ICU护士与患者家属沟通障碍的潜在类型及影响因素研究

doi:10.3761/j.issn.2096-7446.2026.02.005

Abstract

Abstract:

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

LIANG Dalian, LI Cuilan, LI Haiyan, HUANG Yu. Latent types and influencing factors of communication barriers between ICU nurses and patients’ families[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(2): 162-167.

Figures/Tables 1

References 24

[1]	Jo M, Song MK, Knafl GJ, et al. Family-clinician communication in the ICU and its relationship to psychological distress of family members:a cross-sectional study[J]. Int J Nurs Stud, 2019, 95:34-39. doi: 10.1016/j.ijnurstu.2019.03.020
[2]	乔晓婷, 隋伟静, 王凯丽, 等. 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.
	Qiao XT, Sui WJ, Wang KL, et al. Research on the status quo and influencing factors of decision conflict among family members of ICU patients[J]. Chin J Emerg Crit Care Nurs, 2024, 5(8):677-682.
[3]	Chen C, Sullivan SS, Lorenz RA, et al. COMFORT communication in the ICU:pilot test of a nurse-led communication intervention for surrogates[J]. J Clin Nurs, 2022, 31(21/22):3076-3088. doi: 10.1111/jocn.v31.21-22
[4]	马楠. CICARE模式联合Kolb经验学习理论的ICU护士与患者家属沟通培训方案构建研究[D]. 昆明: 昆明医科大学, 2023.
	Ma N. Study on the construction of communication training scheme between ICU nurses and patients’ families based on CICARE model and Kolb empirical learning theory[D]. Kunming: Kunming Medical University, 2023.
[5]	李尊柱, 李真, 张媛媛, 等. ICU护士与患者家属沟通现状与培训需求的调查分析[J]. 基础医学与临床, 2020, 40(1):128-131.
	Li ZZ, Li Z, Zhang YY, et al. Investigation and analysis of communication status and training needs between ICU nurses and patients’ families[J]. Basic Clin Med, 2020, 40(1):128-131.
[6]	Tolotti A, Cadorin L, Bonetti L, et al. Communication experiences of tracheostomy patients with nurses in the ICU:a scoping review[J]. J Clin Nurs, 2023, 32(11/12):2361-2370. doi: 10.1111/jocn.v32.11-12
[7]	Liu PY, Lyndon A, Holl JL, et al. Barriers and facilitators to interdisciplinary communication during consultations:a qualitative study[J]. BMJ Open, 2021, 11(9):e046111. doi: 10.1136/bmjopen-2020-046111
[8]	杨慧贤, 徐晋霞, 徐晶, 等. 基于Q方法的老年头颈癌患者术前预立医疗照护计划决策态度探究[J]. 护理学杂志, 2024, 39(10):6-11.
	Yang HX, Xu JX, Xu J, et al. A study of preoperative advance care planning decision-making attitudes of elderly patients receiving head and neck cancer surgery based on Q methodology[J]. J Nurs Sci, 2024, 39(10):6-11.
[9]	Yeun EJ. Q-methodology:understanding and applying it to nursing and health research[J]. Nurs Health Sci, 2021, 23(4):777-781. doi: 10.1111/nhs.v23.4
[10]	van den Hoed MW, Daniëls R, Beaulen A, et al. Perspectives on managing innovation readiness in long-term care:a Q-methodology study[J]. BMC Geriatr, 2024, 24(1):1017. doi: 10.1186/s12877-024-05572-3
[11]	Şan EG, Çelik R, Altay N. Care needs of children with chronic illnesses from the perspectives of children,parents,and nurses:a Q methodology approach[J]. BMC Nurs, 2025, 24(1):995. doi: 10.1186/s12912-025-03651-3
[12]	Al-Kalaldeh M, Amro N, Qtait M, et al. Barriers to effective nurse-patient communication in the emergency department[J]. Emerg Nurse, 2020, 28(3):29-35. doi: 10.7748/en.2020.e1969 pmid: 32285654
[13]	Gerchow L, Burka LR, Miner S, et al. Language barriers between nurses and patients:a scoping review[J]. Patient Educ Couns, 2021, 104(3):534-553. doi: 10.1016/j.pec.2020.09.017
[14]	Havaei F, MacPhee M. The impact of heavy nurse workload and patient/family complaints on workplace violence:an application of human factors framework[J]. Nurs Open, 2020, 7(3):731-741. doi: 10.1002/nop2.v7.3
[15]	Dees ML, Carpenter JS, Longtin K. Communication between registered nurses and family members of intensive care unit patients[J]. Crit Care Nurse, 2022, 42(6):25-34. doi: 10.4037/ccn2022913 pmid: 36453067
[16]	Tadros EM, Al-Akash HY, Ababneh A, et al. Voices from the intensive care unit:a qualitative study on communication between family members and nurses[J]. Appl Nurs Res, 2025, 85:151991. doi: 10.1016/j.apnr.2025.151991
[17]	黄玉, 梁大炼, 尚静丽, 等. 基于叙事护理的ICU患者家属沟通清单的构建及应用[J]. 护理学杂志, 2025, 40(3):69-73.
	Huang Y, Liang DL, Shang JL, et al. Construction and application of a family communication list of ICU patients based on narrative nursing[J]. J Nurs Sci, 2025, 40(3):69-73.
[18]	魏肖星, 刘清云, 周春燕, 等. 重症监护病房护士道德勇气与道德困境的相关性研究[J]. 医学与哲学, 2023, 44(24):45-50.
	Wei XX, Liu QY, Zhou CY, et al. Study on the correlation between moral courage and moral dilemmas of nurses in intensive care units[J]. Med Philos, 2023, 44(24):45-50.
[19]	Hickey J. Interventions to reduce nurses’ moral distress in the intensive care unit:an integrative review[J]. Dimens Crit Care Nurs, 2022, 41(5):274-280. doi: 10.1097/DCC.0000000000000542
[20]	龚雨蕾, 姚惠萍, 张帅. 巴林特小组管理模式对ICU护士情感衰竭和职业生涯高原的影响研究[J]. 护士进修杂志, 2020, 35(5):448-450.
	Gong YL, Yao HP, Zhang S. Study on the influence of balint group management model on emotional exhaustion and career plateau of ICU nurses[J]. J Nurses Train, 2020, 35(5):448-450.
[21]	唐莉, 李乐之, 杨凤, 等. 重症监护病房医护沟通现状及需求匹配策略研究[J]. 中国护理管理, 2024, 24(9):1412-1417.
	Tang L, Li LZ, Yang F, et al. Nurse-physician communication status and demand matching countermeasures in Intensive Care Unit[J]. Chin Nurs Manag, 2024, 24(9):1412-1417.
[22]	Naef R, Jeitziner MM, Riguzzi M, et al. Nurse-led family support intervention for families of critically ill patients:the FICUS cluster randomized clinical trial[J]. JAMA Intern Med, 2025, 185(9):1138-1149. doi: 10.1001/jamainternmed.2025.3406
[23]	Murphy M, Engel JR, McGugan L, et al. Implementing a standardized communication tool in an intensive care unit[J]. Crit Care Nurse, 2022, 42(3):56-64. doi: 10.4037/ccn2022154 pmid: 35640900
[24]	Happ MB. Giving voice:nurse-patient communication in the intensive care unit[J]. Am J Crit Care, 2021, 30(4):256-265. doi: 10.4037/ajcc2021666

