体外膜肺氧合护士护理体验质性研究的Meta整合

doi:10.3761/j.issn.2096-7446.2026.04.008

摘要/Abstract

摘要：

目的系统评价与整合体外膜肺氧合（extracorporeal membrane oxygenation，ECMO）护士护理体验的质性研究，为国内ECMO护理的高质量发展提供理论依据。方法计算机检索PubMed、Web of Science、the Cochrane Library、Embase、CINAHL、中国知网、万方数据库、维普数据库、中国生物医学文献数据库，收集自建库至2025年3月18日收录的关于ECMO护士护理体验的质性研究。依据乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准评价文献质量，采用Meta整合法整合原始研究结果。结果共纳入7篇文献，提取43个主题，归纳为10个类别，最终形成4个整合结果：ECMO护士的体验与困惑、面临的挑战与困境、支持系统欠缺和支持期望、专业发展与成长获益。结论繁重和高度专业化的ECMO护理工作给护士带来空前的精神压力与职业倦怠体验，同时也使护士从专业中成长获益。未来在ECMO护理实践中，管理者需不断完善护士的社会支持系统，从情感支持、信息支持、工具支持等多维度为护士提供心理咨询和支持、多元化的培训研修平台、多学科沟通与交流机会、有效的奖励机制等，以增强ECMO护士的专业认同感，促进专业高质量发展。

关键词: 体外膜肺氧合, 护士, 护理体验, 质性研究, Meta整合

Abstract:

Objective To systematically evaluate and synthesize qualitative studies on the nursing experiences of extracorporeal membrane oxygenation（ECMO） nurses，aiming to provide a theoretical foundation for the high-quality development of ECMO nursing practice in China. Methods Computerized searches were conducted across PubMed，Web of Science，the Cochrane Library，Embase，CINAHL，CNKI，Wanfang Database，VIP Database，and the China Biology Medicine disc（CBM） to identify qualitative studies on the nursing experiences of ECMO nurses，from the inception of each database until March 18，2025. The methodological quality of the included studies was assessed using the Joanna Briggs Institute（JBI） Critical Appraisal Checklist for Qualitative Research. Findings from the primary studies were synthesized using meta-aggregation. Results Seven studies were included，yielding 43 themes. These themes were grouped into 10 categories，culminating in 4 synthesized findings：experiences and uncertainties of ECMO nurses，challenges and dilemmas，deficiencies in support systems and support expectations，professional development and growth gains. Conclusion The demanding and highly specialized nature of ECMO nursing imposes unprecedented psychological stress and experiences of burnout on nurses. Simultaneously，it facilitates their professional growth and gains. To enhance ECMO nurses’ sense of professional identity and promote high-quality development in the specialty，future ECMO nursing practice requires managers to continuously improve nurses’ social support systems. This should include providing psychological counseling support services from multiple dimensions such as emotional support，information support and tool support，diversified training and professional development platforms，opportunities for multidisciplinary communication and collaboration，and effective incentive mechanisms.

Key words: ECMO, Nurse, Nursing Experience, Qualitative Research, Meta-Synthesis

马娜, 陈旭锋, 陈凤, 张阳春, 季学丽. 体外膜肺氧合护士护理体验质性研究的Meta整合[J]. 中华急危重症护理杂志, 2026, 7(4): 440-446.

MA Na, CHEN Xufeng, CHEN Feng, ZHANG Yangchun, JI Xueli. A meta-synthesis of qualitative studies on nursing experiences of extracorporeal membrane oxygenation nurses[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(4): 440-446.

