Nurs Stud, 2021, 120:103973.
[11]	Nelsen J, Shive N, Robert Bennett C, et al. Experiences of dig-nity:Age at onset of serious illness matters[J]. Nurs Ethics, 2023, 30(7/8):1038-1050.
[12]	Alpers LM. Distrust and patients in intercultural healthcare:a qualitative interview study[J]. Nurs Ethics, 2018, 25(3):313-323.
[13]	Arne R, Åshild S, Vibeke L, et al. Dignity in relationships and existence in nursing homes’ cultures[J]. Nurs Ethics, 2022, 29 (7/8):1761-1772.
[14]	Xiao Y, Qihui W. A study on the factors influencing old age identity among the Chinese elderly[J]. Front Public Health, 2023, 10:1027678.
[15]	Zhou YX, Wang A, Braybrook D, et al. What are the barriers and facilitators to advance care planning with older people in long-term care facilities? A qualitative study[J]. J Clin Nurs, 2024.
[16]	Lyu YW, Xu Q, Liu JR. Exploring the medical decision-making patterns and influencing factors among the general Chinese public:a binary logistic regression analysis[J]. BMC Pub-lic Health, 2024, 24(1):887.
[17]	于冉, 甘青文, 连泽荣, 等. ICU护士道德困境体验质性研究的Meta整合[J]. 中华急危重症护理杂志, 2023, 4(11):1000-1005.
	Yu R, Gan QW, Lian ZR, et al. Meta-integration of a qualitative study on the experience of ethical dilemmas of ICU nurses[J]. Chin J Emerg Crit Care Nurs, 2023, 4(11):1000-1005.
[18]	Puga QC, Espin I JF, Jiménez MJM, et al. Job satisfaction and burnout syndrome among intensive-care unit nurses:a systematic review and meta-analysis[J]. Intensive Crit Care Nurs, 2024, 82:103660.

ICU护士维护老年患者尊严影响因素的质性研究

The influencing factors of ICU nurses maintaining the dignity of elderly patients：a qualitative study

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