Analysis of barriers to thirst intervention in critically ill patients by ICU nurses: A qualitative study based on the Theoretical Domain Framework

Background Thirst is a common and highly distressing core symptom in critically ill patients, ranking as the second most significant source of distress after death. However, healthcare providers often underestimate its severity. Nurses play a crucial role in identifying and alleviating thirst, making it essential to understand the barriers affecting their ability to manage this symptom. Objective To explore the barriers to thirst management behaviors among intensive care unit nurses for critically ill patients, providing a reference basis for developing thirst management strategies for critically ill patients. Methods Purposeful sampling was used to develop an interview guide based on a theoretical domain framework. 13 intensive care unit nursing staff members were interviewed using a face-to-face semi-structured interview method, and the interview content was analyzed and coded using directed content analysis. Results Analysis of the interview results identified six theoretical domains influencing thirst management behaviors in critically ill patients: knowledge, skills, social/professional roles and identity, environment and resources, social influence, and behavioral norms. Key issues included healthcare providers' incomplete understanding of thirst management, weak awareness of thirst management, unfamiliarity with thirst assessment procedures, heavy daily workloads and equipment shortages, unfavorable organizational culture, and unclear processes and specific measures. Conclusion The implementation of thirst management for critically ill patients is influenced by multiple factors. The six areas identified in this study can serve as targets for improvement. Managers should explore strategies, and implementation plans for thirst management in critically ill patients to enhance the quality of thirst management for this population.