Litlhaloso tsa sechaba tsa bophelo bo botle (SDOH) li hokahane haholo le mabaka a mangata a bophelo le moruo.Ho nahanisisa ho bohlokoa ho ithuta SDH.Leha ho le joalo, ke litlaleho tse fokolang feela tse hlahlobang mananeo a SDH;boholo ke lithuto tse fapaneng.Re ne re batla ho etsa tlhahlobo ea nako e telele ea lenaneo la SDH thutong ea bophelo bo botle ba sechaba (CBME) e qalileng ka 2018 ho ipapisitse le boemo le litaba tsa boinahano bo tlalehiloeng ke baithuti ka SDH.
Moralo oa liphuputso: Mokhoa o akaretsang oa tlhahlobo ea data ea boleng.Lenaneo la Thuto: Koetliso e tlamang ea libeke tse 4 ea bongaka bo akaretsang le tlhokomelo ea mantlha Univesithing ea Tsukuba School of Medicine, Japane, e fuoa liithuti tsohle tsa bongaka tsa selemo sa bohlano le sa botšelela.Liithuti li ile tsa qeta libeke tse tharo li le mosebetsing litliliniking tsa sechaba le lipetlele tse metseng ea litoropo le ea mahaeng Seterekeng sa Ibaraki.Ka mor'a letsatsi la pele la lipuo tsa SDH, liithuti li ile tsa kōptjoa hore li lokise litlaleho tsa linyeoe tse hlophisitsoeng ho latela maemo a kopaneng nakong ea thupelo.Letsatsing la ho qetela, baithuti ba ile ba arolelana liphihlelo tsa bona libokeng tsa sehlopha mme ba fana ka pampiri ka SDH.Lenaneo le tsoela pele ho ntlafatsa le ho fana ka ntlafatso ea matichere.Barupeluoa ba ithutoang: baithuti ba qetileng lenaneo lipakeng tsa Mphalane 2018 le Phuptjane 2021. Tlhahlobo: Boemo ba ho nahanisisa bo khetholloa e le bo bonahatsang, bo hlahlobisisang kapa bo hlalosang.Litaba li sekasekoa ho sebelisoa sethala sa Lintlha tse Tiileng.
Re hlahlobile litlaleho tse 118 tsa 2018-19, litlaleho tse 101 tsa 2019-20 le tse 142 tsa 2020-21.Ho bile le litlaleho tse 2 (1.7%), 6 (5.9%) le 7 (4.8%), 9 (7.6%), 24 (23.8%) le 52 (35.9%), 36 (30.5%) ka ho latellana, 48 (47.5%) le 79 (54.5%) litlaleho tse hlalosang.Ha ke na ho bua ka tse ling kaofela.Palo ea merero e tiileng ea lintlha tse tlalehong ke 2.0 ± 1.2, 2.6 ± 1.3, le 3.3 ± 1.4, ka ho latellana.
Ha merero ea SDH lithutong tsa CBME e ntse e ntlafatsoa, kutloisiso ea baithuti ea SDH e ntse e tsoela pele ho teba.Mohlomong sena se nolofalitsoe ke nts'etsopele ea lefapha la thuto.Kutloisiso e hlakileng ea SDH e kanna ea hloka nts'etsopele ea mahlale le thuto e kopaneng ho mahlale a sechaba le bongaka.
Litlhaloso tsa sechaba tsa bophelo bo botle (SDH) ke lintlha tseo e seng tsa bongaka tse susumetsang maemo a bophelo bo botle, ho kenyelletsa le tikoloho eo batho ba tsoaletsoeng ho eona, ba holang, ba sebetsang, ba phelang le lilemo [1].SDH e na le tšusumetso e kholo bophelong ba batho, 'me ho kenella ha meriana feela ho ke ke ha fetola liphello tsa bophelo bo botle ba SDH [1,2,3].Bafani ba tlhokomelo ea bophelo ba tlameha ho hlokomela SDH [4, 5] le ho kenya letsoho sechabeng e le babuelli ba bophelo bo botle [6] ho fokotsa liphello tse mpe tsa SDH [4,5,6].