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参考文献 27

[1]	中国心胸血管麻醉学会, 中华医学会麻醉学分会, 中国医师协会麻醉学医师分会, 等. 不同情况下成人体外膜肺氧合临床应用专家共识(2020版)[J]. 中国循环杂志, 2020, 35(11):1052-1063.
	Chinese Cardiothoracic and Vascular Anesthesia Association, Anesthesiology Branch of Chinese Medical Association, Anesthesiologists Branch of Chinese Medical Doctor Association, et al. Expert consensus on the clinical application of extracorporeal membrane oxygenation in adults under different circumstances(2020 edition)[J]. Chin Circ J, 2020, 35(11):1052-1063.
[2]	张华忠, 梅勇, 吕金如, 等. 40例体外膜肺氧合辅助心肺复苏治疗成人院外心脏骤停的回顾性分析[J]. 中华急诊医学杂志, 2022, 31(12):1618-1622.
	Zhang HZ, Mei Y, Lü JR, et al. Retrospective analysis of 40 cases of extracorporeal cardiopulmo-nary resuscitation in adult out-of-hospital cardiac arrest[J]. Chin J Emerg Med, 2022, 31(12):1618-1622.
[3]	Presti CR, Casey J. Team-based care of the patient receiving venovenous extracorporeal membrane oxygenation[J]. Dimens Crit Care Nurs, 2025, 44(1):2-11. doi: 10.1097/DCC.0000000000000674 pmid: 39570717
[4]	俞晓梅, 倪伟伟, 夏明, 等. 体外膜肺氧合团队中护理人员的职能及发展现状[J]. 护理学杂志, 2020, 35(16):107-110.
	Yu XM, Ni WW, Xia M, et al. Role and development of nurses in extracorporeal membrane oxygenation team[J]. J Nurs Sci, 2020, 35(16):107-110.
[5]	Caulfield R, Wiseman T, Gullick J, et al. Factors preceding occupational distress in emergency nurses:an integrative review[J]. J Clin Nurs, 2023, 32(13/14):3341-3360. doi: 10.1111/jocn.v32.13-14
[6]	Ross P, Sheldrake J, Ilic D, et al. An exploration of intensive care nurses’ perceptions of workload in providing extracorpo-real membrane oxygenation(ECMO) support:a descriptive qualitative study[J]. Aust Crit Care, 2024, 37(4):585-591.
[7]	Constantine L, DeCicco D, Carpenter RD, et al. Healthcare providers’ experiences of caring for patients with COVID-19 requiring extracorporeal membrane oxygenation support[J]. Am J Hosp Palliat Care, 2024, 41(5):568-573. doi: 10.1177/10499091231178503
[8]	Emmarco AK, Toy BK, Pavone JM, et al. Experience of nurses caring for COVID-19 patients supported by venovenous extra-corporeal membrane oxygenation(ECMO) after ECMO educational crash course[J]. ASAIO J, 2023, 69(3):267-271. doi: 10.1097/MAT.0000000000001807
[9]	Alshammari MA, Vellolikalam C, Alfeeli S. Nurses’ perception of their role in extracorporeal membrane oxygenation care:a qualitative assessment[J]. Nurs Crit Care, 2022, 27(2):251-257. doi: 10.1111/nicc.v27.2
[10]	Asgari P, Jackson AC, Esmaeili M, et al. Nurses’ experience of patient care using extracorporeal membrane oxygenation[J]. Nurs Crit Care, 2022, 27(2):258-266. doi: 10.1111/nicc.v27.2
[11]	俞晓梅, 倪伟伟, 张勇, 等. 重症监护室护士对体外膜肺氧合支持危重病人照护体验的质性研究[J]. 全科护理, 2022, 20(30):4272-4275.
	Yu XM, Ni WW, Zhang Y, et al. A qualitative study on the nursing experience of ICU nurses in supporting critically ill patients with extracorporeal membrane oxygenation[J]. Chin Gen Pract Nurs, 2022, 20(30):4272-4275.
[12]	Honey M, Wang WYQ. New Zealand nurses perceptions of car-ing for patients with influenza A(H1N1)[J]. Nurs Crit Care, 2013, 18(2):63-69. doi: 10.1111/nicc.2013.18.issue-2
[13]	Joanna Briggs Institute. JBI critical appraisal checklist for qualitative research[EB/OL]. (2020-02-15)[2024-06-29]. https://jbi.global/critical-appraisal-tools.
