护理学报2025，Vol.32Issue(13)：1-7,7.DOI:10.16460/j.issn2097-6569.2025.13.001
综合ICU患者预立医疗照护计划沟通方案的构建
Construction of advance care planning communication protocol for patients in comprehensive intensive care unit
摘要
Abstract
Objective To develop a patient-and family-centered care(PFCC)-based advance care planning(ACP)communication protocol for patients in comprehensive intensive care unit(ICU),and to provide reference for its implementation in critical care clinical practice.Methods From January to May 2024,a protocol framework was constructed through systematic literature review,and the initial protocol was drafted by semi-structured interviews with ICU patients and family members.Two rounds of Delphi expert consulta-tions were performed to finalize the protocol.Results Seventeen articles were collected through systematic literature screening.Based on qualitative interviews with 12 patients and 12 family members(three themes and eight subthemes from interviews with pa-tients,and three themes and nine subthemes from interviews with family members)and core components of PFCC,the preliminary pro-tocol was developed.Authority coefficients of the two rounds of consultations with 15 experts were 0.85 and 0.87,and coefficients of Kendall's concordance 0.189 and 0.232(both P<0.01),respectively.The final protocol comprised five first-level entries(developing communication strategies,sharing information,participating in communication,reviewing ACP plans,and evaluating communication ef-fectiveness),10 secondary-level and 30 third-level entries.Conclusion The PFCC-based ACP communication protocol for ICU pa-tients constructed through literature review,qualitative interviews,and expert consultations is reliable and scientific,and combines the-oretical depth with clinical applicability.It innovatively integrates PFCC model into ACP communication protocol for ICU patients,sys-tematically operationalizing its four core components—dignity and respect,information sharing,participation,and collaboration—into operational communication processes.关键词
以患者-家庭为中心/重症监护病房/预立医疗照护计划/德尔菲法/方案构建Key words
patient-and family-centered care model/intensive care unit/advance care planning/Delphi method/scheme construction分类
医药卫生引用本文复制引用
彭睿婕,刘书蕃,简旭梅,邓仁丽,杨艳,李昌秀..综合ICU患者预立医疗照护计划沟通方案的构建[J].护理学报,2025,32(13):1-7,7.基金项目
国家自然科学基金面上项目(72274235) （72274235）
贵州省遵义市科技局计划[遵市科合HZ字[(2022)197号] （2022）
