Analysis of Mirrored Psychophysiological Change of Cardiac Surgery Team Members During Open Surgery.
Analysis of Mirrored Psychophysiological Change of Cardiac Surgery Team Members During Open Surgery.
复制标题
开放手术中心外科团队成员镜像心理生理变化分析。
DOI：
10.1016/j.jsurg.2020.08.012
复制
发表时间：
2021-03
影响因子：
2.9
通讯作者：
Zenati MA
中科院分区：
文献类型：
--
作者：
Kennedy-Metz LR;Dias RD;Stevens RH;Yule SJ;Zenati MA
认知负荷指数的心理生理变化可能反映了共享的心理模型和有效的医疗团队动态。在这项探索性分析中，我们调查了心脏手术期间镜像变化的频率，定义为团队成员之间心率变异性（HRV）的并发峰值。通过在心脏手术病例（N=15）期间从主手术团队收集的HRV评估客观认知工作负荷。计算连续差异的均方根（RMSSD）作为主要的HRV测量值。将手术分为连续的非重叠5分钟段，并计算每个段的RMSSD沿着以及与RMSSD的偏差。具有正偏转的片段表示高于平均水平的认知工作负荷。对同一节段内的正偏转和成对峰进行计数。本研究的数据收集在心血管手术室进行。从参与记录病例的主治外科医生、主治麻醉师和主要灌注师处收集并分析生理数据。在分析的641个5分钟片段中，325个（50.7%）为高于平均值的正偏转，至少有两名团队成员同时参与。在325个阳性偏转中，26个（8%）代表至少两个活跃团队成员的HRV同时峰值。在冠状动脉粥样硬化或瓣膜置换阶段（N=12），最常见的是观察到团队成员之间的镜像峰。在这项初步研究中，在心脏手术团队成员的二人组中观察到了代表认知工作负荷峰值的镜像生理反应（平均1.73个峰值/例）。其中近一半发生在技术要求最高的心脏手术阶段，这可能是团队合作质量的基础。未来的工作应该调查技术和非技术性能之间的相互作用周围的镜像峰值的时间，并扩大样本量。基于系统的实践
Mirrored psychophysiological change in cognitive workload indices may reflect shared mental models and effective healthcare team dynamics. In this exploratory analysis, we investigated the frequency of mirrored changes, defined as concurrent peaks in heart rate variability (HRV) across team members, during cardiac surgery. Objective cognitive workload was evaluated via HRV collected from the primary surgical team during cardiac surgery cases (N=15). Root mean square of the successive differences (RMSSD) was calculated as the primary HRV measure. Procedures were divided into consecutive non-overlapping 5-minute segments, and RMSSD along with deviations from RMSSD were calculated for each segment. Segments with positive deflections represent above-average cognitive workload. Positive deflections and peaks across dyads within the same segment were counted. Data collection for this study took place in the cardiovascular operating room during live surgeries. Physiological data was collected and analyzed from the attending surgeon, attending anesthesiologist, and primary perfusionist involved with the recorded cases. Of the 641 five-minute segments analyzed, 325 (50.7%) were positive deflections above average, concurrently across at least two team members. Within the 325 positive deflections, 26 (8%) represented concurrent peaks in HRV across at least two active team members. Mirrored peaks across team members was observed most commonly during the coronary anastomoses or valve replacement phase (N=12). In this pilot study, mirrored physiological responses representing peaks in cognitive workload were observed uncommonly across dyads of cardiac surgery team members (1.73 peaks/case on average). Almost half of these occurred during the most technically demanding phases of cardiac surgery, which may underpin teamwork quality. Future work should investigate interactions between technical and non-technical performance surrounding times of mirrored peaks and expand the sample size. Systems-based practice
登录
查看更多内容
影响因子：
3.1
作者：
Yule, Steven;Paterson-Brown, Simon
通讯作者：
Paterson-Brown, Simon
影响因子：
7.4
作者：
Arora, Sonal;Russ, Stephanie;Sevdalis, Nick
通讯作者：
Sevdalis, Nick
DOI：
10.1046/j.1365-2281.2001.00337.x
发表时间：
2001-05-01
期刊：
CLINICAL PHYSIOLOGY
影响因子：
--
作者：
Penttilä, J;Helminen, A;Scheinin, H
通讯作者：
Scheinin, H
影响因子：
3.7
作者：
Normahani, Pasha;Makwana, Nita;Jaffer, Usman
通讯作者：
Jaffer, Usman
影响因子：
2.7
作者：
Stevens, Ronald;Galloway, Trysha;Willemsen-Dunlap, Ann
通讯作者：
Willemsen-Dunlap, Ann