King R D, Hougland J G, Shepard J M, Gallagher E B
Eval Health Prof. 1980 Mar;3(1):85-101. doi: 10.1177/016327878000300105.
Normalization has gained wide acceptance as a goal that residential institutations for the mentally retarded should strive to achieve, but many organizations have been shown to have difficulty achieving the goal. Theories developed from the organizational contingency perspective suggest that organizations with bureaucratic structures will have particular difficulty accomplishing the nonroutine tasks associated with normalization. Our major purpose was to test the usefulness of such theories for the evaluation of mental retardation facilities by ascertaining whether a less bureaucratic organization for the mentally retarded would achieve greater success than a more bureaucratic organization. The closing of a large public hospital and the subsequent transfer of most of its residents to two new facilities (one of which was more bureaucratic than the other) allowed us to examine bureaucracy's effect on treatment. As predicated, the analysis showed that the less bureaucratic organization produced a greater average positive change in behavior than did the more bureaucratic organization. A number of clinical and demographic characteristics of the residents which could have influenced the observed changes in behavioral level were identified and controlled. They were not found to explain the differences between facilties. Other factors, which could not be controlled in this study, provide suggestions for future research.
将正常化作为智障人士寄宿机构应努力实现的目标已获得广泛认可,但事实表明许多机构在实现这一目标方面存在困难。从组织权变视角发展而来的理论表明,具有官僚结构的组织在完成与正常化相关的非常规任务时会特别困难。我们的主要目的是通过确定一个官僚化程度较低的智障人士机构是否会比官僚化程度较高的机构取得更大成功,来检验此类理论对评估智障设施的有用性。一家大型公立医院的关闭以及随后将其大多数住院患者转移到两个新设施(其中一个比另一个官僚化程度更高),使我们能够研究官僚作风对治疗的影响。正如所预测的那样,分析表明,官僚化程度较低的机构比官僚化程度较高的机构在行为上产生了更大的平均积极变化。确定并控制了一些可能影响观察到的行为水平变化的住院患者的临床和人口统计学特征。未发现这些特征能够解释各机构之间的差异。本研究中无法控制的其他因素为未来研究提供了建议。