摘要目的:调查我国重症医学科护士对重症监护病房（ICU）开放性探视制度的态度，并分析其影响因素，为此ICU探视制度的推行提供参考依据。方法:自制《ICU护士对ICU实行开放性探视制度的态度》问卷调查表，采用便利抽样方法，于2019年10月至12月对全国31个省、自治区、直辖市的重症医学科护士进行匿名网络问卷调查，调查对象为在ICU（包括专科ICU，但不包括普通病区的重症病房）一线工作且愿意参与本次调查的在职护士；调查内容包括调查对象的一般信息以及对ICU实行开放性探视制度的态度及其相关潜在影响因素等35个条目。应用有序Logistic回归分析开放性探视的影响因素。结果:发放问卷1 558份，回收有效问卷1 546份，回收率为99.2%。1 546名调查对象中32.2%赞同实行ICU开放性探视制度，41.3%反对，26.5%持不确定态度。有序Logistic回归分析显示，开放性探视会增加患者感染风险及科室消毒隔离工作的难度〔反对：β＝1.327，95%可信区间（95% CI）为0.242～2.413， P＝0.017；不确定：β＝0.697，95% CI为0.244～1.151， P＝0.003〕，提升护士的职业满足感（反对：β＝-1.406，95% CI为-1.750～-1.062， P＝0.000；不确定：β＝-0.748，95% CI为-1.030～-0.466， P＝0.000），使家属能随时为医护人员提供对患者有价值的信息（反对：β＝-0.644，95% CI为-1.048～-0.240， P＝0.002；不确定：β＝-0.422，95% CI为-0.721～-0.124， P＝0.006），家属能辅助护士对患者进行基础护理（不确定：β＝-0.465，95% CI为-0.729～-0.202， P＝0.001），减少护士治疗护理患者的时间（不确定：β＝0.349，95% CI为0.052～0.646， P＝0.021），同时家属的陪伴利于患者康复（反对：β＝-0.593，95% CI为-1.166～-0.019， P＝0.043），并能增强患者的生存意志（反对：β＝1.293，95% CI为0.426～2.159， P＝0.003），也提高了家属的满意度（反对：β＝-0.981，95% CI为-1.431～-0.531， P＝0.000）。上述各指标是ICU护士对开放性探视态度的独立影响因素。 结论:目前我国ICU护士已认识到开放性探视对患者的早期康复、生存意志及满意度等方面具有积极意义，但同时也认为我国ICU开放性探视制度在预防患者感染风险、消毒隔离、增加护理人力及治疗护理患者时间等多方面需要进一步完善。

abstractsObjective:To investigate the nurses' attitude towards open visitation policy in intensive care unit (ICU) and its potential influence factors, and further to provide evidence for carrying out this policy in ICU.Methods:A self-designed, anonymous online questionnaire of "attitude of ICU nurses to open visiting system in ICU" was performed in 31 provinces, autonomous regions and municipalities in China from October to December 2019, using convenient sampling method approach. Only nurses working in ICU (including specialized ICU, but excluding the critical ward in general ward) and willing to participate in the survey were included. The survey included 35 items, including the general information of each participant, the attitude towards the implementation of the open visitation system in ICU and its potential influencing factors. Ordinal Logistic regression analysis was used to identify the significant influencing factors.Results:A total of 1 558 questionnaires were sent out and 1 546 effective questionnaires were retrieved, with a response rate of 99.2%. Overall, 32.2% of them agreed with the policy, 41.3% of them disagree with the policy and 26.5% of them were uncertain. The Ordinal Logistic regression analysis showed that the independent influencing factors of ICU nurses' attitude towards open visitation policy including the possibility of increasing healthcare-associated infection [disagree: β = 1.327, 95% confidence interval (95% CI) was 0.242 to 2.413, P = 0.017; uncertain: β = 0.697, 95% CI was 0.244 to 1.151, P = 0.003], the improvement of nurses' job satisfaction (disagree: β = -1.406, 95% CI was -1.750 to -1.062, P = 0.000; uncertain: β = -0.748, 95% CI was -1.030 to -0.466, P = 0.000), the information support for medical staffs from family members (disagree: β = -0.644, 95% CI was -1.048 to -0.240, P = 0.002; uncertain: β = -0.422, 95% CI was -0.721 to -0.124, P = 0.006), the feasibility that the family members can assist the nurses in the basic nursing for patients (uncertain: β = -0.465, 95% CI was -0.729 to -0.202, P = 0.001), reducing the time that a nurse spent on caring for the patients (uncertain: β = 0.349, 95% CI was 0.052 to 0.646, P = 0.021), improving early rehabilitation (disagree: β = -0.593, 95% CI was -1.166 to -0.019, P = 0.043), and getting psychological support for patients from family members (disagree: β = 1.293, 95% CI was 0.426 to 2.159, P = 0.003), family members' satisfaction (disagree: β = -0.981, 95% CI was -1.431 to -0.531, P = 0.000). Conclusion:ICU nurses in China have realized that open visitation policy has positive effect on patients' early rehabilitation, willing to live and satisfaction; meanwhile, this policy may need more improvement in many ways such as healthcare-associated infection control, disinfection and isolation, allocation of human resources and time spent treating and caring for patients.