Bohlokoa ba ho ruta SDH thutong ea bongaka ea pele e tsebahala [4,5,7], empa ho boetse ho na le mathata a mangata a amanang le thuto ea SDH.Bakeng sa liithuti tsa bongaka, bohlokoa ba bohlokoa ba ho hokahanya SDH le litsela tsa mafu a likokoana-hloko [8] e ka 'na ea e-ba e tloaelehileng haholoanyane, empa kamano pakeng tsa thuto ea SDH le koetliso ea meriana e ntse e ka fokotseha.Ho ea ka American Medical Association Alliance for Accelerating Change in Medical Education, ho fanoa ka thuto e eketsehileng ea SDH selemong sa pele le sa bobeli sa thuto ea bongaka ea pele ho feta selemong sa boraro kapa sa bone [7].Hase likolo tsohle tsa bongaka United States tse rutang SDH maemong a kliniki [9], bolelele ba thupelo bo fapana [10], 'me lithuto hangata ke tsa khetho [5, 10].Ka lebaka la khaello ea tumellano mabapi le bokhoni ba SDH, maano a tlhahlobo bakeng sa baithuti le mananeo a fapana [9].Ho ntšetsa pele thuto ea SDH ka har'a thuto ea bongaka ea pele, hoa hlokahala ho kenya ts'ebetsong merero ea SDH lilemong tsa ho qetela tsa thuto ea bongaka ea pele le ho etsa tlhahlobo e nepahetseng ea merero [7, 8].Japane e boetse e hlokometse bohlokoa ba thuto ea SDH thutong ea bongaka.Ka 2017, thuto ea SDH e kenyelelitsoe lenaneong la motheo la thuto ea bongaka ea pontšo, ho hlakisa lipakane tse lokelang ho finyelloa ha ba qeta sekolong sa bongaka [11].Sena se totobatsoa hape ho ntlafatso ea 2022 [12].Leha ho le joalo, mekhoa ea ho ruta le ho hlahloba SDH ha e e-s'o thehoe Japane.
Thutong ea rona e fetileng, re ile ra hlahloba boemo ba ho nahanisisa litlalehong tsa liithuti tse phahameng tsa bongaka hammoho le mekhoa ea bona ka ho hlahloba tlhahlobo ea morero oa SDH thutong ea sechaba ea thuto ea bongaka (CBME) [13] univesithing ea Japane.Ho utloisisa SDH [14].Ho utloisisa SDH ho hloka thuto e fetolang [10].Lipatlisiso, ho kenyeletsoa le tsa rona, li tsepamisitse maikutlo maikutlong a baithuti mabapi le ho lekola merero ea SDH [10, 13].Lithutong tsa pele tseo re ileng ra fana ka tsona, liithuti li ne li bonahala li utloisisa likarolo tse ling tsa SDH ho feta tse ling, 'me boemo ba bona ba ho nahana ka SDH bo ne bo batla bo le tlaase [13].Baithuti ba ile ba tebisa kutloisiso ea bona ea SDH ka liphihlelo tsa sechaba le ho fetola maikutlo a bona ka mohlala oa bongaka hore e be mohlala oa bophelo [14].Liphetho tsena li bohlokoa ha litekanyetso tsa kharikhulamo bakeng sa thuto ea SDH le tlhahlobo ea tsona le tlhahlobo li e-so thehoe ka botlalo [7].Leha ho le joalo, litlhahlobo tsa longitudinal tsa mananeo a undergraduate SDH ha li tlalehoe hangata.Haeba re ka lula re bonts'a ts'ebetso ea ho ntlafatsa le ho hlahloba mananeo a SDH, e tla sebetsa e le mohlala bakeng sa moralo o ntlafetseng le tlhahlobo ea mananeo a SDH, a tla thusa ho hlahisa litekanyetso le menyetla ea SDH ea pele.
Sepheo sa thuto ena e ne e le ho bontša ts'ebetso ea ntlafatso e tsoelang pele ea lenaneo la thuto la SDH bakeng sa liithuti tsa bongaka le ho etsa tlhahlobo ea longitudinal ea lenaneo la thuto la SDH thupelong ea CBME ka ho hlahloba boemo ba ho nahanisisa litlalehong tsa liithuti.
Boithuto bo sebelisitse mokhoa o akaretsang oa inductive mme ba etsa tlhahlobo ea boleng ba data ea projeke selemo le selemo ka lilemo tse tharo.E lekola litlaleho tsa SDH tsa baithuti ba bongaka ba ngolisitseng mananeong a SDH ka har'a likharikhulamo tsa CBME.Induction ka kakaretso ke mokhoa o hlophisitsoeng oa ho hlahloba lintlha tsa boleng moo tlhahlobo e ka tataisoang ke lipakane tse khethehileng tsa tlhahlobo.Sepheo ke ho lumella liphuputso tsa lipatlisiso hore li hlahe hangata, tse hlaheletseng, kapa tsa bohlokoa tse hlahang ho data e tala ho e-na le ho hlalosoa esale pele ka mokhoa o hlophisitsoeng [15].
Barupeluoa ba ithutoang e ne e le baithuti ba bongaka ba selemo sa bohlano le sa botšelela Univesithing ea Tsukuba School of Medicine ba qetileng koetliso ea bongaka ea libeke tse 4 thutong ea CBME lipakeng tsa Loetse 2018 le Mots'eanong 2019 (2018-19).Hlakubele 2020 (2019-20) kapa Mphalane 2020 le Phupu 2021 (2020-21).
