重症护理临床决策研究热点及发展趋势的可视化分析

doi:10.3761/j.issn.2096-7446.2026.01.016

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (1): 96-102.doi: 10.3761/j.issn.2096-7446.2026.01.016

重症护理临床决策研究热点及发展趋势的可视化分析

张帅¹(), 陈莹莹², 杨慧³, 夏莹⁴^,^*()

1.中国医学科学院北京协和医院神经内科一病房北京市 100730
2.中国医学科学院北京协和医院风湿免疫内科一病房北京市 100730
3.中国医学科学院北京协和医院内科综合病房北京市 100730
4.中国医学科学院北京协和医院内科学系肾内科病房北京市 100730

收稿日期:2025-01-27 出版日期:2026-01-10 发布日期:2026-01-06
通讯作者: 夏莹，E-mail：xiaying881@sina.com
作者简介:张帅：女，硕士，护师，E-mail：13141007055@163.com
基金资助:
中央高水平医院临床科研专项(2022-PUMCH-B-130)

Visualization analysis of research hotspots and development trend for intensive nursing care decision-making

ZHANG Shuai¹(), CHEN Yingying², YANG Hui³, XIA Ying⁴^,^*()

^1. Ward 1， Neurology Department，Peking Union Medical College Hospital，Chinese Academy of Medical Sciences， Beijing 100730， China
^2. Ward 1， Rheumatology and Immunology Department，Peking Union Medical College Hospital，Chinese Academy of Medical Sciences， Beijing 100730， China
^3. Internal Medicine Comprehensive Ward， Peking Union Medical College Hospital，Chinese Academy of Medical Sciences， Beijing 100730， China
^4. Renal Medicine Ward， Department of Internal Medicine，Peking Union Medical College Hospital，Chinese Academy of Medical Sciences， Beijing 100730， China

Received:2025-01-27 Online:2026-01-10 Published:2026-01-06
Contact: XIA Ying，E-mail：xiaying881@sina.com
Supported by:
National High Level Hospital Clinical Research Funding(2022-PUMCH-B-130)

摘要/Abstract

摘要：

目的分析国内外重症护理临床决策的研究热点及趋势，为后续研究提供参考。方法在中国知网和Web of Science核心集数据库中检索相关文献，时间为2013年1月1日—2024年5月6日，使用Excel、VOSviewer及Citespace软件进行可视化分析。结果最终纳入265篇文献，Web of Science 153篇，中国知网112篇。全球历经突发公共卫生事件的影响，发文量近十年迎来首次高峰期，进入研究的起步阶段。关键词聚类显示，重症护理决策下道德困境是全球共同关注热点，国际聚焦于重症临终患者的决策困境，国内聚焦于基于循证的科学方法辅助护理决策。结论重症护理决策下的道德困境、循证支持与能力提升是目前的研究热点，建议通过实践经验转化、道德韧性培养、人工智能革新3个方面推动重症护理临床决策的发展与革新。

关键词: 重症护理, 临床决策, 研究热点, 文献计量学, 可视化分析

Abstract:

Objective To analyze the research hotspots and development trend of intensive nursing care decision-making at home and abroad，in order to provide references for subsequent research. Methods We searched the CNKI and Web of Science Core database from January 1，2013 to May 6，2024，and used Excel，VOS viewer and Citespace to conduct the visualization analysis. Results A total of 265 articles were included in the search，153 articles from WOS while 112 articles from CNKI. The world has experienced the impact of public health emergencies，and the number of publications has reached its first peak in the past decade，entering the initial stage of research. Keyword clustering revealed that moral dilemmas in critical care decision-making constitute a globally shared research focus，international studies predominantly focused on critically ill end-of-life patients’ moral dilemmas，while China’s research priorities centered on evidence-based scientific methods to support nursing decision-making. Conclusion Ethical dilemmas in critical care decision-making，evidence-based support，and competency enhancement are current research hotspots. It is recommended to advance the development and innovation of clinical decision-making in critical care through three key strategies，including translating practical experience into practice，fostering moral resilience，and integrating artificial intelligence innovation.

