中青年脑卒中患者早期康复治疗疗效观察

Observation on the Efficacy of Early Rehabilitation Therapy in Young and Middle-aged Stroke Patients

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目的:探讨早期康复治疗对中青年脑卒中患者肢体运动功能恢复等影响。方法:从我院选取中青年脑卒中患者90例作为实验对象,分为实验组和观察组各45例,两组同时接受相同常规治疗并给予早期康复介入,并对其进行患侧上肢和下肢功能评定量表( Fugl-Meyer, FMMS),以及患者日常生活活动能力(Modified Barthel Index,MBI)评定。实验组给予进一步强化康复运动治疗,以加速提高患者康复速率;2周结束时对实验组和观察组再次进行评估,比较2组患者治疗前后组内和组间治疗疗效。结果:早期康复2周后,实验组FMMS量表上肢评分为(29.82±15.43)分,观察组上肢评分为(21.33±11.98)分,组间存在统计学差异(P=0.005)。实验组FMMS量表下肢评分为(21.18±8.97)分,观察组下肢评分为(15.40±7.40)分,实验组得分高于观察组且两组间存在显著统计学差异(P=0.002);随访1个月后实验组上下肢功能呈持续改善趋势,且两组间差异具有显著统计学意义。实验组MBI量表评分为(35.56±18.93)分,高于对照组(28.56±14.68)分,但未见统计学意义;1个月后两组间差异具有显著统计学意义(P<0.001)。结论:研究表明,早期康复治疗对改善中青年脑卒中患者肢体功能和日常生活活动能力具有显著康复效果。
Objective:Exploring the impact of early rehabilitation therapy on the recovery of limb motor function and other aspects in young and middle-aged stroke patients. Methods: Ninety young and middle-aged stroke patients were selected from our hospital as experimental subjects and divided into two groups, namely the experimental group and the observation group, with 45 cases in each group. Both groups received the same conventional treatment and early rehabilitation intervention simultaneously, and were evaluated using the Fugl-Meyer Motor Scale (FMMS) for the affected upper and lower limbs, as well as the Modified Barthel Index (MBI) for activities of daily living. The experimental group received further intensive rehabilitation exercise therapy to accelerate the rehabilitation rate. At the end of 2 weeks, both groups were reassessed, and the therapeutic effects within and between the two groups before and after treatment were compared. Results: After 2 weeks of early rehabilitation, the FMMS upper limb score in the experimental group was (29.36±15.27) points, while that in the observation group was (25.18±11.99) points, with no statistically significant difference observed between the groups. The FMMS lower limb score in the experimental group was (20.93±8.93) points, higher than that in the observation group (15.40±7.40) points, with a significant statistical difference between the two groups (P=0.002). The MBI score in the experimental group was (33.22±15.96) points, higher than that in the control group (28.56±14.68) points, but no statistical significance was observed. Conclusions: Our study indicates that early rehabilitation therapy has certain effects on upper limb function and activities of daily living in patients, particularly demonstrating significant rehabilitation effects in improving lower limb functional recovery in young and middle-aged stroke patients.

基于潜类别增长模型的脑出血患者神经功能恢复轨迹及预后

Neurological recovery trajectory and prognosis of patients with cerebral hemorrhage based on latent class growth model

