ICU护士疼痛管理循证护理实践行为意向的质性研究OA

Objective To explore ICU nurses'perspectives on evidence-based practice in pain management,aiming to provide a reference for promoting high-quality pain management practice in the ICU setting.Methods Using a phenomenological approach,14 ICU nurses were selected from a Grade Ⅲ-A hospital in Guiyang by purposive sampling for semi-structured interviews.Their interview data were coded,categorized and extracted for themes using Colaizzi's seven-step method.Results Based on the initiation and maintenance stages in the multi-theoretical model,a total of 6 themes and 16 sub-themes were extracted:1)participatory dialogue(efficacy-oriented value identity;sense of frustration due to conflict between norms and real-world practice;sense of powerlessness due to input-output imbalance),2)behavioral confidence(perceived lack of efficacy due to insufficient knowledge;perceived efficacy compensation supported by empathy),3)changes in physical environment(distress caused by inadequate tools and lack of management;anticipation of environmental optimization),4)emotional shift(reflective growth amidst setbacks;professional detachment due to lack of decision-making;intrinsic satisfaction derived from value realization),5)changes in behavioral practice(sense of powerlessness due to theory-practice gap;sense of dependence on external supervision and feedback),and 6)changes in social environment(expectations for support from professional organizations;confusion about policy-execution gap;decisive role of leadership and teamwork;resource dilemmas for sustainable learning).Conclusion ICU nurses generally hold positive attitudes towards pain management and express a strong desire to play a more proactive role in practice.However,numerous barriers and influencing factors hinder this process.These findings suggest that nursing administrators should emphasize and optimize pain management systems and strengthen pain management training for ICU nurses to facilitate evidence-based nursing practice in this area.