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。

Objective: 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.

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。

Objective: 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.

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。

Objective: 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.

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。

Objective: 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.

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。

目的 基于生物—心理—社会模式分析精神专科住院患者负荷现状及其关联因素。 方法 选取某三级精神专科医院住院患者为研究对象，构建涵盖住院天数、费用、护理风险、联合用药、危机干预及出院准备难度的住院负荷综合评分，采用多元线性回归和Logistic回归分析影响因素。 结果 患者住院负荷评分为57.16±15.36分，高负荷患者约占三分之一；生物、心理、社会因素联合模型可解释68.4%的负荷变异；明显睡眠问题、既往住院次数≥3次、治疗依从性差、家庭支持低、社会功能重度受损及缺乏社区衔接资源等为高住院负荷危险因素。 结论 精神专科住院负荷具有复合性和多因素累积特征，应建立多维评估与分层干预机制，以优化资源配置和连续照护。

Objective To analyze the current status of inpatient burden and its associated factors among psychiatric inpatients based on the biopsychosocial model. Methods Inpatients from a tertiary psychiatric hospital were selected as study subjects. A comprehensive inpatient burden score was developed, incorporating length of stay, cost, nursing risk, polypharmacy, crisis intervention, and difficulty in discharge preparation. Multivariate linear regression and logistic regression analyses were used to identify influencing factors. Results The mean inpatient burden score was 57.16 ± 15.36 points, with approximately one-third of patients experiencing high burden. The combined model of biological, psychological, and social factors explained 68.4% of the variance in burden. Significant sleep problems, prior hospitalizations ≥3 times, poor treatment adherence, low family support, severe impairment in social functioning, and lack of community follow-up resources were identified as risk factors for high inpatient burden. Conclusion Psychiatric inpatient burden is complex and characterized by cumulative multifactorial influences; therefore, a multidimensional assessment and tiered intervention system should be established to optimize resource allocation and ensure continuous care.

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。

Operating Room, Qidong People's Hospital, Jiangsu Province, Qidong 226200, Jiangsu, China Objective: 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.

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。

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。

目的 分析2021-2025年某社区卫生服务中心失眠患者用药趋势，为社区失眠规范化管理提供参考。方法 回顾性收集某社区卫生服务中心2021年1月至2025年12月失眠相关药物处方数据，共纳入处方18,042张，涉及患者3,805人。统计处方量、药物种类、患者年龄、性别、伴随疾病等信息。根据处方次数及平均处方间隔天数将患者分为三类：偶发就诊型（1次）、短期治疗型（2~10次且平均间隔≥60天）和长期用药型（>10次或平均间隔<60天），分析各类患者的用药特征及伴随疾病分布。结果 处方量从2021年2,688张增至2025年5,734张，增长2.1倍，就诊人数增长1.6倍。艾司唑仑占比从66.22%降至41.75%，右佐匹克隆从13.28%升至54.99%，2024年为关键转折点；各年龄组右佐匹克隆使用均呈上升趋势，2025年组间差异趋于消失（48%~61%）。患者平均年龄从73.2岁降至69.5岁（Tukey HSD，P<0.05），≥80岁组占比从29.36%降至14.28%。偶发就诊型占42.6%，短期治疗型占25.9%，长期用药型占31.6%。长期用药型消耗全部处方的68.2%，平均处方间隔37.3 d（中位34 d），右佐匹克隆占比43.2%。高血压是最常见伴随疾病，患病率随年龄升高（28.17%~68.17%）；高血脂和焦虑呈倒U型分布。结论 社区失眠就诊需求快速增长，药物结构向新型非苯二氮?类药物明显转变。失眠患者呈年轻化趋势。长期用药型患者消耗了大部分处方资源，其用药管理模式需结合处方间隔特征进行精准分层，并重视老年患者心血管代谢共病的综合管理。

To analyze the medication trends and characteristics of insomnia patients in a community health service center from 2021 to 2025, and to provide evidence for standardized community-based insomnia management. METHODS A retrospective analysis was conducted on insomnia-related prescription data from a community health service center between January 2021 and December 2025. A total of 18,042 prescriptions involving 3,805 patients were included. Prescription volume, drug types, patient age, sex, and comorbidities were analyzed. Patients were classified into three types based on prescription count and average prescription interval: episodic consultation type (1 prescription), short-term treatment type (2–10 prescriptions with interval ≥60 days), and long-term medication type (>10 prescriptions or interval <60 days). RESULTS Prescriptions increased from 2,688 in 2021 to 5,734 in 2025 (2.1-fold), with a 1.6-fold increase in patient visits. Estazolam decreased from 66.22% to 41.75%, while eszopiclone increased from 13.28% to 54.99%, with 2024 as the turning point. Eszopiclone usage increased across all age groups, converging to 48%–61% by 2025. Mean age decreased from 73.2 to 69.5 years (Tukey HSD, P<0.05), and the proportion of patients aged ≥80 years dropped from 29.36% to 14.28%. Episodic consultation type accounted for 42.6%, short-term treatment type 25.9%, and long-term medication type 31.6%. The long-term type consumed 68.2% of all prescriptions, with an average prescription interval of 37.3 days (median 34 days) and eszopiclone accounting for 43.2%. Hypertension was the most common comorbidity, increasing with age (28.17%–68.17%). Hyperlipidemia and anxiety showed an inverted U-shaped distribution. CONCLUSION Community insomnia treatment demand is growing rapidly, with a significant shift toward newer non-benzodiazepines and a trend toward younger patient demographics. Long-term medication patients consume the majority of prescription resources and require precise stratification based on prescription interval patterns, along with integrated management of cardiometabolic comorbidities in older adults.