一起死者家属要求职业病诊断的案例分析与思考

职业病诊断申请时,没有职业病危害接触史或者健康检查没有发现异常的,诊断机构可以不予受理。通过报道一起非直接接铅工人输液引起死亡,由家属提请的职业病诊断的案例,对职业病诊断申请过程中存在的一些问题进行探讨,并寻找相关的解决方案。     

泉州市2009～2011年疑似职业病诊断申请及诊断情况分析

目的了解泉州市职业病诊断申请情况及诊断情况。方法选择2009~2011年到我市职业病诊断机构申请职业病诊断的人员共134人,并对他们的申请及诊断情况进行分析。结果 2009~2011年泉州市职业病诊断申请主体为劳动者(59.7%),职业病诊断申请未受理的主要原因为劳动关系不明确或存在劳动关系但资料不全,用人单位不提供资料为多(57.1%);职业病诊断病种以尘肺为主为89.2%,慢性职业中毒次之为10.0%(职业性慢性苯中毒4.2%,职业性慢性正己烷中毒5.8%),职业性噪声聋0.83%。职业病病例主要发生在小型企业,特别是小作坊等,占67.5%。结论劳动者在职业病诊断申请中仍为弱势群体,职业病防治以尘肺为主,防治重点在小型私营企业。     

避免职业病诊断重复申请的思考

职业病诊断申请过程中, 出现重复诊断的现象一直未能引起足够的重视。通过报道一起因用人单位未开展上岗前体检, 劳动者隐瞒既往职业史和职业病诊断结果, 诊断机构不能获取其他诊断机构诊断记录而导致的职业病重复诊断的案例, 对职业病诊断申请过程中存在的解决问题进行探讨, 并提出需完善相关法律法规、加大执法监督力度、加强各部门之间的联系以及加强宣传教育等建议。     

疑似职业病发现与诊断法律问题的探讨

目的分析现行职业病防治法律法规中对于疑似职业病发现及诊断的几个法律规定。方法对两起"疑似职业病"案件发现及诊断过程进行探讨。结果①接触粉尘与接触引起急性中毒化学毒物的上岗前、在岗期间职业健康体检时限的界定要结合实际情况;②疑似职业病申请确诊属于要式申请行为;③未进一步进行疑似职业病确诊的企业应受法律的制裁。启示用人单位始终是职业病防治工作的主体,应进一步贯彻职业病防治法的方针和原则。     

对职业病诊断过程中所遇若干问题的处理

自《中华人民共和国职业病防治法》及其相关法规《职业病诊断与鉴定管理办法》颁布以来,申请职业病诊断的劳动者与用人单位日益增多,现就我们在职业病实际诊断过程中所遇若干问题的处理做一简述,以便及时发现问题,共同探讨,更好地开展职业病诊断工作。     

职业病诊断问题与对策

职业病诊断是一项法制性和技术性很强的工作。但在职业病诊断过程中存在诸多问题,如职业病危害接触史材料提供、职业病诊断机构选择、临床诊断后再申请职业病诊断等。为保障劳动者健康权益,进一步规范职业病诊断与鉴定工作,现结合工作实际,特就职业病诊断中存在的问题提出一些建议,为政府部门制订相关政策提供科学依据。     

121例职业病鉴定结果分析

<正>根据《中华人民共和国职业病防治法》和《职业病诊断与鉴定管理办法》(中华人民共和国卫生部第24号令)的有关规定,当事人(用人单位、劳动者)双方对职业病诊断结果有异议时,可以向诊断机构所在地的卫生行政部门职业病鉴定机构申请职业病鉴定。现对某区职业病鉴定办公室2009—2013年受理的121例职业病鉴定结果进行分析,旨在探讨职业病诊断、鉴定过程中存在的问题并提出对策。     

如何进行职业病诊断

职业病诊断一般要经历六个阶段:一、申请提交《职业病诊断申接触情况、临床表现和就诊情况、申请诊断职业病种类。劳动者可以选择用人单位所在地或本人居住地的职业病诊断机构申请诊断。请书》:个人信息、职业病危害因素     

1例追溯诊断病例引发的思考

<正>《中华人民共和国职业病防治法》第四十六条规定：“职业病诊断应当综合分析下列因素：(1)病人的职业史;(2)职业病危害接触史和工作场所职业病危害因素情况;(3)临床表现以及辅助检查结果等。没有证据否定职业病危害因素与病人临床表现之间的必然联系的,应当诊断为职业病”。若劳动者在脱离存在职业病危害的作业岗位多年后申请职业病诊断,则需要对其证据资料进行追溯。由于时间久远,资料欠缺程度高,追溯难度大。现将1例追溯诊断病例的诊断过程加以分析,     

