Given the complexities involved in identifying and reporting suspected cases of child abuse and neglect, it's crucial that the Mandated Reporter Guide emphasizes the importance of objective findings as solid evidence.
Objective Findings Objective findings, such as radiological findings in chiropractic clinics, can provide concrete evidence of abuse that may otherwise be missed. Radiological examinations often reveal patterns of injuries that are inconsistent with the explanations provided. For example, multiple fractures at different stages of healing, unusual fractures for the child's developmental stage, or injuries that are rare from accidental trauma. Therefore, the guide should recommend that: Chiropractors should consider ordering radiological examinations when physical examination and patient history raise suspicion of abuse, even in the absence of visible injuries. Findings from these examinations should be thoroughly documented, including the location, nature, and age of injuries. Any discrepancy between these findings and the provided history of the injury should be noted as it may indicate a potential case of abuse. Subjective Findings While subjective findings such as inconsistencies in injury history or behavioral signs can be crucial, they should not be the sole basis for reporting suspicion of abuse. Children and elderly patients may have difficulty accurately recalling events, leading to inconsistencies that are not necessarily indicative of abuse. This doesn't mean we should disregard subjective findings. On the contrary, the guide should instruct chiropractors to: Be attentive to verbal and non-verbal cues that may indicate distress or fear. Document any observed behavioral changes or emotional responses that seem disproportionate to the situation. Note any inconsistencies in the history and presentation of injuries. Limitations of Physical Examination Given the nature of chiropractic practice, chiropractors may not examine private parts such as breasts and female chest, potentially missing signs of abuse. The guide should acknowledge this limitation and recommend that: Chiropractors should be trained to identify signs of abuse visible in the areas they typically examine. If suspicion arises from observed or reported symptoms that fall outside the chiropractor's scope of practice, the chiropractor should refer the patient to a suitable medical professional for a more comprehensive examination. In conclusion, the Mandated Reporter Guide should emphasize the importance of both objective and subjective findings in identifying potential abuse cases. It should also acknowledge the limitations of physical examinations in chiropractic settings and provide guidance on referring patients for further evaluation when necessary. |
我們最近發表在《自然科學報告》上的研究剛剛在上週於澳大利亞黃金海岸舉行的第17 屆世界脊骨神經科聯合會(WFC) 雙年度大會上獲得了國際脊醫國家考試委員會(IBCE)海報獎,這標誌著該研究是最重要的研究之一專業人士:
https://www.nature.com/articles/s41598-023-28520-4。 我們的工作代表了與脊醫手法相關的不良事件的最大研究之一,包括 960,140 次治療。
✔ 我們發現與脊椎矯正相關的嚴重不良事件非常罕見,只有兩起嚴重不良事件(發生率為每 10 萬人中 0.21 例),均為骨質疏鬆症的老年女性發生的肋骨骨折。 沒有危及生命或導致死亡的不良事件。
祝賀香港執業脊醫協會和會員榮獲得了三個國際最大的奬項:世界脊柱日獎。
Public consultation on tobacco control strategies for vibrant, healthy and tobacco-free Hong Kong
尊敬的黃元山組長,
對於《2023年施政報告》的諮詢提出以下建議。我們深信脊醫在提升公眾健康,特別是針對長者和青年的保健和教育方面,均可以發揮重要作用。
1 疫情的爆發讓我們明白醫療系統的優化不僅需要增加醫護人手,更需要擴大和多元化醫療服務的提供。脊醫可以在減輕傳統醫療系統的壓力,提升城市應對突發公共衛生事件的能力方面發揮作用。因此,我們建議政府考慮在基層醫療系統中加入脊醫服務,以提供更全面的醫療護理。我們之前的建議已經交給基層醫療健康管理局 [1]。並可完善開發病假紙的權力,提升病患的照顧 [2]
2 關懷安老助弱解困的政策中,我們建議政府能夠考慮脊醫在長者健康上的貢獻。脊醫可以透過非侵入性的治療方式,幫助減輕長者的疼痛,提升他們的生活品質。對於長期關注長者健康的政府來說,這是一種有效且預防的解決方案。
3 青年的健康和教育是社會發展的重要基石。脊醫可以為青年提供正確的身體保健知識和生活習慣建議,防止因長時間坐姿不正、學習壓力大等因素導致的身體問題如脊椎側彎。業界多年來兒童提供脊科義診,及早偵查脊骨問題,從而建立「脊骨護理從小做起」的護脊習慣。我們並舉行護脊大使工作坊,裝備參加者各種護脊知識。我們需要更多的政府支持讓香港的兒童可以成長的健康和預防疾病。
4 促進脊骨神經科在香港的發展:因為尚未得到大專院校和政府的支持,業界已透過和英國大學在港成立脊骨神經醫學院,可以讓更多青年人提供脊醫訓練和發展機會,可確保脊科服務質量不斷提高。
2022年施政報告》,為香港推廣國內和國際兼得良性互動。我們在過去一年提高管理水平,完成了以下的項目