收稿日期: 2025-07-19
网络出版日期: 2026-02-02
Latent types and influencing factors of communication barriers between ICU nurses and patients’ families
Received date: 2025-07-19
Online published: 2026-02-02
目的 探索ICU护士与患者家属沟通障碍的潜在类型及其影响因素，为ICU护士沟通模式的干预策略构建提供参考。方法 2025年6月，以广州市某三级甲等医院的20名综合ICU护士为研究对象，采用Q方法，通过构建Q样本、选择P样本、进行Q排序与Q分析，对ICU护士的沟通障碍及影响因素进行排序与分类。结果 最终17名ICU护士纳入本研究，共提取4个因子，累计解释方差为82%，分别命名为制度制约型，特征值为9.11，方差贡献率46%；情感耗竭型，特征值为3.82，方差贡献率19%；支持缺失型，特征值为1.74，方差贡献率9%；技巧困境型，特征值为1.58，方差贡献率8%。结论 各类型ICU护士在沟通障碍及影响因素方面差异显著，ICU护士因高负荷工作、内在心理耗竭、职业倦怠、沟通技能欠缺、情感支持不足等因素而面临沟通困境，应根据不同的因素，优化ICU护士与患者家属的沟通策略，提升沟通效果与家属满意度。
梁大炼 , 李翠兰 , 李海艳 , 黄玉 . ICU护士与患者家属沟通障碍的潜在类型及影响因素研究[J]. 中华急危重症护理杂志, 2026 , 7(2) : 162 -167 . DOI: 10.3761/j.issn.2096-7446.2026.02.005
Objective To identify latent types and determinants of nurse-family communication barriers in ICUs and inform targeted intervention design. Methods In June 2025，twenty nurses from a comprehensive ICU of a tertiary hospital in Guangzhou were enrolled. Using Q-methodology，we constructed the Q-set，selected the P-sample，conducted Q-sorting，and performed Q-analysis to rank and classify barriers and influencing factors. Results Seventeen nurses were included in the final analysis. Four factors were extracted，explaining 82% of the total variance，including institutional constraints（eigenvalue 9.11； 46% variance），emotional exhaustion（3.82； 19%），support deficiency（1.74； 9%），and skill dilemma（1.58； 8%）. Conclusion ICU nurses show distinct patterns of communication barriers and determinants. High workload，psychological strain，burnout，limited communication skills，and inadequate emotional support contribute to communication difficulties. Tailored strategies addressing these factors are needed to improve nurse-family communication and family satisfaction.
Key words： Q Method; ICU; Nurses; Family Members; Communication Barriers
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