Key words: Intensive Care Nursing, Clinical Decision-Making, Research Hotspots, Bibliometrics, Visual Analysis

张帅, 陈莹莹, 杨慧, 夏莹. 重症护理临床决策研究热点及发展趋势的可视化分析[J]. 中华急危重症护理杂志, 2026, 7(1): 96-102.

ZHANG Shuai, CHEN Yingying, YANG Hui, XIA Ying. Visualization analysis of research hotspots and development trend for intensive nursing care decision-making[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 96-102.

图/表 4

参考文献 23

[1]	Oh S, Gu M, Sok S. A concept analysis of nurses’ clinical deci-sion making:implications for Korea[J]. Int J Environ Res Public Health, 2022, 19(6):3596. doi: 10.3390/ijerph19063596
[2]	Nibbelink CW, Brewer BB. Decision-making in nursing prac-tice:an integrative literature review[J]. J Clin Nurs, 2018, 27(6):917-928. doi: 10.1111/jocn.2018.27.issue-5pt6
[3]	胡琴, 石泽亚, 甘晓庆, 等. 医护一体化模式在ICU患者管理中的应用[J]. 当代护士(中旬刊), 2021, 28(5):186-188.
	Hu Q, Shi ZY, Gan XQ, et al. Medical integration mode in ICU patient management[J]. Mod Nurse, 2021, 28(5):186-188.
[4]	陈悦, 陈翠萍, 徐帅帅, 等. 急危重症科低年资护士护理临床决策意识现状分析及对策[J]. 循证护理, 2020, 6(12):1382-1387.
	Chen Y, Chen CP, Xu SS, et al. Analysis of the status quo of nursing clinical decision-making awareness of junior nurses and countermeasures in emergency department[J]. Chin Evid Based Nurs, 2020, 6(12):1382-1387.
[5]	Pan XL, Yan EJ, Cui M, et al. Examining the usage,citation,and diffusion patterns of bibliometric mapping software:a com-parative study of three tools[J]. J Informetr, 2018, 12(2):481-493. doi: 10.1016/j.joi.2018.03.005
[6]	万雅雯, 邵宏奇, 杨芳, 等. 赴英国、美国护理交流生对国内外护理教育差距切身体验的质性研究[J]. 护理研究, 2016, 30(16):1994-1996.
	Wan YW, Shao HQ, Yang F, et al. Qualitative study on fir-sthand experience of nursing exchange students to England and the United States on domestic and foreign nursing edu-cation gap[J]. Chin Nurs Res, 2016, 30(16):1994-1996.
[7]	刘晓惠, 岳丽青, 谭哲煜, 等. 三阶梯护理人力管理在防控新型冠状病毒肺炎中的应用[J]. 中华急危重症护理杂志, 2020, 1(2):133-137.
	Liu XH, Yue LQ, Tan ZY, et al. Application of three-step nurs-ing workforce management in the prevention and control of COVID-19 epidemic[J]. Chin J Emerg Crit Care Nurs, 2020, 1(2):133-137.
[8]	Christianson J, Guttormson J, McAndrew NS, et al. Impact of COVID-19 on intensive care unit nurse duty of care and pro-fessional roles:a qualitative content analysis[J]. SAGE Open Nurs, 2022, 8:23779608221113539.
[9]	刘苑菲, 张玉萍, 金静芬. 急危重症护士道德困境的范围综述[J]. 中华急危重症护理杂志, 2022, 3(3):269-275.
	Liu YF, Zhang YP, Jin JF. A scoping review of moral distress of emergency and critical care nurses[J]. Chin J Emerg Crit Care Nurs, 2022, 3(3):269-275.
[10]	HICKEY J. Interventions to reduce nurses’ moraldistress in the intensivecare unit:An integrative review[J]. Dimens Crit Care Nurs, 2022, 41(5):274-280 doi: 10.1097/DCC.0000000000000542
[11]	赵宝生, 王娟, 王曼丽, 等. ICU护士道德困境心理体验质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(10):1263-1269. doi: 10.3761/j.issn.0254-1769.2024.10.016
	Zhao BS, Wang J, Wang ML, et al. Meta-synthesis of qualita-tive studies on the authentic experience of moral dilemmas of ICU nurse[J]. Chin J Nurs, 2024, 59(10):1263-1269.
