Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health research institute, Amsterdam, the Netherlands.
Occup Med (Lond). 2018 Nov 16;68(8):555-558. doi: 10.1093/occmed/kqy112.
Information is collected worldwide on the diagnosis and assessment of occupational diseases (ODs) by occupational physicians (OPs). However, information on perceived facilitators and barriers to assessment is scarce.
To evaluate the perceived barriers and facilitators in the assessment of ODs by OPs.
We conducted a qualitative study, using interviews and focus groups. We held 12 interviews and two focus groups with Dutch OPs, to identify barriers and facilitators in the assessment of ODs.
Case definition, exposure assessment, attribution to work, guidelines and decision tools, external expertise, individual motivation and consequences were identified as themes. Barriers and facilitators were mainly reported regarding assessing work attribution, e.g. how to assess multifactorial causes or the need for training, and individual motivation such as the perceived lack of usefulness or the need for monitoring suspected OD cases. Within the theme of consequences, only barriers to the assessment of ODs were reported, including the liability of employers.
Perceived facilitators in the assessment of ODs were practical assessment tools, multifaceted education, ability to assess work exposures and professional independence. Perceived barriers were lack of usefulness, lack of urgency, complexity of assessment and concerns about liability issues.
全世界的职业医生(OP)都在收集有关职业病(OD)的诊断和评估信息。然而,关于评估的促进因素和障碍因素的信息却很少。
评估职业医生评估职业病时的感知障碍和促进因素。
我们进行了一项定性研究,采用访谈和焦点小组的形式。我们与荷兰的职业医生进行了 12 次访谈和两次焦点小组讨论,以确定在评估职业病时的障碍和促进因素。
确定了病例定义、暴露评估、归因于工作、指南和决策工具、外部专业知识、个人动机和后果等主题。障碍和促进因素主要是关于评估工作归因的,例如如何评估多因素原因或培训的需求,以及个人动机,例如认为缺乏有用性或需要监测疑似 OD 病例。在后果主题中,仅报告了评估 OD 的障碍,包括雇主的责任。
评估 OD 时的感知促进因素包括实用的评估工具、多方面的教育、评估工作暴露的能力和专业独立性。感知障碍包括缺乏有用性、缺乏紧迫性、评估的复杂性以及对责任问题的担忧。