目的 深入了解重症监护室（intensive care unit，ICU）护士对有创机械通气患者离床活动评估的障碍因素，为保障患者安全、提高离床活动提供参考。方法 2023年5月，采用目的抽样法选取某院ICU护士11名为研究对象，对其进行半结构式深度访谈，采用Colaizzi的现象学7步分析法分析访谈资料。结果 ICU护士对有创机械通气患者离床活动评估的障碍因素被提炼为3个主题，即：评估面临客观障碍，评估的意识及经验欠缺，离床活动可能引发的不良后果阻碍护士实施评估。结论 建议研发标准化的评估工具、规范评估流程，倡导多学科团队的参与，提高评估的知识技能和重视程度，以保障患者安全、提高有创机械通气患者离床活动开展率。

Objective To investigate the barriers of nurses in ICU in evaluating patients with invasive mechanical ventilation， in order to provide reference for ensuring patient safety and improving patients’ out-of-bed activities.Methods In May 2023,11 ICU nurses in a hospital were selected as research subjects by the objective sampling method.A semi-structured in-depth interview was conducted on them,and the interview data were analyzed by Colaizzi’s 7-step phenomenological analysis method.Results The barriers for ICU nurses to evaluate the out-of-bed activity of patients with invasive mechanical ventilation were summarized into three themes：objective obstacles to evaluation,lack of awareness,experience in evaluation,and adverse consequences that may be caused by out-of-bed activities.Conclusions It is necessary to develop standardized assessment tools,standardize the assessment process,advocate the participation of multidisciplinary teams,improve the assessment of knowledge,skills and attention,in order to ensure patient safety and improve the rate of out-of-bed activities in patients with invasive mechanical ventilation.

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重庆市教育委员会研究生教育改革项目（YJG 233061）；重庆市卫生健康委医学科研项目（2024WSJK029）；重庆医科大学创新团队项目（W0009 ）