Enguidanos S
School of Social Work, University of Southern California, USA.
Home Health Care Serv Q. 2001;20(1):67-83. doi: 10.1300/J027v20n01_04.
Case management practices have continued to grow despite a lack of clear evidence of their efficacy. With the expanding segment of the elderly population, there is a critical need to develop and identify programs that will address the many needs of the aging. Geriatric Case Management has been the avenue selected by many health care providers to address these issues, focusing on maintaining health status and improving linkages with medical and community resources. Studies testing the effectiveness of these models have failed to demonstrate their effectiveness in reducing depression, reducing acute care service use, and improving or maintaining health status. The Geriatric Case Management models presented in these lack an evidence-based, theoretical framework that provides definition and direction for case management practice. This article introduces behavior change theories as a method of structuring and delineating the case management intervention. The Transtheoretical Model and the Theory of Planned Behavior are discussed and methods of integrating these theories into practice are discussed.
尽管缺乏明确的疗效证据，但病例管理实践仍在不断发展。随着老年人口的不断增加，迫切需要开发和确定能够满足老年人多种需求的项目。老年病例管理已成为许多医疗保健提供者选择的解决这些问题的途径，其重点是维持健康状况并改善与医疗和社区资源的联系。测试这些模式有效性的研究未能证明它们在减轻抑郁、减少急性护理服务使用以及改善或维持健康状况方面的有效性。这些文献中介绍的老年病例管理模式缺乏一个基于证据的理论框架，该框架可为病例管理实践提供定义和指导。本文引入行为改变理论作为构建和描述病例管理干预措施的一种方法。文中讨论了跨理论模型和计划行为理论，并探讨了将这些理论融入实践的方法。
