现在是时候了：培养以关系为中心的关于患者健康的社会决定因素的讨论。
The time is now: Fostering relationship-centered discussions about patients' social determinants of health.
机构信息
Center for Healthful Behavior Change, Division of Health & Behavior, Department of Population Health, NYU Langone Health, NY USA.
Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
出版信息
Patient Educ Couns. 2019 Apr;102(4):810-814. doi: 10.1016/j.pec.2018.10.025. Epub 2018 Oct 29.
OBJECTIVE
This paper discusses the importance of developing best practices in communication strategies to identify and act on social determinants of health (SDOH) in care settings in ways that minimizes shame and builds patient trust in the process.
DISCUSSION
We leverage the relationship-centered care framework to provide health care teams guidance in how to foster meaningful discussions about SDOH at three pivotal points in the process: 1) at the initial screening; 2) once an unmet social need has been identified; and 3) when exchanging SDOH data with team members and external organizations.
CONCLUSION
This discussion piece uses a relationship-centered framework to offer several evidence-based recommendations for health care systems on how to help their workforce respectfully listen and collaborate with patients to address SDOH. Additional research into patient and provider perceptions of relationship-centered communication surrounding screening and referral practices can help further adapt and refine best practices to maximize chances for addressing patients' SDOH.
目的
本文讨论了制定最佳沟通策略的重要性，以便在护理环境中识别和应对健康的社会决定因素（SDOH），同时尽量减少羞耻感并建立患者对这一过程的信任。
讨论
我们利用以关系为中心的护理框架，为医疗保健团队提供指导，说明如何在以下三个关键阶段促进关于 SDOH 的有意义的讨论：1）在初始筛查时；2）一旦确定存在未满足的社会需求；3）与团队成员和外部组织共享 SDOH 数据时。
结论
本文使用以关系为中心的框架，为医疗保健系统提供了一些基于证据的建议，帮助其工作人员尊重地倾听并与患者合作，以解决 SDOH。对围绕筛查和转介实践的以患者和提供者为中心的沟通的看法进行进一步研究，可以帮助进一步调整和完善最佳实践，以最大限度地提高解决患者 SDOH 的机会。
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