关键词: 免陪照护, 急诊室, 医院, 社会生态系统理论, 定性研究

Abstract:

Objective To explore the facilitators and barriers of non-accompanied care implementation in emergency departments，so as to provide references for its further promotion. Methods From September to November 2025，8 nurses，6 nursing assistants and 5 patients’ family members were selected from the emergency department of a Grade A tertiary hospital in Nanjing by purposive sampling for semi-structured interviews. Based on the social ecological system theory，directed content analysis was used to code，extract and thematically analyze the interview data. Results Five facilitating factors and five hindering factors were identified. The facilitating factors included professional cognition and value recognition，division of labor collaboration and trust connection，institutional guarantee and training support，publicity and cognitive improvement，and policy guidance and norms. The hindering factors included unbalanced professional competence and emotional needs conflict，communication barriers and differences in professional identity，insufficient resource support and lack of incentive mechanisms，low social recognition and traditional concept constraints，weak policy implementation and lagging professional security system. Conclusion The implementation of non-accompanied care in emergency departments is affected by multi-dimensional interactive factors. Governments，medical institutions and third parties should take collaborative measures to solve problems and promote the standardized and sustainable development of non-accompanied care services.

Key words: Non-Accompanied Care Services, Emergency Service, Hospital, Social Ecological Theory, Qualitative Research