[12]	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 quali-tative study on the experience of ethical dilemmas of ICU nurses[J]. Chin J Emerg Crit Care Nurs, 2023, 4(11):1000-1005.
[13]	Falcó-Pegueroles A, Bosch-Alcaraz A, Terzoni S, et al. COVID-19 pandemic experiences,ethical conflict and decision-making process in critical care professionals(Quali-Ethics-COVID-19 research part 1):an international qualitative study[J]. J Clin Nurs, 2023, 32(15):5185-5200. doi: 10.1111/jocn.v32.15-16
[14]	李丽娜, 张艳, 左美云, 等. 南通市5所医院急、危重症科护士决策风格与灾害救护能力相关性研究[J]. 职业与健康, 2024, 40(8):1067-1072.
	Li LN, Zhang Y, Zuo MY, et al. Correlation between decision-making styles and disaster rescue competency among critical care nurses in five hospitals of nantong city[J]. Occup Health, 2024, 40(8):1067-1072.
[15]	向洋, 倪崴莲. 气管插管非计划性拔管预警及决策支持系统的研发与应用[J]. 中华护理杂志, 2022, 57(1):61-65. doi: 10.3761/j.issn.0254-1769.2022.01.009
	Xiang Y, Ni WL. Development and application of early warn-ing and decision support system for unplanned endotracheal extubation[J]. Chin J Nurs, 2022, 57(1):61-65.
[16]	Asadi N, Royani Z, Maazallahi M, et al. Being torn by inevi-table moral dilemma:experiences of ICU nurses[J]. BMC Med Ethics, 2021, 22(1):159. doi: 10.1186/s12910-021-00727-y pmid: 34847926
[17]	Jalalpour H, Jahani S, Asadizaker M, et al. The impact of critical thinking training using critical thinking cards on clinical decision-making of CCU nurses[J]. J Family Med Prim Care, 2021, 10(10):3650-3656. doi: 10.4103/jfmpc.jfmpc_319_21 pmid: 34934661
[18]	Khalid I, Imran M, Yamani RM, et al. Comparison of clinical characteristics and end-of-life care between COVID-19 and non-COVID-19 muslim patients during the 2020 pandemic[J]. Am J Hosp Palliat Care, 2021, 38(9):1159-1164. doi: 10.1177/10499091211018657
[19]	Sakurai Y, Yamamoto M. Perceived difficulties and learning needs among acute care ward nurses providing end-of-life care during the COVID-19 pandemic:comparison by years of clinical experience[J]. Yonago Acta Med, 2023, 66(3):334-344. doi: 10.33160/yam.2023.08.002 pmid: 37621980
[20]	Rushton CH. Cultivating moral resilience[J]. Am J Nurs, 2017, 117(2):S11-S15.
[21]	Sblendorio E, Dentamaro V, Lo Cascio A, et al. Integrating human expertise & automated methods for a dynamic and multi-parametric evaluation of large language models’ feasibi-lity in clinical decision-making[J]. Int J Med Inform, 2024, 188:105501. doi: 10.1016/j.ijmedinf.2024.105501
[22]	Buhr CR, Ernst BP, Blaikie A, et al. Assessment of decision-making with locally run and web-based large language models versus human board recommendations in otorhinolaryngology,head and neck surgery[J]. Eur Arch Otorhinolaryngol, 2025, 282(3):1593-1607. doi: 10.1007/s00405-024-09153-3
[23]	Abd-Alrazaq A, AlSaad R, Alhuwail D, et al. Large language models in medical education:opportunities,challenges,and fu-ture directions[J]. JMIR Med Educ, 2023, 9:e48291. doi: 10.2196/48291

