Assessment of the Cardiovascular System at the Workplace

Details

• Personal Author:
  Belkic K ; Pickering TG ; Schnall P ; Belkic K ; Pickering TG ; Schnall P
• Description:
  In the process of ascertaining the cause of an illness (i.e., making the diagnosis) the medical history plays a key role, as the information obtained from the patient informs the analytic process and shapes subsequent questioning. This exchange leads to an ongoing iterative process which, hopefully, results in an intervention intended to correct the problem. The key to the success of this endeavor for the physician is to obtain complete and accurate information from the patient(s) regarding symptoms and other related historical information such as past history of exposures. There are unfortunately, a number of reasons, many of which are not under the control of the clinician, as to why this is easier said than done. The person being interviewed may be unaware of his or her condition, or may feel anxious over the symptom or illness and frightened of the possible diagnosis with its implications for future health. Denial may dominate the person's responses if there is a general' fear of life-threatening illness, or if there are other possible negative consequences of a diagnosis. All of these factors may interfere with the doctor-patient relationship. The health professional must be aware that employees may fear losing their jobs under certain circumstances as the result of a visit to a physician. This obstacle is of greatest concern in the work setting. In fact, doctors often function as "gatekeepers," especially in their role of evaluating an individual's· fitness for work. Working people usually are well aware of this function and may act in what they perceive to be "their own best interest." The individual's need to continue working may hamper a frank admission of symptoms or conditions which could compromise employability. The physician needs to be acutely aware of the complex social relationships among the patient, clinician, and employer, as well as of societal expectations. The perception that the clinician is acting in the interests of the company can have a chilling effect on the patient. Ethical issues involving confidentiality are raised by this gatekeeping function (see Chapters 8, 9, and 10). Limitation on clinician's time, especially in primary care settings, represents yet another impediment to obtaining an adequate history. Accurate history-taking requires that the clinician first and foremost establish a rapport with the patient. The interview must be conducted in an environment that is conducive to developing a trusting relationship. The clinician must communicate an interest in the person and a willingness to listen. Time constraints undermine this entire process. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Diagnosis Occupational Health Safety Stress, Psychological Workplace
• Keywords:
  Blood Pressure Cardiovascular Disease Clinical Diagnosis Heart Disease Hypertension Job Stress Medical Screening Workplace Monitoring
• ISSN:
  0885-114X
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article ; Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH) ; National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health ; Workplace Safety & Health
• Location:
  North America ; North America
• Pages in Document:
  189-212
• Volume:
  15
• Issue:
  1
• NIOSHTIC Number:
  nn:20058212
• Citation:
  Occup Med: State of the Art Rev 2000 Jan-Mar; 15(1):189-212
• Federal Fiscal Year:
  2000
• Performing Organization:
  University of California, School of Public Health, Los Angeles, CA
• Peer Reviewed:
  True
• Start Date:
  19990701
• Source Full Name:
  Occupational Medicine: State of the Art Reviews
• End Date:
  20040630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7efe963395a4f90a0cfed5f8b1590627a99ac84f151428a182f648412da6df3ba39b1c34ed28eeac81ff04c30ecd179e3c99f432af23154c5951bd2d79fb1af7
• Download URL:
  https://stacks.cdc.gov/view/cdc/221346/cdc_221346_DS1.pdf
• File Type:
  [PDF - 1.77 MB ]