Institute for Health and Social Science Research, CQUniversity Australia, QLD.
Int J Ment Health Nurs. 2012 Apr;21(2):131-7. doi: 10.1111/j.1447-0349.2011.00777.x. Epub 2011 Oct 30.
Deinstitutionalization, and more recently, earlier discharges from psychiatric inpatient units, have created and intensified the need for case management in community mental health. Nurses have been at the forefront of providing this case management. This literature review provides a synthesis of research and policy on the contribution of mental health nurses to community case management. The focus of this review is on the proportion of case management that mental health nurses undertake, the caseloads of case managers, and the interventions that mental health nurses most frequently perform in the community. The professional compositions of mental health case management workforces have been associated with economic imperatives, professional priorities, and the choice of case management models. The influence of mental health nurses in the case management workforce is particularly strong in the U.K. and Australia, but less so in the U.S.A. where social workers and people without mental health qualifications perform similar roles. Although heavy caseloads seem to be common among case managers, the research in this area is quite weak. The interventions that mental health nurses perform most often include case management (e.g., coordinating care), counselling, and medication management. Caring for the physical health of consumers might often be overlooked.
去机构化，以及最近精神科住院病房更早出院，导致并加剧了社区心理健康服务中病例管理的需求。护士一直处于提供这种病例管理的前沿。本文献综述综合了关于精神科护士对社区病例管理贡献的研究和政策。本综述的重点是精神科护士承担的病例管理比例、病例管理员的工作量，以及精神科护士在社区中最常进行的干预措施。精神科病例管理工作队伍的专业构成与经济需要、专业重点和病例管理模式的选择有关。在英国和澳大利亚，精神科护士在病例管理工作队伍中的影响力尤其强大，但在美国则较弱，因为社会工作者和没有心理健康资格的人也扮演着类似的角色。尽管病例管理员的工作量似乎很大，但该领域的研究相当薄弱。精神科护士最常进行的干预措施包括病例管理（例如，协调护理）、咨询和药物管理。照顾消费者的身体健康往往容易被忽视。