重症护理临床决策研究热点及发展趋势的可视化分析

Visualization analysis of research hotspots and development trend for intensive nursing care decision-making

RichHTML

PDF下载

可视化

摘要/Abstract

引用本文

使用本文

图/表 4

参考文献 23

相关文章 15

编辑推荐

Metrics

本文评价

[1]	王雪琴, 吕颖, 赵庆华, 张川林, 米洁. 早期活动多学科协作模式在机械通气患者中的实施效果研究[J]. 中华急危重症护理杂志, 2025, 6(9): 1029-1035.
[2]	邹颖, 陈偶英, 丁俊豪, 刘苹, 李妮吉娜. 危重症护理研究热点的文献计量分析[J]. 中华急危重症护理杂志, 2025, 6(9): 1131-1137.
[3]	费玲, 陈秀萍, 章毅, 杨挺, 陈芷涵, 诸纪华. 系统性红斑狼疮患儿行嵌合抗原受体T细胞治疗的护理[J]. 中华急危重症护理杂志, 2025, 6(7): 853-855.
[4]	周春霞, 田萌, 吴丽贞, 李倩. 老年人跌倒防控研究热点及发展趋势的可视化分析[J]. 中华急危重症护理杂志, 2025, 6(7): 879-884.
[5]	王德生, 景新华, 韩小云, 刘玲, 钱婷, 冯毅. 幽门后喂养信息化预警系统在神经重症患者中的应用[J]. 中华急危重症护理杂志, 2025, 6(4): 475-479.
[6]	夏桦, 潘向滢, 金佳家, 陈臣侃, 赵雪红. 清醒体外膜肺氧合患者辅助治疗体验的质性研究[J]. 中华急危重症护理杂志, 2025, 6(2): 153-157.
[7]	贺叶梅, 胡亚喧, 刘秀梅, 廖诗怡, 陈偶英. 儿科重症监护病房安宁疗护研究热点及发展趋势的可视化分析[J]. 中华急危重症护理杂志, 2025, 6(12): 1503-1509.
[8]	仝紫薇, 王红, 孙旭, 周智聪, 刘晓熠, 王意茹. 数字孪生技术在急危重症护理领域应用研究的范围综述[J]. 中华急危重症护理杂志, 2025, 6(12): 1523-1528.
[9]	张帅, 陈莹莹, 杨慧, 夏莹. ICU护士临床决策的行为经济学分析与优化对策研究进展[J]. 中华急危重症护理杂志, 2025, 6(11): 1399-1403.
[10]	王妍, 张慧, 唐春, 巴依尔才次克. NICU无创呼吸机通气患儿肠内营养喂养不耐受的影响因素分析[J]. 中华急危重症护理杂志, 2025, 6(10): 1189-1194.
[11]	周泓廷庄一渝王新安黄洌彬. 护理领域第二受害者研究热点及发展趋势的可视化分析[J]. 中华急危重症护理杂志, 2024, 5(9): 812-817.
[12]	乔晓婷隋伟静王凯丽宫晓艳庄一渝. ICU患者家属决策冲突现状及影响因素研究[J]. 中华急危重症护理杂志, 2024, 5(8): 677-682.
[13]	杜金磊聂臣聪雷玲叶群赵洪祥张继权张得月彭古涛. 危重症患者肠内营养治疗后管饲依赖症状发生现况及影响因素研究[J]. 中华急危重症护理杂志, 2024, 5(6): 493-498.
[14]	岳雯静王子涵江莹林佳艺王琴潞王菲季诗明康晓凤. 重症专科护士实施床旁即时肺部超声影响因素的质性研究[J]. 中华急危重症护理杂志, 2024, 5(5): 389-394.
[15]	谢派玲袁帅帅刘凤清连素冰. 重症肺炎并发严重肌溶解及多脏器功能损害患者的护理[J]. 中华急危重症护理杂志, 2024, 5(1): 61-64.