A systematic review of the promoting and obstructive factors of delirium management in ICU patients is based on CFIR2.0 theory
ICU患者谵妄管理促进和障碍因素的系统评价——基于CFIR2.0理论

摘要

目的 梳理与整合ICU患者谵妄管理过程中所面临的促进因素和障碍因素。方法 利用计算机系统检索4大中文数据库和4大英文数据库内关于ICU患者谵妄管理相关文献，时间为建库至2024年8月。通过主题分析法对提取到的因素进行归纳和总结。结果 共纳入21项研究，识别出关于ICU患者谵妄管理的促进因素和障碍因素分别为12个和15个，可分为创新、外部因素、内部因素、个体特征和实施过程5大类；其中内部因素占比较高，但更关注ICU护士知识水平，较少关注领导者和促进者等角色在研究中的作用。结论 通过分析ICU患者谵妄管理促进与障碍因素，可优化谵妄管理策略制定。但部分亚类别较少关注领导者和促进者的角色作用，未来应构建包含组织支持、团队协作和个人能力提升的多维度干预体系，以系统化推动谵妄管理的临床实践质量。

Abstract

Objective To sort out and integrate the promoting and obstructive factors faced in the management of delirium in ICU patients.
Methods The relevant literature on delirium management in ICU patients was retrieved from four major Chinese databases and four major English databases using a computer system from the establishment of the databases to August 2024. The extracted factors are summarized and concluded through the thematic analysis method.
Results A total of 21 studies were included. Fourteen promoting factors and sixteen obstructive factors regarding delirium management in ICU patients were identified, which could be classified into five major categories: innovation, external factors, internal factors, individual characteristics, and implementation process. Among them, internal factors account for a relatively high proportion, but more attention is paid to the knowledge level of ICU nurses, and less attention is paid to the role of leaders and facilitators and other roles in the research.
Conclusion   By analyzing the promoting and obstructive factors of delirium management in ICU patients, the formulation of delirium management strategies can be optimized. However, some subcategories pay less attention to the role of leaders and facilitators. In the future, a multi-dimensional intervention system that includes organizational support, team collaboration, and individual ability improvement should be constructed to systematically promote the clinical practice quality of delirium management.