You Emily Chuanmei, Dunt David, Doyle Colleen
Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
The Wesley-St. Andrew's Research Institute, Toowong, Queensland, Australia.
Health Soc Care Community. 2016 Jul;24(4):495-506. doi: 10.1111/hsc.12238. Epub 2015 May 13.
This study aimed to explore the perceptions of case managers about their roles in providing community aged care in Australia. Purposeful sampling was used and 33 qualitative semi-structured interviews with 47 participants were conducted. Participants were drawn from a list of all case managers working in aged care organisations that provided publicly funded case-managed community aged care programmes in the State of Victoria, Australia. Participant selection criteria included age, gender, job titles, professional backgrounds, practice locations, organisational attributes and organisational size. Data collection was implemented between September 2012 and March 2013. Thematic analysis was performed. Participants believed that case managers performed diverse roles based on clients' needs. They also articulated 16 important roles of case managers, including advisors, advocates, carers, communicators, co-ordinators, educators, empowering clients, engaging clients and families, liaising with people, managing budgets, navigators, negotiators, networking with people, facilitators, problem solvers and supporters. However, they were concerned about brokers, mediators and counsellors in terms of the terminology or case managers' willingness to perform these roles. Moreover, they perceived that neither gatekeepers nor direct service provision was case managers' role. The findings of this study suggest that case managers working in community aged care sectors may be more effective if they practised the 16 roles aforementioned. With the value of helping rather than obstructing clients to access services, they may not act as gatekeepers. In addition, they may not provide services directly as opposed to their peers working in medical care settings. The findings will also assist organisations to design job descriptions specifying case managers' roles and associated job responsibilities. Clear job descriptions will further benefit the organisations in staff recruitment, orientation and ongoing development, as well as facilitate case managers to set professional boundaries in the delivery of case management interventions to their clients.
本研究旨在探究个案经理对自身在澳大利亚社区老年护理中所扮演角色的看法。采用了立意抽样法，对47名参与者进行了33次定性半结构化访谈。参与者来自在澳大利亚维多利亚州提供由公共资金资助的个案管理社区老年护理项目的老年护理机构的所有个案经理名单。参与者的选择标准包括年龄、性别、职位、专业背景、工作地点、组织属性和组织规模。数据收集于2012年9月至2013年3月期间进行。进行了主题分析。参与者认为个案经理根据客户需求履行多种角色。他们还阐明了个案经理的16个重要角色，包括顾问、倡导者、照顾者、沟通者、协调者、教育者、赋能客户、让客户及家庭参与、与人联络、管理预算、导航者、谈判者、与人建立网络、促进者、问题解决者和支持者。然而，他们在术语或个案经理履行这些角色的意愿方面对经纪人、调解人和顾问存在疑虑。此外，他们认为把关人和直接提供服务都不是个案经理的角色。本研究结果表明，在社区老年护理部门工作的个案经理如果履行上述16种角色可能会更有效。由于秉持帮助而非阻碍客户获取服务的价值观，他们可能不会充当把关人。此外，与在医疗环境中工作的同行不同，他们可能不会直接提供服务。这些结果还将帮助组织设计明确个案经理角色及相关工作职责的职位描述。清晰的职位描述将进一步使组织在员工招聘、入职培训和持续发展方面受益，同时也有助于个案经理在向客户提供个案管理干预时设定专业界限。