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【摘要】目的:基于潜类别增长模型(LCGM)探讨脑出血患者神经功能恢复轨迹及不同轨迹对预后的影响。方法:回顾性采集360例自发性脑出血患者(2023年6月~2025年6月)的临床资料及神经功能评分[美国国立卫生研究院卒中量表(NIHSS)],并采用LCGM识别神经功能恢复轨迹的潜在类别,分析影响恢复不良型轨迹的危险因素,对比不同轨迹的预后情况[改良Rankin量表(mRS)、格拉斯哥预后评分(GOS)]。结果:LCGM模型拟合结果显示,3类轨迹为最优拟合模型,可将360例自发性脑出血患者分为快速恢复型139例(38.61%)、稳定恢复型154例(42.78%)、恢复不良型67例(18.61%);入院格拉斯哥昏迷量表(GCS)评分、初始NIHSS评分、机械通气、血管活性药物使用及血肿体积是神经功能恢复不良的独立影响因素(P<0.05);预后方面,三组患者mRS、GOS评分存在显著差异(P<0.05)。结论:基于LCGM可有效识别脑出血患者神经功能恢复的异质性轨迹,同时还能明确影响患者神经功能修复的独立危险因素及不同神经功能恢复轨迹与预后的关联。
Abstract Objective: To explore the trajectory of neurological recovery in patients with cerebral hemorrhage and the impact of different trajectories on prognosis based on latent class growth model (LCGM). Methods: The clinical data and neurological function scores [National Institutes of Health Stroke Scale (NIHSS)] of 360 patients with spontaneous cerebral hemorrhage (June 2023 to June 2025) were retrospectively collected, and LCGM was used to identify potential categories of neurological recovery trajectories, analyze risk factors affecting poor recovery trajectories, and compare the prognosis of different trajectories [modified Rankin Scale (mRS), Glasgow Outcome Score (GOS)]. Results: The LCGM model fitting results showed that the three types of trajectories were the optimal fitting model, and 360 patients with spontaneous cerebral hemorrhage could be divided into 139 cases (38.61%) of rapid recovery type, 154 cases (42.78%) of stable recovery type, and 67 cases (18.61%) of poor recovery type; admission to Glasgow Coma Scale (GCS) score, initial NIHSS score, mechanical ventilation, use of vasoactive drugs and hematoma volume are independent influencing factors of poor neurological recovery (P<0.05); in terms of prognosis, there were significant differences in mRS and GOS scores among the three groups of patients (P<0.05).Conclusion: Based on LCGM, it is possible to effectively identify the heterogeneous trajectories of neurological function recovery in patients with intracerebral hemorrhage (ICH), while also identifying independent risk factors influencing neurological function repair and establishing associations between different recovery trajectories and prognosis.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

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探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

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探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

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目的 探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

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探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

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探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

槐花散合桃花汤联合FP化疗方案治疗寒热错杂型晚期食管癌患者的多维度疗效评价

Multidimensional efficacy evaluation of Huaihua San and Taohua Decoction combined with FP chemotherapy regimen in the treatment of patients with advanced esophageal cancer of intermingled cold-heat syndrome

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目的 分析槐花散合桃花汤联合FP(顺铂、5-氟尿嘧啶)化疗方案治疗寒热错杂型晚期食管癌患者的效果。方法 选取我院2023年1月~2024年8月寒热错杂型晚期食管癌患者98例,依照随机数字表法分为两组,各49例。对照组接受FP化疗方案治疗,观察组接受槐花散合桃花汤联合FP化疗方案治疗。比较两组多维度疗效[西医疗效(疾病控制率)、中医疗效]、治疗前后中医证候积分(TCMSS)、肿瘤标志物[鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)]、生活质量[食管癌生命质量测定量表(QLICP-ES)]、毒副反应、1年生存率。结果 观察组中医疗效(89.80%)较对照组(65.31%)高(P<0.05),而两组疾病控制率比较无明显差异(P>0.05);观察组TCMSS低于对照组(P<0.05);治疗后,观察组CEA、CYFRA21-1、SCC-Ag水平低于对照组(P<0.05);治疗后,观察组QLICP-ES评分低于对照组(P<0.05);观察组恶心呕吐、消化系出血、脱发发生率较对照组低(P<0.05);两组1年生存率对比无明显差异(P>0.05)。结论 槐花散合桃花汤联合FP化疗方案治疗寒热错杂型晚期食管癌,能提高中医疗效,降低患者肿瘤标志物水平,减轻毒副反应,改善中医症状,并有助于减轻化疗对生活质量的负面影响。
Objective To analyze the efficacy of Huaihua San and Taohua Decoction combined with FP (cisplatin, 5-fluorouracil) chemotherapy regimen in the treatment of patients with advanced esophageal cancer of intermingled cold-heat syndrome type. Methods A total of 98 patients with advanced esophageal cancer complicated with intermingled cold-heat syndrome admitted to our hospital from January 2023 to August 2024 were enrolled and divided into two groups by the random number table method, with 49 cases in each group. The control group was treated with FP chemotherapy regimen, and the observation group was treated with Huaihua San and Taohua Decoction combined with FP chemotherapy. Multi-dimensional efficacy indicators [western medicine efficacy (disease control rate) and traditional Chinese medicine (TCM) efficacy], as well as the TCM syndrome score (TCMSS), tumor markers [squamous cell carcinoma antigen (SCC-Ag), carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1)], quality of life [quality of life instrument for cancer patients-esophageal cancer scale (QLICP-ES)] before and after treatment, adverse reactions and 1-year survival rate were compared between the two groups. Results The TCM efficacy rate of the observation group was 89.80%, which was significantly higher than 65.31% of the control group (P<0.05), no significant difference was found in disease control rate between the two groups (P>0.05). The TCMSS of the observation group was lower than that of the control group (P<0.05). After treatment, the levels of CEA, CYFRA21-1 and SCC-Ag in the observation group were lower than those in the control group (P<0.05). The QLICP-ES score of the observation group was superior to the control group after treatment (P<0.05). The incidences of nausea and vomiting, digestive tract hemorrhage and alopecia in the observation group were markedly lower (P<0.05). There was no statistical difference in 1-year survival rate between the two groups (P>0.05). Conclusion The regimen of Huaihua San and Taohua Decoction combined with FP chemotherapy for advanced esophageal cancer of intermingled cold-heat syndrome can improve TCM therapeutic efficacy, reduce the levels of tumor markers, alleviate toxic and side effects, ameliorate TCM symptoms, and lessen the negative impact of chemotherapy on patients quality of life.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

