两名患者的故事:以患者为中心的方法作为减少差异的门户
Nancy R Kressin1, Sheila E Chapman2, Jared W Magnani2
1From VA Boston Healthcare System, Jamaica Plain, MA (N.R.K.); Department of Medicine, Boston University School of Medicine and Boston Medical Center, MA (N.R.K., S.E.C.); and Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.). Nkressin@bu.edu.
Circulation
|June 15, 2016
概括
了解健康的社会决定因素可以改善心血管保健. 解决患者障碍和临床医生的偏见可以提高患者对治疗方法的坚持,从而改善健康结果.
科学领域:
- 心脏病学
- 公共卫生
- 医疗公平
背景情况:
- 健康的社会决定因素 (SDOH) 显著影响心血管健康和医疗保健.
- 有限的研究探讨了SDOH如何改善临床相互作用和患者对治疗的坚持.
- 临床医生的无意识偏见可能会对患者的护理和结果产生负面影响.
研究的目的:
- 为了说明心血管临床医生如何识别和解决SDOH阻碍治疗的障碍.
- 展示以患者为中心的方法来减少临床医生的无意识偏见的影响.
- 提出将SDOH考虑纳入临床实践的框架.
主要方法:
- 提供一个临床案例来说明解决SDOH的挑战.
- 提出一种以患者为中心的方法,
- 强调了解患者的解释模型和社会背景的重要性.
主要成果:
- 临床医生应该认识到患者对疾病和治疗的不同信仰.
- 根据个体患者的理解量身定制临床方法至关重要.
- 尊重记忆提供了一个结构化的方法来参与患者.
结论:
- 将SDOH意识纳入临床实践可以改善患者的坚持.
- 以患者为中心的沟通策略对于有效的心血管护理至关重要.
- 解决临床医生偏见和患者特异性障碍可以改善治疗关系和结果.
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