目的:探讨ICU肠内营养喂养不足的影响因素，并提出干预建议。方法:回顾性分析2021年2月至2022年2月在华中科技大学同济医学院附属协和医院ICU接受肠内营养支持的患者80例的临床资料，根据是否发生肠内营养喂养不足分为完成组和未完成组，使用问卷调查方式收集患者临床信息，并对两组患者临床资料进行分析。结果:单因素分析结果显示，患者急性生理与慢性健康评分Ⅱ(Acute Physiology and Chronic Health Evaluation，APACHE Ⅱ)、腹内压、低蛋白血症、使用镇静剂是导致ICU肠内营养支持患者喂养不足的影响因素( P<0.05)；二元Logistic回归分析结果显示，APACHE Ⅱ评分>20分、腹内压≥12 mmHg、合并低蛋白血症、使用镇静剂为患者发生营养支持喂养不足的独立危险因素( P<0.05)。 结论:导致ICU接受肠内营养支持患者发生喂养不足的危险因素较多，可根据相关高危因素对患者肠内营养喂养不足进行预测，根据其具体情况制定相应预防措施。

[目的]深入了解重症监护室 (ICU) 护士对ICU探视制度的真实体验, 为探索符合我国国情及临床需要的新型探视制度提供参考依据.[方法]采用质性研究中的现象学研究方法, 对ICU内11名护士进行半结构式访谈, 根据Colaizzi的七步分析法分析资料.[结果]ICU探视制度对ICU护士心理真实体验提炼出4个主题:ICU探视制度的影响、完善相关ICU探视制度的辅助设施、不支持实行开放性探视、实行灵活多变的限制性探视制度.[结论]ICU探视制度有利有弊, 限制性探视制度被广泛接受, 但不支持实行开放性探视制度.需构建更完善的社会支持系统, 符合我国国情, 逐步建立由病人、家属和医护人员共同满意的探视制度.

Objective To explore the intervention effect of ICU nurses' scientific research behavior and psychological contract based on psychological contract theory.Methods Totally 48 ICU nurses' willingness of nursing research was investigated based on psychological contract theory,then the goals of hierarchical personal nursing research were set according to the investigation result,which was combined with the nursing scientific research target of the department,and the contract interventions were provided at the same time,such as training support,diversified incentive and communication preventing contract breach.Results After the intervention,the number of ICU nurses'publications and patents were significantly more than those before the intervention,more nurses involved in scientific research.The nurses' perceived degree of psychological contract performance was improved gradually (P＜0.05 P＜0.01).Conclusion The intervention based on psychological contract can promote nurses to carry out nursing research activities actively,increase scientific research output,and improve the level of nursing scientific research in department.