Sebopeho sa thupelo ea CBME ea libeke tse 4 se ne se ka bapisoa le lithuto tsa rona tse fetileng [13, 14].Baithuti ba nka CBME selemong sa bona sa bohlano kapa sa botšelela e le karolo ea thupelo ea Introduction to Medicine, e reretsoeng ho ruta litsebi tsa tlhokomelo ea bophelo tsebo ea motheo, ho kenyeletsoa ntlafatso ea bophelo bo botle, botsebi, le tšebelisano-'moho le litsebi.Lipheo tsa kharikhulamo ea CBME ke ho pepesetsa baithuti liphihlelong tsa lingaka tsa malapa tse fanang ka tlhokomelo e nepahetseng maemong a fapaneng a bongaka;tlaleha matshwenyeho a bophelo ho baahi, bakudi, le malapa tsamaisong ya lehae ya tlhokomelo ya bophelo;le ho ntlafatsa tsebo ea ho beha mabaka ka bongaka..Libeke tse ling le tse ling tse 4, baithuti ba 15-17 ba nka thupelo.Liphetoho li kenyelletsa beke ea 1 sebakeng sa sechaba, libeke tse 1-2 tleliniking ea sechaba kapa sepetlele se senyenyane, ho fihlela beke e le 'ngoe sepetleleng sa sechaba, le beke ea 1 lefapheng la meriana ea malapa sepetleleng sa univesithi.Matsatsing a pele le a ho qetela, baithuti ba bokana univesithing ho tla lipuong le lipuisanong tsa sehlopha.Letsatsing la pele, matichere a ile a hlalosetsa liithuti lipakane tsa thupelo.Baithuti ba tlameha ho fana ka tlaleho ea ho qetela e amanang le sepheo sa thupelo.Litsi tse tharo tsa mantlha (AT, SO, le JH) li rera boholo ba lithuto tsa CBME le merero ea SDH.Lenaneo le fanoa ke lefapha la mantlha le lefapha la adjunct la 10-12 bao e ka bang ba nkang karolo lithutong tsa undergraduate univesithing ha ba ntse ba fana ka mananeo a CBME joalo ka lingaka tsa malapa kapa lefapha la bongaka leo e seng ngaka le tloaelaneng le CBME.
Sebopeho sa morero oa SDH thupelong ea CBME se latela sebopeho sa lithuto tsa rona tse fetileng [13, 14] 'me se lula se fetoloa (setšoantšo sa 1).Letsatsing la pele, liithuti li ile tsa ea puong ea SDH ea matsoho 'me tsa qeta likabelo tsa SDH nakong ea potoloho ea libeke tse 4.Baithuti ba ile ba kōptjoa hore ba khethe motho kapa lelapa leo ba kopaneng le lona nakong ea koetliso ea bona ’me ba bokelle boitsebiso ho nahana ka lintlha tse ka ’nang tsa ama bophelo ba bona.Mokhatlo oa Lefatše oa Bophelo o fana ka lintlha tse tiileng Khatisong ea Bobeli [15], lipampiri tsa tšebetso tsa SDH, le sampole ea maqephe a phethiloeng e le lisebelisuoa tsa litšupiso.Letsatsing la ho qetela, baithuti ba ile ba hlahisa linyeoe tsa bona tsa SDH ka lihlopha tse nyane, sehlopha ka seng se na le baithuti ba 4-5 le tichere e le 'ngoe.Ka mor'a tlhahiso, baithuti ba ile ba fuoa mosebetsi oa ho fana ka tlaleho ea ho qetela ea thupelo ea CBME.Ba ile ba kōptjoa ho hlalosa le ho e amahanya le phihlelo ea bona nakong ea potoloho ea libeke tsa 4;ba ile ba kōptjoa hore ba hlalose 1) bohlokoa ba litsebi tsa tlhokomelo ea bophelo bo botle ho utloisisa SDH le 2) karolo ea bona ea ho tšehetsa karolo ea bophelo bo botle ba sechaba e lokelang ho bapaloa.Liithuti li ile tsa fuoa litaelo tsa ho ngola tlaleho le boitsebiso bo qaqileng ba mokhoa oa ho hlahloba tlaleho (lisebelisoa tse tlatsetsang).Bakeng sa litlhahlobo tsa baithuti, litho tse ka bang 15 tsa lefapha la thuto e phahameng (ho kenyeletsoa le litho tsa mantlha) li ile tsa lekola litlaleho khahlano le litekanyetso tsa tlhahlobo.
Kakaretso ea lenaneo la SDH ho kharikhulamo ea CBME ea Univesithi ea Tsukuba Faculty of Medicine selemong sa thuto sa 2018-19, le ts'ebetso ea ntlafatso ea lenaneo la SDH le nts'etsopele ea mahlale lilemong tsa thuto tsa 2019-20 le 2020-21.2018-19 e bua ka moralo ho tloha ka October 2018 ho ea ho May 2019, 2019-20 e bua ka morero oa ho tloha ka October 2019 ho ea ho March 2020, 'me 2020-21 e bua ka morero ho tloha ka October 2020 ho ea ho June 2021. SDH: Litlhaloso tsa Sechaba sa Bophelo bo Botle, COVID-19: Lefu la Coronavirus la 2019
Ho tloha ha e qala ka 2018, re 'nile ra fetola lenaneo la SDH le ho fana ka nts'etsopele ea thuto.Ha morero ona o qala ka 2018, matichere a mantlha a e ntlafalitseng a ile a fana ka lipuo tsa ntlafatso ea matichere ho matichere a mang a neng a tla kenya letsoho morerong oa SDH.Thuto ea pele ea ntlafatso ea bokaholimo e ne e shebane le SDH le maikutlo a kahisano maemong a kliniki.