Latent types and influencing factors of communication barriers between ICU nurses and patients’ families

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 1

References 24

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	ZHENG Xiaochen, CUI Mingou, AN Cong, LIU Yousheng. Research on the application of goal-oriented rehabilitation training based on virtual reality technology in ICU patients [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(2): 175-181.
[2]	SHI Min, ZHAI Huaixiang, ZHANG Xingxing, XU Ping, LI Xiaoqing. Current status and latent profile analysis of post-traumatic growth in young and middle-aged patients with mechanical ventilation in ICU [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(2): 182-189.
[3]	MA Jianping, HUANG Pei, LIN Yao, XIA Liuqin, ZHANG Qian, ZHENG Yue, YANG Xiangying. Design of a visualized navigational ECMO pre-filling device and its application in ICU nurse pre-filling training [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(2): 248-252.
[4]	HUANG Jing, CHEN Junjun, WANG Dianrong. Effect of ICU intelligent guidance science popularization system on enhancing patients’ and their families’ cognition [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 16-22.
[5]	REN Guangxiu, QIN Xiaoxin, ZHANG Yanfang, WANG Wenran, HAN Chao, WANG Shouxi. The status and latent profile analysis of palliative care competence among nurses in intensive care unit [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 89-95.
[6]	HU Xinyuan, SHI Yu, NIE Linwen, GAN Xiuni. Nursing involvement in electroencephalogram monitoring of ICU patients：a scoping review [J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(1): 116-122.
[7]	WANG Xueqin, LÜ Ying, ZHAO Qinghua, ZHANG Chuanlin, MI Jie. Effects of implementing an early activity multidisciplinary collaboration model in ICU mechanically ventilated patients [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(9): 1029-1035.
[8]	YUAN Cui, XIAO Yanyan, CHEN Kaisheng, WANG Fang, WANG Yi, HU Meihua, YAO Xi, WANG Dongxin, LI Shuangling. The effect of preventive contact isolation cluster measures on the prevention of multidrug-resistant organisms in ICU patients [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(9): 1106-1111.
[9]	WANG Ping, LAO Yuewen, CHEN Xiangping, DONG Lianlian, GONG Xiaoyan, ZHUANG Yiyu. The current status of ICU nurses’ competence in delirium care and analysis of influencing factors [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(9): 1112-1117.
[10]	JIANG Weilin, WANG Li, HUANG Zhenzhen, YAN Ran, YI Jia, ZHUANG Yiyu. Influencing factors of sleep disorders in post-ICU patients：a systematic review and meta-analysis [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 945-952.
[11]	GU Xin, YANG Yanjie, PENG Hu, CAO Zhijie, MA Lina, ZHANG Li. Analysis on the status quo and influencing factors of post core competence of ICU nurses in Xinjiang [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 988-994.
[12]	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.
[13]	YU Xiaoling, Qian Weiming, YU Liangmeng, JIN Xiaojuan, CHEN Lichai. The experience of anesthesia nurses using the difficult airway information management system：a qualitative study [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(6): 692-696.
[14]	JIA Yan, XU Qin, LU Hong, HU Jieman, WANG Liqin, YAO Wenjun. Latent profile analysis and influencing factors of happiness of ICU nurses [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(6): 725-730.
[15]	XIONG Xingyu, ZHANG Dandan, CHENG Shouzhen. Application and development of of ICU nursing quality evaluation indicators：a scoping review [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(6): 758-764.