ABSTRACT
The Work Accidents and Occupational Diseases Act exists in Chile since 1968. It uses a single model for the understanding and management of both somatic diseases like silicosis and psychiatric disorders. During the last decade in Chile, the consultation rates due to psychiatric conditions of probable labor origin has rose over 1,000%, a factor that underscored the deficiencies of this model. The aim of this paper is to analyze the consequences of the application of this act in the psychiatric field for almost 50 years after its promulgation. This article contains an historical overview and an epistemological debate based on the authors experience dealing with clinical and administrative work both in occupational psychiatry departments and in regulatory entities. The development of occupational mental health in Chile is examined as part of an historical process that initially did not consider the relationship between work and mental suffering as relevant. The application of a single causality model in psychiatry, as well as the effects of building a psychiatric nosology upon legal rather than medical criteria is contested.
Subject(s)
Humans , Mental Disorders , Occupational Diseases/psychology , Occupational Medicine/legislation & jurisprudence , ChileABSTRACT
Objetivo: Implementar el modelo de manejo de casos y evaluar su efectividad en pacientes hospitalizados con diabetes mellitus tipo 2Metodología: Muestra de 17 pacientes hospitalizados con diabetes mellitus tipo 2 para dos grupos, experimental y control. Etapas del estudio: a) selección de pacientes y capacitación del equipo multidisciplinario, b) intervención multidisciplinaria y c) seguimiento en el hogar.Resultados: Grupo experimental: media de días estancia hospitalaria de 4.88. Sólo 11.8 por ciento de los pacientes tuvo un reingreso hospitalario en los seis meses posteriores al egreso. Media de hemoglobina glucosilada al ingreso al hospital 11.45 por ciento; al finalizar la intervención 8.84 por ciento, la prueba de comparación de medias t de Student reportó diferencia significativa (p=.001).Grupo control: media de días estancia de 6.24. En los siguientes seis meses 35.3 por ciento tuvieron de uno a dos reingresos. Conclusiones: El grupo experimental reportó menores días estancia y reingresos hospitalarios, mayor conocimiento y acciones de autocuidado para el tratamiento de la enfermedad, mayor involucramiento de la familia en el cuidado y mejor control glucémico a través de la hemoglobina glucosilada...