An Evaluation of the Implementation of Case Management in the Community Psychiatric Nursing Service (CPNS)

2.50
Hdl Handle:
http://hdl.handle.net/10755/151845
Type:
Presentation
Title:
An Evaluation of the Implementation of Case Management in the Community Psychiatric Nursing Service (CPNS)
Abstract:
An Evaluation of the Implementation of Case Management in the Community Psychiatric Nursing Service (CPNS)
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Chan, Sally
P.I. Institution Name:University of Hong Kong
Title:Professor, Faculty of Medicine Building
Objectives: The aim of this study was to compare the outcomes of a case management service with that of the conventional CPNS for chronic schizophrenic clients living in Hong Kong. The objectives were: to estimate the impact of case management on clients' clinical outcome, functional level, satisfaction, and readmission rate; and to compare the cost-effectiveness of the two interventions. Design: An experimental design was used. Population, sample, setting, years: 62 subjects were recruited from a mental hospital in Hong Kong and they were randomly assigned to experimental and control group with 31 in each group. Recruitment of clients took place over a 6-month period. Inclusion criteria were: · those who were diagnosed by their whose attending psychiatrist as having schizophrenia according to criteria of the Diagnostic Statistical Manual IV and who has had the illness for at least 2 years · those who were new to the CPNS · those with three or more hospital admissions in the past 24 months, and any one of the following criteria: · those who require supervision with their living skills, · those who have been unemployed for at least the past 3 months, · those who have been unreliable in compliance with treatment over the past 24 months, and · those who have history or tendency of self-harm or harming others · lived with one or more dependent persons, e.g. elderly parent(s), child(ren). A sampling exclusion criteria were · clients who are at age 65 or above or under 18. · clients with a secondary diagnosis. Ten CPNs working in the research site were chosen as Case Managers by the Departmental Operation Manager. The inclusion criteria for these Case Managers were: .hold a Registered Nurse grade or above. .have at least 2 years' experience in CPNs. Intervention and outcome variables: The experimental group was taken care of by CPNs using case management model while the control group was taken care of by CPNs using conventional care model. A case management model was developed by the research team based on the practice model in Carondelet Saint Mary's Hospital and Health Centre in Tucson (Mitchell and Reaghard, 1996) and relevant literature (Carpenter, 1992). Application of the case management model or conventional CPNS for each client was for at least five months in all cases. Subjects were then being followed up for six months to monitor readmission rate. During the follow up period, the service to the experimental group and control group was maintained. Main outcome measures were: . Brief Psychiatric Rating Scale (BPRS) (Overall and Gorham, 1962). Specific level of Functioning Scale (SLOF) (Schneider and Struening, 1983). Patient Satisfaction Instrument (PSI) (Risser, 1975)(Chinese version) Readmission rate. Cost-effective analysis. Method: Pre and post measures were taken upon recruitment and at 5 months later. Subjects were followed up for six months. Findings: The results showed that the experimental group had better outcome in terms of their mental status and functional level, and satisfaction with the service when compared with control group. Clients in the experimental group showed more improvement in areas such as tension, suspiciousness, hallucinatory behaviour and thought disturbance. The experimental groups had better improvement when compared with control group in areas such as personal care skills, interpersonal relationship, social acceptability and community living skills. The experimental group also felt that the case managers had more time to listen and talk to them and they felt secure when being with the case managers. However, there was no difference in the readmission rate between the two groups. When analysing the cost, there was no significant difference in the cost of the service between the two groups. Conclusion: Results of this study showed that case management model seemed to have a positive impact on clients' mental status, functional level and satisfaction. There was no significant difference between the cost of the two groups. Case management is an effective care model for chronic mentally ill clients in the community. Implications: The implementation of case management is recommended for this group of clients. CPNs appeared to be suitable persons to take up the role of the case managers and are value for money. Case management can be an expanded role for CPNs. CPNs need to develop skills and knowledge to accomplish the expanded role. It is recommended that CPN training should prepare the CPNs for this expanded role.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAn Evaluation of the Implementation of Case Management in the Community Psychiatric Nursing Service (CPNS)en_GB
dc.identifier.urihttp://hdl.handle.net/10755/151845-