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探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.

Root Cause Analysis 质量管理模式联合心理资本理论在手术核查团队沟通中断中的能力提升研究

Effect of Integrating Root Cause Analysis–Based Quality Management with Psychological Capital Theory on Reducing Communication Interruptions in Surgical Safety Check Teams

:-
 
探讨将 Root Cause Analysis(RCA)质量管理模式与心理资本理论相结合应用于手术核查团队,对改善沟通中断、提升沟通执行质量与团队协作能力的效果。方法 选取 2025年 1 月至 2025 年12 月某三级医院手术室手术团队成员 80 名,按手术间编号分为对照组与实验组,各 40 名。对照组实施常规手术核查流程;实验组在此基础上实施基于 RCA 的流程诊断与基于心理资本理论的综合沟通能力提升干预。干预结束后,比较两组沟通中断发生率、核查流程执行质量、沟通效率,以及心理资本量表(PCQ-24)和团队协作量表(T-TPQ)得分。结果 实验组沟通中断发生率显著低于对照组(P<0.05),核查流程执行质量和沟通效率均显著优于对照组(P<0.001)。实验组 PCQ-24 各维度及总分、T-TPQ 各维度及总分均显著高于对照组(均 P<0.001)。结论 将 RCA 流程分析与心理资本理论干预相结合,可通过流程规范化与心理动力增强双路径同步改善手术团队沟通质量与协作水平,具有良好的临床应用价值与推广潜力。
To evaluate the effectiveness of an intervention combining Root Cause Analysis (RCA)–based quality management and Psychological Capital (PsyCap) theory in reducing communication interruptions and improving communication quality and teamwork in surgical safety check teams. Methods: Eighty surgical team members from a tertiary hospital (January 2025 - December 2025.) were assigned to a control group or an intervention group according to operating room allocation (40 per group). The control group followed routine surgical safety check procedures, whereas the intervention group additionally received an RCA-guided workflow analysis and a PsyCap-based communication enhancement program. Post-intervention outcomes included communication interruption rate, execution quality and efficiency of safety checks, Psychological Capital Questionnaire (PCQ-24) scores, and TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) scores. Results: The intervention group demonstrated a significantly lower communication interruption rate compared with the control group (P<0.05). Execution quality and communication efficiency were significantly improved in the intervention group (P<0.001). PCQ-24 total and subscale scores were significantly higher in the intervention group than in the control group (P<0.001), as were T-TPQ total and subscale scores (P<0.001). Conclusion: Integrating RCA-based workflow optimization with PsyCap-oriented psychological and behavioral training can effectively enhance communication quality, reduce interruptions, and strengthen teamwork in surgical safety check teams. The combined model has strong applicability and potential for wider clinical promotion.
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