Ka mor'a ho phethoa ha morero selemong sa sekolo sa 2018-19, re ile ra tšoara kopano ea ntlafatso ea matichere ho buisana le ho netefatsa lipakane tsa morero le ho fetola morero ka nepo.Bakeng sa lenaneo la selemo sa sekolo sa 2019-20, le qalileng ho tloha ka Loetse 2019 ho isa Hlakubele 2020, re fane ka Litataiso tsa Batataisi, Liforomo tsa Tekolo, le Mekhoa ea Bahokahanyi ba Lefapha ho tsamaisa Litlhahiso tsa Sehlopha sa Sehlooho sa SDH ka letsatsi la ho qetela.Ka mor’a nehelano e ’ngoe le e ’ngoe ea sehlopha, re ne re tšoara lipuisano tsa sehlopha le mohokahanyi oa matichere ho nahanisisa ka lenaneo.
Selemong sa boraro sa lenaneo, ho tloha ka Loetse 2020 ho isa Phuptjane 2021, re ile ra tšoara liboka tsa ntlafatso ea mahlale ho buisana ka lipheo tsa lenaneo la thuto la SDH re sebelisa tlaleho ea ho qetela.Re entse liphetoho tse nyane tlalehong ea ho qetela ea mosebetsi le litekanyetso tsa tlhahlobo (lisebelisoa tsa tlatsetso).Hape re fetotse mokhoa oa ho kenya likopo le linako tsa ho qetela tsa ho kenya likopo ka letsoho le ho kenya pele ho letsatsi la ho qetela ho li kenya le ho kenya likopo nakong ea matsatsi a 3 ho tloha nyeoeng.
Ho khetholla lihlooho tsa bohlokoa le tse tloaelehileng tlalehong eohle, re ile ra lekola hore na litlhaloso tsa SDH li bontšitsoe hakae le ho ntša lintlha tse matla tsa 'nete tse boletsoeng.Hobane litlhahlobo tse fetileng [10] li nkile ho thuisa e le mokhoa oa tlhahlobo ea thuto le lenaneo, re entse qeto ea hore boemo bo boletsoeng ba ho thuisa tlhahlobo bo ka sebelisoa ho lekola mananeo a SDH.Ka lebaka la hore ho thuisa ho hlalosoa ka tsela e fapaneng maemong a fapaneng, re amohela tlhaloso ea ho thuisa moelelong oa thuto ea bongaka e le "mokhoa oa ho sekaseka, ho botsa le ho hlophisa bocha liphihlelo ka sepheo sa ho li lekola molemong oa ho ithuta."/ kapa ho ntlafatsa mokhoa oa ho itloaetsa," joalokaha ho hlalositsoe ke Aronson, ho latela tlhaloso ea Mezirow ea ho nahanisisa ka ho teba [16].Joalo ka thutong ea rona e fetileng [13], nako ea lilemo tse 4 ka 2018-19, 2019-20 le 2020-21.tlalehong ea ho qetela, Zhou o ile a hlalosoa e le ea hlalosang, ea hlahlobisisang, kapa e nahanang.Sehlopha sena se ipapisitse le mokhoa oa ho ngola oa thuto o hlalosoang ke Univesithi ea ho Bala [17].Kaha liphuputso tse ling tsa thuto li hlahlobile boemo ba ho thuisa ka tsela e tšoanang [18], re fumane hore ho loketse ho sebelisa sehlopha sena ho hlahloba boemo ba ho nahanisisa tlalehong ena ea lipatlisiso.Tlaleho ea tlaleho ke tlaleho e sebelisang moralo oa SDH ho hlalosa nyeoe, empa moo ho se nang kopanyo ea lintlha.Tlaleho ea tlhahlobo ke tlaleho e kopanyang lintlha tsa SDH.Reflection Litlaleho tsa thobalano ke litlaleho tseo bangoli ba tsoelang pele ho nahana ka maikutlo a bona ka SDH.Litlaleho tse sa kang tsa oela ho o mong oa lihlopha tsena li ne li hlophisoa e le tse ke keng tsa hlahlojoa.Re sebelisitse tlhahlobo ea litaba tse thehiloeng ho Sistimi e tiileng ea Lintlha, mofuta oa 2, ho lekola lintlha tsa SDH tse hlalositsoeng litlalehong [19].Likahare tsa tlaleho ea ho qetela li lumellana le merero ea lenaneo.Baithuti ba ile ba kōptjoa ho nahanisisa ka liphihlelo tsa bona ho hlalosa bohlokoa ba litsebi tsa tlhokomelo ea bophelo bo botle ho utloisisa SDH le karolo ea bona.sechabeng.SO e hlahlobile boemo ba ho bonahatsa bo hlalositsoeng tlalehong.Ka mor'a ho hlahloba lintlha tsa SDH, SO, JH, le AT li ile tsa buisana le ho tiisa mekhoa ea lihlopha.SO pheta tlhahlobo.SO, JH, le AT li ile tsa tsoela pele ho buisana ka tlhahlobo ea litlaleho tse hlokang liphetoho tsa lihlopha.Ba fihletse tumellano ea ho qetela ka tlhahlobo ea litlaleho tsohle.