获知职业病诊断结果后患者心理健康状况及其影响因素分析

目的 探讨申请职业病诊断人群在完成职业病诊断后的心理健康状况及可能影响因素。
方法 2016年6月—12月,对在某职业病诊断机构完成职业病诊断并领取职业病诊断证明书后1~2个月的患者进行调查。采用12项一般健康问卷（GHQ-12）及自编相关因素调查表进行心理健康状况及可能影响因素调查。
结果 本次共随访调查完成职业病诊断人员129例,最后纳入研究94例,71例被诊断为职业病。申请职业病诊断人员GHQ-12平均得分为（7.23±4.61）分,心理障碍高危人群（总分≥ 4分者）占74.5%。logistic逐步回归分析结果显示:在性别、文化程度、病种、疾病严重程度、职业病诊断结果、对疾病认知、职业病诊断预期与结果一致性、单位客观支持评分、单位主观支持评分、月收入减少和家庭经济状况等各潜在的影响因素中,诊断为职业病的患者成为心理障碍高危人群的危险性是不能诊断为职业病患者的8.767倍（P < 0.01）;家庭经济状况越好、用人单位主观支持评分越高,越不容易成为心理障碍高危人群（OR=0.144、0.740,P < 0.05）。
结论 申请职业病诊断人群在职业病诊断后心理健康状况不佳,尤其是已确诊为职业病的患者。家庭经济状况较好且生活有结余、用人单位主观支持度高可能是保护因素。这些因素在诊治过程中应得到高度重视,以促进患者心理健康。
     

有性才会有健康

性是基本的人权。根据我国著名的性学家史成礼教授的研究,性有“三大功能”:生育功能、享乐功能和健康功能。     

Communicating with people with dementia

It can be very difficult to communicate with people with dementia. Each case requires its own unique handling. Not every scenario is covered, as many times your own judgment is what will work, best according to the circumstances. These can change from dawn to evening and from day to day. Never assume things will be the way they were the last time you communicated. Be on your guard. Be adaptable. The article will help get you started to think of your own ways to communicate.     

Coping with Children with ADHD: Coping Styles of Mothers with Children with ADHD or Challenging Behaviours

Parents of children with Attention Deficit Hyperactivity Disorder (ADHD) can experience significant levels of stress in their parenting roles, however, little is known about the specific coping strategies used by these parents. This pilot study Investigated the coping strategies used by mothers of children with ADHD. A 34 item questionnaire was developed to identify maternal coping strategies. A cohort of 38 mothers of children with ADHD and a control group of 30 mothers of children without ADHD or any other disability/illness completed the questionnaire. Factor analysis of responses produced three factors: Aggressive/Confrontive Coping, Rational Coping, and Indirect Coping. These factors are similar to coping dimensions proposed by Folkman and Lazarus. Comparisons between the two groups of mothers revealed that mothers of children with ADHD used significantly more Indirect Coping.     

经方汗证治验

临床上汗证病情复杂,分自汗、盗汗、黄汗和但头汗出,治疗汗证方药诸多,有益气固表、养阴清热和清热除湿等方法,疗效不一。受恩师刘健主任教导和《伤寒论》《金匮要略》病脉证并治启发,以脉证并治、方证对应思想,浅谈桂枝加附子汤、黄芪芍药苦酒汤、柴胡桂枝干姜汤和三物黄芩汤治疗汗证的经验,为经方治疗汗证提供新思路。     

Working with patients with physical disabilities

Medical practices need to make a number of adaptations to ensure that their facilities and staff are accessible to patients and other office visitors with physical disabilities. This article describes 10 specific strategies for preparing your medical practice for patients with disabilities, both inside and outside your office. It describes minimum standards for office doorways, sidewalk inclines, ramps, reception areas, and other adaptations medical offices need to make. The article also describes specific do and don't advice for communicating with patients with physical disabilities. It suggests strategies for preparing written materials for disabled patients, for communicating verbally, and for providing healthcare education. Finally, it suggests an appropriate role for medical practice staff in the delivery of healthcare services to patients with physical disabilities.     

Problems with measuring satisfaction with social care

The measurement of customer satisfaction has become widespread in both healthcare and social care services, and is informative for performance monitoring and service development. Satisfaction with social care services is routinely measured with a single question on overall satisfaction with care, comprising part of the Adult Social Care Survey. The measurement of satisfaction has been problematised, and existing satisfaction measures are known to be under‐theorised. In this article, the process of making an evaluation of satisfaction with social care services is first informed by a literature review of the theoretical background, and second examined through qualitative interviews conducted in 2012–2013 with 82 service users and family carers in Hampshire, Portsmouth and Southampton. Participants in this study were from white British and South Asian backgrounds, and the influence of ethnicity in the process of satisfaction evaluation is discussed. The findings show that the majority of participants selected a positive satisfaction rating even though both positive and negative experiences with services were described in their narratives. It is recommended that surveys provide opportunity for service users and family carers to elaborate on their satisfaction ratings. This addition will provide more scope for services to review their strengths and weaknesses.     

Qualitative research with people with intellectual disability

Qualitative research methods are gaining popularity in disability research, in particular as a way to explore the personal experience of disability. However, using these methods can be problematic with people traditionally regarded as vulnerable in the research relationship. People with intellectual disability are often so regarded. This paper discusses ethical concerns and issues of research credibility in qualitative research with this group of disabled people. An ethnographic study about the parenting experience of parents with intellectual disability is used to illustrate strategies to achieve credibility in qualitative studies in intellectual disability research.