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.

案例管理是已开发的服务的重要组成部分 过去二十年来，对于患有严重精神障碍的人来说。 已经阐明了案件管理的几种模型。 所有这些 重点关注案例经理需要执行的任务和职能 代表客户执行，以及执行这些活动 很大程度上依赖于令人满意的合作关系的发展 案件经理和客户之间。 这个成立的重要性 联盟在所有方面都被隐式承认或明确指定 主要型号。 然而，客户与案例经理的关系本身 没有得到充分的定义和研究。 的概念和措施 心理治疗中的帮助关系对此的适用性有限 服务。 案例管理的充分定义和衡量 联盟将增强监测和改进实施的能力 案例管理发挥核心作用的服务干预措施 的重要作用。 拟议工作的目标是开发和 验证用于服务研究的措施，以改善这一点 衡量和优化客户案例管理联盟的能力 为了更快地稳定社区中的客户，并最终 长期结果。 拟议的研究将包括几个主要部分。 首先， 案件管理联盟的构建将被仔细定义和 在初步项目集中进行量化。 定义将借鉴一系列 定性和定量来源，包括先前和初步 使用现有仪器。 概念化咨询和 仪器开发将由临床医生和服务研究人员进行 在案例的定义和衡量方面具有丰富的经验 管理层以及消费者。 其次，评估项目 对 500 个案例经理-客户二人组的横断面研究，以及可靠的 将得出案例管理联盟的衡量标准并对其进行评估 构造效度和判别效度。 三、对措施进行评估 针对前瞻性预测有效性的两年结果， 180 组的纵向研究。 农村地区的消费者和提供者 新罕布什尔州和华盛顿特区的城市环境将提供以下数据： 仪器开发和验证。 最终分析将评估 案例管理联盟对焦点、中程的贡献 结果，例如住房稳定、物质使用、破坏性 症状的后果以及参与治疗和社区， 还将阐述联盟及其发展的时间 与其他成果领域的相关性。