Kakaretso ea baithuti ba 118, 101 le 142 ba nkile karolo lenaneong la SDH lilemong tsa thuto tsa 2018-19, 2019-20 le 2020-21.Ho bile le baithuti ba basali ba 35 (29.7%), 34 (33.7%) le 55 (37.9%) ka ho latellana.
Setšoantšo sa 2 se bonts'a kabo ea maemo a ho thuisa ka selemo ho bapisoa le thuto ea rona e fetileng, e hlahlobileng maemo a ho thuisa litlalehong tse ngotsoeng ke baithuti ka 2018-19 [13].Ka 2018-2019, litlaleho tse 36 (30.5%) li ile tsa hlalosoa e le litlaleho, ka 2019-2020 - 48 (47.5%) litlaleho, ka 2020-2021 - 79 (54.5%).Ho bile le litlaleho tsa tlhahlobo tse 9 (7.6%) ka 2018-19, 24 (23.8%) litlaleho tsa 2019-2020 le 52 (35.9%) ka 2020-21.Ho bile le litlaleho tse 2 (1.7%) tse bonts'itsoeng ka 2018-19, 6 (5.9%) ka 2019-20 le 7 (4.8%) ka 2020-21.Litlaleho tse 71 (60.2%) li ne li arotsoe e le tse ke keng tsa lekanngoa ka 2018-2019, tse 23 (22.8%) ka 2019-2020.le 7 (4.8%) litlaleho tsa 2020–2021.E khethiloe e le e ke keng ea hlahlojoa.Letlapa la 1 le fana ka litlaleho tsa mohlala bakeng sa boemo bo bong le bo bong ba boinahano.
Boemo ba ho nahanisisa ka litlaleho tsa baithuti tsa merero ea SDH e fanoeng lilemong tsa thuto tsa 2018-19, 2019-20 le 2020-21.2018-19 e bua ka moralo ho tloha ka October 2018 ho ea ho May 2019, 2019-20 e bua ka morero ho tloha ka October 2019 ho ea ho March 2020, 'me 2020-21 e bua ka morero oa ho tloha ka October 2020 ho ea ho June 2021. SDH: Li-Determinants tsa Bophelo ba Sechaba.
Liphesente tsa lintlha tsa SDH tse hlalositsoeng tlalehong li bontšoa ho Setšoantšo sa 3. Karolelano ea lintlha tse hlalositsoeng litlalehong e ne e le 2.0 ± 1.2 ka 2018-19, 2.6 ± 1.3 ka 2019-20.le 3.3 ± 1.4 ka 2020-21.
Liperesente tsa baithuti ba tlalehileng ho bua ka ntlha ka 'ngoe ho Solid Facts Framework (Khatiso ea Bobeli) litlalehong tsa 2018-19, 2019-20, le 2020-21.Nako ea 2018-19 e bua ka Mphalane 2018 ho isa Mots'eanong 2019, 2019-20 e bua ka Mphalane 2019 ho isa Hlakubele 2020 mme 2020-21 e bua ka Mphalane 2020 ho fihlela Phuptjane 2021, ana ke matsatsi a morero.Selemong sa thuto sa 2018/19 ho bile le baithuti ba 118, selemong sa thuto sa 2019/20 - baithuti ba 101, selemong sa thuto sa 2020/21 - baithuti ba 142.
Re tsebisitse lenaneo la thuto la SDH ka thupelo e hlokehang ea CBME bakeng sa baithuti ba bongaka ba pele 'me ra fana ka liphetho tsa tlhahlobo ea lilemo tse tharo ea lenaneo le hlahlobang boemo ba ho bonahatsa SDH litlalehong tsa baithuti.Ka mor'a lilemo tsa 3 tsa ho phethahatsa morero le ho tsoela pele ho o ntlafatsa, liithuti tse ngata li ile tsa khona ho hlalosa SDH le ho hlalosa tse ling tsa lintlha tsa SDH tlalehong.Ka lehlakoreng le leng, ke liithuti tse fokolang feela tse khonang ho ngola litlaleho tse nahanang ka SDH.
