Assistant Professor, Department of Pediatrics, Johns Hopkins University School of Medicine.
Associate Professor, Department of Pediatrics, Johns Hopkins University School of Medicine.
MedEdPORTAL. 2020 Jul 30;16:10939. doi: 10.15766/mep_2374-8265.10939.
Home visits allow physicians to develop a deeper understanding of patients' homes and community, enhance physician-patient connectedness, and improve physician treatment plans for patients. We describe a unique pediatric posthospitalization home visit curriculum to train residents about the social determinants of health (SDH).
Residents participated in an interactive presentation that discussed the logistics of making home visits and a background detailing SDH. During subsequent home visits, residents got to know the family and neighborhood on a deeper level. After each home visit, residents participated in a reflection session and considered the impact of SDH. Surveys were completed to capture data about residents' knowledge and attitudes regarding SDH and connectedness with the families. Families' perspectives were captured by phone surveys.
Of residents, 23 of 31 (74%) were able to make at least one home visit. After participating in the curriculum, residents reported increased confidence in understanding SDH ( = .048) and increased consideration of SDH when developing treatment plans ( = .007). All residents who made home visits predicted they would feel more confident in understanding how SDH impact patients they will care for in the future. Ninety percent of residents felt they made a stronger connection with the family. Eight families were surveyed, and all stated that the home visit had positive effects.
This curriculum teaches SDH while improving connections between physicians and patients.
家访使医生能够更深入地了解患者的家庭和社区，增强医患联系，并改善医生对患者的治疗计划。我们描述了一个独特的儿科出院后家访课程，旨在培训住院医生了解健康的社会决定因素（SDH）。
住院医生参加了一个互动式的演讲，讨论了家访的后勤工作和 SDH 的背景细节。在随后的家访中，住院医生更深入地了解了家庭和邻里情况。每次家访后，住院医生都会参加反思会议，并考虑 SDH 的影响。通过调查收集有关住院医生对 SDH 的知识和态度以及与家庭联系的信息。通过电话调查了解家庭的观点。
31 名住院医生中有 23 名（74%）能够进行至少一次家访。参加课程后，住院医生报告称，他们对理解 SDH 的信心有所增强（ =.048），并且在制定治疗计划时更多地考虑 SDH（ =.007）。所有进行家访的住院医生都预测，他们将来会更有信心理解 SDH 如何影响他们所照顾的患者。90%的住院医生表示与家庭的联系更加紧密。对 8 个家庭进行了调查，所有家庭都表示家访有积极影响。
本课程在教授 SDH 的同时，还增进了医生与患者之间的联系。
