MEASUREMENT OF ALLIANCE IN CASE MANAGEMENT SERVICES

案例管理服务联盟的衡量

• 批准号: 2643623
• 负责人: GREGORY B. TEAGUE
• 金额: $ 20.73万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-01 至 2001-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2643623
• 关键词: community mental health services; comprehensive care; data collection methodology /evaluation; dyadic interaction; functional ability; health care service evaluation; health care service utilization; housing; human subject; interview; longitudinal human study; mental disorder diagnosis; patient care management; psychiatric patient care; psychological tests; psychometrics; psychosis; psychosocial service; quality of life; self concept; social support network

Case management is a critical component of services that have developed over the past two decades for people with severe mental disorders. Several models of case management have been articulated. All of these focus significantly on the tasks and functions that case managers need to perform in behalf of the client, and performance of these activities relies heavily on development of a satisfactory collaborative relationship between case manager and client. Importance of the formation of this alliance is acknowledged implicitly or specified explicitly across all major models. However, the client-case manager relationship per se has not been adequately defined and studied. Concepts and measures of the helping relationship in psychotherapy have limited applicability to this service. Adequate definition and measurement of the case management alliance will enhance the capacity to monitor and improve implementation of service interventions in which case management plays a central and significant role. The goal of the proposed work is to develop and validate a measure for use in services research that will improve this capacity to measure and optimize client-case management alliances, both for more rapidly stabilizing clients in the community and ultimately for long-term outcome. The proposed study will entail several major components. First, the construct of case management alliance will be carefully defined and quantified in a preliminary item set. Definition will draw on a range of qualitative and quantitative sources, including previous and preliminary work with existing instruments. Consultation for conceptualization and instrument development will come from clinicians and services researchers with significant experience in the definition and measurement of case management, as well as from consumers. Second, items will be evaluated in a cross-sectional study of 500 case manager-client dyads, and a reliable measure of case management alliance will be derived and evaluated for construct and discriminant validity. Third, the measure will be evaluated against two-year outcomes for predictive validity in a prospective, longitudinal study with 180 dyads. Consumers and providers in both rural urban settings in New Hampshire and Washington, D.C. will provide data for instrument development and validation. Final analysis will evaluate the contribution of case management alliance to focal, intermediate-range outcomes, such as stabilization of housing, substance use, disruptive consequences of symptoms, and engagement in both treatment and community, and will also address the time of development of alliance and its relevance to other outcome domains.

案例管理是开发服务的关键组成部分 在过去的二十年中，患有严重精神障碍的人。 已经阐明了几种案例管理模型。 所有这些 大量专注于案件经理需要的任务和功能 代表客户执行和这些活动的表现 在很大程度上依赖于令人满意的协作关系的发展 在案例经理和客户端之间。 形成的重要性 联盟被隐式地承认或明确指定 主要模型。 但是，客户端经理关系本身具有 未得到充分定义和研究。 概念和衡量 在心理治疗方面有帮助的关系有限 服务。 案件管理的适当定义和衡量 联盟将增强监视和改善实施的能力 服务干预措施在这种情况下扮演着中心和 重要作用。 拟议工作的目的是发展和 验证一种用于服务研究的措施，以改善这一点 衡量和优化客户库管理联盟的能力 为了更快地稳定社区中的客户，最终 长期结果。 拟议的研究将需要几个主要组成部分。 首先， 案件管理联盟的构建将仔细定义，并 在初步项目集中量化。 定义将利用一系列 定性和定量来源，包括以前和初步 使用现有工具。 概念化咨询和 仪器开发将来自临床医生和服务研究人员 在案件的定义和测量方面具有丰富的经验 管理以及消费者。 其次，将评估项目 对500个案例经理 - 客户二元组的横断面研究，可靠 案件管理联盟的衡量标准将得出和评估 构建和判别有效性。 第三，将评估该措施 反对预期有效性两年的结果， 纵向研究，有180个二元组。 两个农村的消费者和提供者 新罕布什尔州和华盛顿特区的城市环境将为 仪器开发和验证。 最终分析将评估 案例管理联盟对焦点，中间范围的贡献 结果，例如稳定住房，使用物质，破坏性 症状的后果以及在治疗和社区中的参与， 并将解决联盟及其发展的时间 与其他结果领域相关。