Kanter J
Community Care Unit, Mount Vernon Center for Community Mental Health, Alexandria, Virginia.
Hosp Community Psychiatry. 1989 Apr;40(4):361-8. doi: 10.1176/ps.40.4.361.
The burgeoning field of case management for long-term psychiatric patients has been handicapped by a lack of conceptual models that delineate the diverse activities of case managers. Based on the actual practice of case management, the author outlines a model of clinical case management that moves beyond the view of the case manager as a systems coordinator, service broker, or supportive companion. Using a contemporary biopsychosocial model of mental illness, the clinical case management model integrates the clinical acumen, personal involvement, and environmental interventions needed to address the overall maintenance of the patient's physical and social environment. Clinical case management involves 13 distinct activities, including engagement of the patient, assessment, planning, linkage with resources, consultation with families, collaboration with psychiatrists, patient psychoeducation, and crisis intervention.
长期精神病患者病例管理这一新兴领域因缺乏描述病例管理者各种不同活动的概念模型而受到阻碍。基于病例管理的实际实践,作者概述了一种临床病例管理模型,该模型超越了将病例管理者视为系统协调员、服务经纪人或支持伙伴的观点。临床病例管理模型运用当代生物心理社会精神疾病模型,整合了应对患者身体和社会环境全面维护所需的临床敏锐度、个人参与度和环境干预措施。临床病例管理涉及13项不同活动,包括患者参与、评估、规划、资源链接、与家属协商、与精神科医生协作、患者心理教育以及危机干预。