[14]	Hancock J, Witter T, Comber S, et al. Understanding burnout and moral distress to build resilience:a qualitative study of an interprofessional intensive care unit team[J]. Can J Anaesth, 2020, 67(11):1541-1548. doi: 10.1007/s12630-020-01789-z
[15]	Kirsch R, Munson D. Ethical and end of life considerations for neonates requiring ECMO support[J]. Semin Perinatol, 2018, 42(2):129-137. doi: S0146-0005(17)30146-5 pmid: 29331209
[16]	Wellman J. An exploration of staff experiences of extracorporeal membrane oxygenation(ECMO)[D]. London: University of East London, 2017.
[17]	侯晓彤, 杨峰, 杜中涛, 等. 高仿真情景体外膜氧合模拟培训在医学继续教育中的价值[J]. 医学教育管理, 2022, 8(5):552-556,562.
	Hou XT, Yang F, Du ZT, et al. Value of a high-fidelity extracorporeal membrane oxygenation simulation training program in medical continuing education[J]. Med Educ Manag, 2022, 8(5):552-556,562. doi: 10.3969/j.issn.2096-045X.2022.05.009
[18]	Rhéaume A, Breau M, Boudreau S. A critical incident study of ICU nurses during the COVID-19 pandemic[J]. Nurs Ethics, 2022, 29(2):317-329. doi: 10.1177/09697330211043270
[19]	孙莹, 林牡丹, 刘春梅, 等. 正念减压训练对急诊科护士职业倦怠和生活质量的影响[J]. 护理研究, 2023, 37(16):3007-3011.
	Sun Y, Lin MD, Liu CM, et al. Influence of mindfulness decompression training on job burnout and quality of life of emergency department nurses[J]. Chin Nurs Res, 2023, 37(16):3007-3011.
[20]	张苗, 李欢欢, 李小寒. 正念减压疗法与巴林特小组对护士压力及职业倦怠效果比较的Meta分析[J]. 循证护理, 2021, 7(9):1152-1159.
	Zhang M, Li HH, Li XH. Comparison of the effects on mindfulness-based stress reduction and Balint group on nurses’ stress and job burnout:a Meta-analysis[J]. Chin Evid Based Nurs, 2021, 7(9):1152-1159.
[21]	鲁鑫, 江智霞, 胥露, 等. 护士参与体外膜肺氧合监护培训的进展及启示[J]. 中华护理杂志, 2022, 57(4):502-506. doi: 10.3761/j.issn.0254-1769.2022.04.018
	Lu X, Jiang ZX, Xu L, et al. Progress and enlightenment of ECMO training at home and abroad[J]. Chin J Nurs, 2022, 57(4):502-506. doi: 10.3761/j.issn.0254-1769.2022.04.018
[22]	Melnikov S, Furmanov A, Gololobov A, et al. Recommendations from the professional advisory committee on nursing practice in the care of ECMO-supported patients[J]. Crit Care Nurse, 2021, 41(3):e1-e8. doi: 10.4037/ccn2021415 pmid: 33588431
[23]	赵月月, 张丽, 杨亚新, 等. ECMO专科护士培训方案的构建[J]. 护理学杂志, 2022, 37(9):69-73.
	Zhao YY, Zhang L, Yang YX, et al. Development of a program for training nurse specialist in ECMO[J]. J Nurs Sci, 2022, 37(9):69-73.
[24]	赵震, 刘慧君, 方振根, 等. 体外膜肺氧合专科护士核心知识能力评价指标体系的构建[J]. 中国急救医学, 2023, 43(8):647-651.
	Zhao Z, Liu HJ, Fang ZG, et al. Construction of the core knowledge evaluation index system of ECMO nurses[J]. Chin J Crit Care Med, 2023, 43(8):647-651.
[25]	姜孟涵, 阚东方, 林翠霞, 等. 医护合作高仿真模拟训练课程的设计与实施[J]. 护理学杂志, 2023, 38(15):9-13.
	Jiang MH, Kan DF, Lin CX, et al. Design and implementation of high-fidelity simulation training course for doctor-nurse cooperation[J]. J Nurs Sci, 2023, 38(15):9-13.
[26]	Wong AS, Marwali EM, MacLaren G, et al. ECMO simulation training during a worldwide pandemic:The role of ECMO telesimulation[J]. Perfusion, 2023, 38(5):1029-1036. doi: 10.1177/02676591221093868
[27]	张刚, 孙峰, 张喆, 等. 基于虚拟现实技术的体外膜肺氧合培训应用调查:针对ECMO培训班学员的研究[J]. 中华急诊医学杂志, 2024, 33(11):1613-1617.
	Zhang G, Sun F, Zhang Z, et al. Application of virtual-reality-based extracorporeal membrane oxygenation training:a survey of ECMO course participants[J]. Chin J Emerg Med, 2024, 33(11):1613-1617.