Ha ho bapisoa le selemo sa sekolo sa 2018-19, lilemo tsa sekolo tsa 2019-20 le 2020-21 li bone keketseho butle-butle ea karolo ea litlaleho tsa tlhahlobo le tse hlalosang, ha karolo ea litlaleho tse sa hlahlojoeng e fokotsehile haholo, e ka ba ka lebaka la ntlafatso ea lenaneo le ntshetsopele ya matichere.Nts'etsopele ea matichere e bohlokoa haholo mananeong a thuto a SDH [4, 9].Re fana ka ntlafatso e tsoelang pele ea profeshenale bakeng sa matichere a nkang karolo lenaneong.Ha lenaneo le ne le thakholoa ka 2018, Mokhatlo oa Tlhokomelo ea Motheo oa Japane, e leng e 'ngoe ea meriana ea malapa ea thuto ea Japane le mekhatlo ea bophelo bo botle ba sechaba, e ne e sa tsoa phatlalatsa polelo ea SDH bakeng sa lingaka tsa tlhokomelo ea mantlha tsa Japane.Matichere a mangata ha a tsebe lentsoe SDH.Ka ho kenya letsoho mererong le ho sebelisana le liithuti ka lipuo tsa linyeoe, butle-butle matichere a ile a tebisa kutloisiso ea bona ea SDH.Ho feta moo, ho hlakisa lipheo tsa mananeo a SDH ka nts'etsopele ea profeshenale ea matichere e tsoelang pele ho ka thusa ho ntlafatsa mangolo a thuto a matichere.Khopolo e 'ngoe e ka etsahalang ke hore lenaneo le ntlafetse ha nako e ntse e ea.Lintlafatso tse joalo tse reriloeng li ka hloka nako e ngata le boiteko.Mabapi le morero oa 2020–2021, phello ea seoa sa COVID-19 bophelong le thutong ea baithuti [20, 21, 22, 23] e ka etsa hore baithuti ba nke SDH e le taba e amang maphelo a bona le ho ba thusa ho nahana ka SDH.
Le hoja palo ea lintlha tsa SDH tse boletsoeng tlalehong e eketsehile, liketsahalo tsa lintlha tse fapaneng li fapane, tse ka 'nang tsa amana le litšobotsi tsa tikoloho ea boikoetliso.Litefiso tse phahameng tsa tšehetso ea sechaba ha li makatse ha ho nahanoa ka ho kopana khafetsa le bakuli ba seng ba ntse ba fumana tlhokomelo ea meriana.Lipalangoang li ne li boetse li boleloa khafetsa, e ka bang ka lebaka la hore libaka tsa CBME li libakeng tsa litoropo kapa tsa mahaeng moo baithuti ba hlileng ba bang le maemo a sa thabiseng a lipalangoang mme ba ba le monyetla oa ho sebelisana le batho ba maemong a joalo.Ho boetse ho boletsoe khatello ea maikutlo, ho itšehla thajana, mosebetsi le lijo, tseo baithuti ba bangata ba ka bang le tsona ha ba ntse ba ikoetlisa.Ka lehlakoreng le leng, phello ea ho se lekane sechabeng le ho hloka mosebetsi ho bophelo bo botle ho ka ba thata ho utloisisa nakong ena e khutšoanyane ea thuto.Lintlha tsa SDH tseo liithuti li kopanang le tsona ts'ebetsong li ka boela tsa itšetleha ka litšobotsi tsa sebaka sa boikoetliso.
Boithuto ba rona bo bohlokoa hobane re tsoela pele ho lekola lenaneo la SDH ka har'a lenaneo la CBME leo re le fang baithuti ba pele ba bongaka ka ho lekola boemo ba ho thuisa litlalehong tsa baithuti.Baithuti ba phahameng ba bongaka ba ithutileng bongaka ba bongaka ka lilemo tse ngata ba na le pono ea bongaka.Kahoo, ba na le monyetla oa ho ithuta ka ho amahanya mahlale a sechaba a hlokehang bakeng sa mananeo a SDH le maikutlo a bona a bongaka [14].Ka hona, ho bohlokoa haholo ho fana ka mananeo a SDH ho baithuti bana.Thutong ena, re khonne ho etsa tlhahlobo e tsoelang pele ea lenaneo ka ho lekola boemo ba ho thuisa litlalehong tsa baithuti.Campbell le ba bang.Ho ea ka tlaleho, likolo tsa bongaka tsa US le mananeo a thuso ea lingaka a hlahloba mananeo a SDH ka lipatlisiso, lihlopha tse tsepamisitsoeng maikutlo, kapa lintlha tsa tlhahlobo ea sehlopha sa bohareng.Mekhoa ea ho lekanya e sebelisoang ka ho fetisisa tlhahlobo ea morero ke karabelo le khotsofalo ea seithuti, tsebo ea seithuti, le boitšoaro ba seithuti [9], empa mokhoa o tloaelehileng le o sebetsang oa ho hlahloba merero ea thuto ea SDH ha e e-s'o thehoe.Phuputso ena e totobatsa liphetoho tsa longitudinal tlhahlobo ea lenaneo le ntlafatso e tsoelang pele ea lenaneo 'me e tla kenya letsoho ntlafatsong le tlhahlobong ea mananeo a SDH litsing tse ling tsa thuto.
