McDaniel C
Issues Ment Health Nurs. 1990;11(4):397-405. doi: 10.3109/01612849009006525.
This article describes the reorganization of one part of an individual, home visiting service for mentally dysfunctional women into a group intervention. Deinstitutionalization has been followed by escalating health care costs, cost containment, and restructuring of services, affecting the already constrained resources for community psychiatric services. Faced with these challenges, a nursing staff, under the administration of a clinical specialist psychiatric nurse, began reorganization of a home visiting service with one trial group. The model group used the prior success reports of groups that were adapted prospectively with a focus on immediate needs and led by nurses for women. The aims were to enhance social supports of the clients while reducing their relapse rates and to reduce the personnel time and cost. Evaluation found that these objectives were met. Thus, the involvement of nurses in the assessment, planning, implementation, and evaluation of its services demonstrates success in the redesign and reorganization of community psychiatric services.
本文描述了将针对精神功能失调女性的一项个体上门服务的一部分重新组织为小组干预的过程。去机构化之后,医疗保健成本不断攀升、成本控制以及服务结构调整,影响了本就有限的社区精神科服务资源。面对这些挑战,一组护理人员在一位临床专科精神科护士的管理下,开始对一个上门服务进行重组,并设立了一个试验组。该模式组借鉴了以往那些根据即时需求进行前瞻性调整、由护士主导且针对女性群体的成功案例。其目标是增强服务对象的社会支持,同时降低她们的复发率,并减少人员时间和成本。评估发现这些目标均已实现。因此,护士参与服务的评估、规划、实施及评价,证明了在社区精神科服务的重新设计和重组方面取得了成功。