Research on the Development of the Model of Case Management for Mental Disorders in the Community

本研究旨在发展个案管理模式，以加强社区精神障碍患者的自我调节。本研究共分三个步骤。第一步，1995年对8例精神障碍患者进行访谈，并进行定性分析。在1996年的第二步研究中，对10名护理者进行了访谈和分析，这些护理者分别是医生、公共卫生护士、家访护士和工作培训机构的顾问。在1997年的第三步，将前人的研究结果与文献进行了比较，并建立了加强社区精神障碍患者自我调节的病例管理模式。这些研究的结果是愚蠢的：1)社区精神障碍患者的自我调节包括4个组成部分，分别是学会与疾病和症状相伴；学会与他人互动；学会有日常生活的方式；扩大白天的消遣场所；2)照顾者对社区精神障碍患者有5项功能，分别是加强自我决定力、掌握疾病意识、应对症状、安排日常生活节奏、白天有地方住。3)照顾者有特殊能力发展与精神障碍者之间的关系，并从病例管理者和协调系统的功能角度进行了讨论。讨论了没有病例经理来协调服务和精神疾患的需求，也没有与每个专业人员合作的制度。

The purpose of this study was to develop the case management model, which was for reinforcement of self-regulation among mental disorders who were living in the community. There were 3 steps in this study. On the first step, in 1995,8 mental disorders were interviewed and analyzed qualitatively. Then on the second step of this study in 1996,10 care takers, who were physicians, public health nurses, home-visit nurse, and advisor at work-training house, were interviewed and analyzed by grounded-theory approach. On the third step in 1997, the results of the previous studies were compared with literature, and case management model for reinforcement of self-regulation among mental disorders, who were living in the community, was developed.The results of these studies were as foolws :1)Self-regulation of mental disorders who were living in the community consisted of 4 components, which were <learning to keep company with illness and symptoms><learning to interact with others><learning to have rtythm of daily-living><expanding the place to spend in the day>.2)There were 5 function of care-takers to mental disorders who were living in the community, which were reinforcement of <self-determination ><grasp sense of illness><coping with symptoms><arrangement rhythm of daily-living>having the place to spend in the day>.3)Care takers had special competent to develop the relation-ship between them and mental disorders.These results were discussed from the view point of function of case-manager and coordination system. It was discussed that there was no case-manager to coodinate service along with needs of mental disoders and no system to cooperate with each professionals.