Leha boemo ba ho thuisa ka kakaretso ba baithuti bo eketsehile haholo nakong eohle ea boithuto, karolo ea baithuti ba ngolang litlaleho tse hlasimollang e lutse e le tlase.Ho ka 'na ha hlokahala hore ho hlahisoe mekhoa e meng ea kahisano bakeng sa ntlafatso e 'ngoe.Likabelo lenaneong la SDH li hloka hore baithuti ba kopanye maikutlo a bophelo le a bongaka, a fapaneng ka ho rarahana ha a bapisoa le mohlala oa bongaka [14].Joalokaha re boletse ka holimo, ke habohlokoa ho fana ka lithuto tsa SDH ho liithuti tsa sekolo se phahameng, empa ho hlophisa le ho ntlafatsa mananeo a thuto ho qala qalong ea thuto ea bongaka, ho hlahisa maikutlo a kahisano le a bongaka, le ho a kopanya ho ka ba le katleho ho ntšetseng pele tsoelo-pele ea liithuti.'ntlafatsa.Ho utloisisa SDH.Katoloso e eketsehileng ea maikutlo a mesuoe ea kahisano le eona e ka thusa ho eketsa boinahano ba baithuti.
Koetliso ena e na le mefokolo e mengata.Taba ea pele, boemo ba ho ithuta bo ne bo lekanyelitsoe sekolong se le seng sa bongaka Japane, 'me boemo ba CBME bo ne bo lekanyelitsoe sebakeng se le seng sa toropo kapa mahaeng a Japane, joalo ka lithutong tsa rona tse fetileng [13, 14].Re hlalositse semelo sa phuputso ena le lithuto tse fetileng ka botlalo.Leha ho na le mefokolo ena, ke habohlokoa ho hlokomela hore re bontšitse liphetho tsa merero ea SDH mererong ea CBME ho theosa le lilemo.Ea bobeli, ho ipapisitsoe le thuto ena feela, ho thata ho fumana monyetla oa ho kenya ts'ebetsong thuto ea ho bonahatsa ka ntle ho mananeo a SDH.Lipatlisiso tse ling lia hlokahala ho khothaletsa thuto e hlakileng ea SDH lithutong tsa bongaka tsa pele.Taba ea boraro, taba ea hore na nts'etsopele ea mahlale e kenya letsoho ntlafatsong ea lenaneo e ka holimo ho menahano ea boithuto bona.Ho sebetsa hantle ha sehlopha sa matichere ho hloka boithuto le liteko tse ling.
Re entse tlhahlobo ea longitudinal ea lenaneo la thuto la SDH bakeng sa baithuti ba phahameng ba bongaka ka har'a kharikhulamo ea CBME.Re bontša hore kutloisiso ea baithuti ea SDH e ntse e tsoela pele ho teba ha lenaneo le ntse le hola.Ho ntlafatsa mananeo a SDH ho ka hloka nako le boiteko, empa nts'etsopele ea matichere e reretsoeng ho eketsa kutloisiso ea matichere ka SDH e ka atleha.Ho tsoela pele ho ntlafatsa kutloisiso ea baithuti ea SDH, ho ka 'na ha hlokahala hore ho ntlafatsoe lithupelo tse kenyellelitsoeng ho saense ea sechaba le tsa bongaka.
Lintlha tsohle tse hlahlobiloeng nakong ea thuto ea hajoale li fumaneha ho tsoa ho sengoli se tsamaisanang le sona ka kopo e utloahalang.
Mokgatlo wa Lefatshe wa Bophelo bo Botle.Lintlha tsa sechaba tsa bophelo bo botle.E fumaneha ho: https://www.who.int/health-topics/social-determinants-of-health.E fihletsoe ka la 17 Pulungoana 2022
Braveman P, Gottlieb L. Litlhaloso tsa Sechaba tsa bophelo bo botle: Ke nako ea ho sheba lisosa tsa lisosa.Litlaleho tsa Bophelo bo Botle ba Sechaba 2014;129:19–31 .
2030 Batho ba phelang hantle.Lintlha tsa sechaba tsa bophelo bo botle.E fumaneha ho: https://health.gov/healthypeople/priority-areas/social-determinants-health.E fihletsoe ka la 17 Pulungoana 2022
Komeshene ea Litsebi tsa Bophelo bo Botle ba Koetliso ea ho Kopanela Litlhaloso tsa Sechaba sa Bophelo bo Botle, Komisi ea Bophelo bo Botle ba Lefatše, Setsi sa Meriana, Likolo tsa Sechaba tsa Saense, Boenjiniere le Bongaka.Mokhoa oa ho koetlisa litsebi tsa bophelo bo botle ho sebetsana le lintlha tsa sechaba tsa bophelo bo botle.Washington, DC: National Academies Press, 2016.
