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“自从我有了个案管理员,我便重获新生”——克罗地亚的个案管理

"Since I have my case manager, I am back to life" case management in Croatia.

作者信息

Gruber Ema N, Ivezić-Strkalj Sladana, Agius Mark, Martić-Biocina Sanja

机构信息

Neuropsychiatric hospital Dr I Barbot, Popovaca, Croatia.

出版信息

Psychiatr Danub. 2008 Mar;20(1):63-70.

Abstract

The authors present a case report of a patient who was treated by a case manager, a member of a Croatian Community Mental Health (CMH) Team, following the recommendations of WHO 2004 as well as the IRIS guidelines and the Basic Standards for Management of Patients with Serious Mental Illness in the Community (Agius 2005) and using the elements of Clinical case management (Muser 1998), Assertive community treatment model (Burns 1995, Scott 1995, Wolfsan 1990), the personal strength model (Rapp 1988) and Rehabilitation model (Anthony 1993). In order to emphasize the importance of the therapist-patient relationship in the treatment of chronic schizophrenic patients (Ivezic 2001) and creating the group atmosphere a Croatian model of case management is created where the patient's needs and risks are assessed by a multidisciplinary team which also conducts the recommended psychosocial interventions plan. The majority of interventions are conducted in groups. The case manager develops a confident relationship with a patient, nourishes the positive transference and aids the delivery of the treatment. The main goals of the interventions are empowerment of the patient, improvement of his abilities and decreasing of disabilities. The case manager also carries out a full assessment of the needs of the patient's family so that the family or carers are also included in the treatment or support if necessary (Gruber 2006). A case report of a patient and the work of her case manager as well as the case manager's diary (Gruber 2007) and the Croatian model of case management is presented in this article.

摘要

作者介绍了一例患者的病例报告。该患者由克罗地亚社区心理健康(CMH)团队的一名个案管理员按照世界卫生组织2004年的建议、IRIS指南以及社区严重精神疾病患者管理基本标准(阿吉乌斯,2005年)进行治疗,并运用了临床个案管理(穆泽尔,1998年)、积极社区治疗模式(伯恩斯,1995年;斯科特,1995年;沃尔夫桑,1990年)、个人优势模式(拉普,1988年)和康复模式(安东尼,1993年)的要素。为强调治疗师与患者关系在慢性精神分裂症患者治疗中的重要性(伊韦齐奇,2001年)并营造团体氛围,创建了一种克罗地亚个案管理模式,由多学科团队评估患者的需求和风险,该团队还实施推荐的心理社会干预计划。大多数干预在团体中进行。个案管理员与患者建立信任关系,培养积极移情并协助治疗的实施。干预的主要目标是增强患者的能力,提高其技能并减少残疾。个案管理员还对患者家庭的需求进行全面评估,以便在必要时让家庭或护理人员也参与治疗或获得支持(格鲁伯,2006年)。本文介绍了一名患者的病例报告、其个案管理员的工作以及个案管理员的日记(格鲁伯,2007年)和克罗地亚个案管理模式。

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