dc.description.abstract<table><tr><td colspan="2" class="item-title">An Evaluation of the Implementation of Case Management in the Community Psychiatric Nursing Service (CPNS)</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Chan, Sally</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Hong Kong</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor, Faculty of Medicine Building</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">sallychan@cuhk.edu.hk</td></tr><tr><td colspan="2" class="item-abstract">Objectives: The aim of this study was to compare the outcomes of a case management service with that of the conventional CPNS for chronic schizophrenic clients living in Hong Kong. The objectives were: to estimate the impact of case management on clients' clinical outcome, functional level, satisfaction, and readmission rate; and to compare the cost-effectiveness of the two interventions. Design: An experimental design was used. Population, sample, setting, years: 62 subjects were recruited from a mental hospital in Hong Kong and they were randomly assigned to experimental and control group with 31 in each group. Recruitment of clients took place over a 6-month period. Inclusion criteria were: &middot; those who were diagnosed by their whose attending psychiatrist as having schizophrenia according to criteria of the Diagnostic Statistical Manual IV and who has had the illness for at least 2 years &middot; those who were new to the CPNS &middot; those with three or more hospital admissions in the past 24 months, and any one of the following criteria: &middot; those who require supervision with their living skills, &middot; those who have been unemployed for at least the past 3 months, &middot; those who have been unreliable in compliance with treatment over the past 24 months, and &middot; those who have history or tendency of self-harm or harming others &middot; lived with one or more dependent persons, e.g. elderly parent(s), child(ren). A sampling exclusion criteria were &middot; clients who are at age 65 or above or under 18. &middot; clients with a secondary diagnosis. Ten CPNs working in the research site were chosen as Case Managers by the Departmental Operation Manager. The inclusion criteria for these Case Managers were: .hold a Registered Nurse grade or above. .have at least 2 years' experience in CPNs. Intervention and outcome variables: The experimental group was taken care of by CPNs using case management model while the control group was taken care of by CPNs using conventional care model. A case management model was developed by the research team based on the practice model in Carondelet Saint Mary's Hospital and Health Centre in Tucson (Mitchell and Reaghard, 1996) and relevant literature (Carpenter, 1992). Application of the case management model or conventional CPNS for each client was for at least five months in all cases. Subjects were then being followed up for six months to monitor readmission rate. During the follow up period, the service to the experimental group and control group was maintained. Main outcome measures were: . Brief Psychiatric Rating Scale (BPRS) (Overall and Gorham, 1962). Specific level of Functioning Scale (SLOF) (Schneider and Struening, 1983). Patient Satisfaction Instrument (PSI) (Risser, 1975)(Chinese version) Readmission rate. Cost-effective analysis. Method: Pre and post measures were taken upon recruitment and at 5 months later. Subjects were followed up for six months. Findings: The results showed that the experimental group had better outcome in terms of their mental status and functional level, and satisfaction with the service when compared with control group. Clients in the experimental group showed more improvement in areas such as tension, suspiciousness, hallucinatory behaviour and thought disturbance. The experimental groups had better improvement when compared with control group in areas such as personal care skills, interpersonal relationship, social acceptability and community living skills. The experimental group also felt that the case managers had more time to listen and talk to them and they felt secure when being with the case managers. However, there was no difference in the readmission rate between the two groups. When analysing the cost, there was no significant difference in the cost of the service between the two groups. Conclusion: Results of this study showed that case management model seemed to have a positive impact on clients' mental status, functional level and satisfaction. There was no significant difference between the cost of the two groups. Case management is an effective care model for chronic mentally ill clients in the community. Implications: The implementation of case management is recommended for this group of clients. CPNs appeared to be suitable persons to take up the role of the case managers and are value for money. Case management can be an expanded role for CPNs. CPNs need to develop skills and knowledge to accomplish the expanded role. It is recommended that CPN training should prepare the CPNs for this expanded role.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T11:15:37Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T11:15:37Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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