Siegel J, Coleman DL, James T. Ho kopanya mekhoa ea sechaba ea bophelo bo botle ho thuto ea bongaka ea mangolo: pitso ea ho nka khato.Academy of Medical Sciences.2018;93(2):159–62.
Royal College ea Lingaka le Lingaka tsa Lingaka tsa Canada.Sebopeho sa CanMEDS.E fumaneha ho: http://www.royalcollege.ca/rcsite/canmeds/canmeds-framework-e.E fihletsoe ka la 17 Pulungoana 2022
Lewis JH, Lage OG, Grant BK, Rajasekaran SK, Gemeda M, Laik RS, Santen S, Dekhtyar M. Ho bua ka lintlha tsa sechaba tsa bophelo bo botle lithutong tsa thuto ea undergraduate Thuto ea Bongaka: Tlaleho ea Lipatlisiso.Tloaelo ea thuto e phahameng ea bongaka.2020;11:369–77.
Martinez IL, Artze-Vega I, Wells AL, Mora JC, Gillis M. Litlhahiso tse leshome le metso e 'meli tsa ho ruta mekhoa ea sechaba ea bophelo bo botle meriana.Thuto ea bongaka.2015;37(7):647–52.
Campbell M, Liveris M, Caruso Brown AE, Williams A, Ngongo V, Pessel S, Mangold KA, Adler MD.Ho lekola le ho lekola lintlha tsa sechaba tsa thuto ea bophelo bo botle: Phuputso ea naha ea likolo tsa bongaka tsa US le mananeo a bathusi ba lingaka.J Gen Mokoetlisi.2022;37(9):2180–6.
Dubay-Persaud A., Adler MD, Bartell TR Ho ruta likarolo tsa bophelo bo botle ba bophelo bo botle lithutong tsa bongaka tse fumaneng mangolo: tlhahlobo ea scoping.J Gen Mokoetlisi.2019;34(5):720–30.
Lekala la Thuto, Setso, Lipapali, Saense le Thekenoloji.Mohlala oa thuto ea mantlha ea thuto ea bongaka e ntlafalitsoeng 2017. (puo ea Sejapane).E fumaneha ho: https://www.mext.go.jp/comComponent/b_menu/shingi/toushin/__icsFiles/afieldfile/2017/06/28/1383961_01.pdf.E fihletsoe: December 3, 2022
Lekala la Thuto, Setso, Lipapali, Saense le Thekenoloji.Kharikhulamo ea Moetso oa Thuto ea Bongaka, Phetolelo ea 2022.E fumaneha ho: https://www.mext.go.jp/content/20221202-mtx_igaku-000026049_00001.pdf.E fihletsoe: December 3, 2022
Ozone S, Haruta J, Takayashiki A, Maeno T, Maeno T. Kutloisiso ea Liithuti tsa mekhoa ea sechaba ea bophelo bo botle thutong ea sechaba: mokhoa o akaretsang oa ho hlahloba lintlha tsa boleng.Thuto ea Bongaka ea BMC.2020;20(1):470.
Haruta J, Takayashiki A, Ozon S, Maeno T, Maeno T. Liithuti tsa bongaka li ithuta joang ka SDH sechabeng?Patlisiso ea boleng e sebelisang mokhoa oa sebele.Thuto ea bongaka.2022:44(10):1165–72.
Ngaka Thomas.Mokhoa o akaretsang oa ho hlahloba lintlha tsa tlhahlobo ea boleng.Lebitso la ka ke Jay Eval.2006;27(2):237–46.
Aronson L. Litlhahiso tse leshome le metso e 'meli bakeng sa thuto ea ho nahanisisa maemong ohle a thuto ea bongaka.Thuto ea bongaka.2011;33(3):200–5.
Univesithi ea ho Bala.Sengolwa se hlalosang, se hlahlobisisang le se nahanang.E fumaneha ho: https://libguides.reading.ac.uk/writing.E ntlafalitsoe ka la 2 Pherekhong 2020. E fihletsoe ka la 17 Pulungoana 2022.
Hunton N., Smith D. Ho nahanisisa ka thuto ea matichere: tlhaloso le ts'ebetsong.Ruta, ruta, ruta.1995;11(1):33-49.
Mokgatlo wa Lefatshe wa Bophelo bo Botle.Lintho tse khethollang bophelo bo botle ba sechaba: Lintlha tse thata.khatiso ea bobeli.E fumaneha ho: http://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf.E fihletsoe: November 17, 2022
Michaeli D., Keogh J., Perez-Dominguez F., Polanco-Ilabaca F., Pinto-Toledo F., Michaeli G., Albers S., Aciardi J., Santana V., Urnelli C., Sawaguchi Y., Rodríguez P, Maldonado M, Raffic Z, de Araujo MO, Michaeli T. Thuto ea bongaka le bophelo bo botle ba kelello nakong ea COVID-19: thuto ea linaha tse robong.International Journal of Medical Education.2022;13:35–46.
Nako ea poso: Oct-28-2023