دکتر محمد کمالی

کمالی - محمد 1386دکتر

دکتر محمد کمالیاستاديار دانشکده علوم

توانبخشیدانشگاه علوم پزشکی ايران

پستی - صندوق 17445-183تهران

[email protected]



در ارزیابیتوانبخش*ی

توانبخشی اصول بازآموزی دورهکشور بهزیستی سازمان

ماه 1386آذر


تعاریف


Assessment The act of assessing; appraisal. An amount assessed, as for taxation.

The qualified opinion of a healthcare provider, informed by patient feedback and examination results, with regard to a specific health issue, whether critical, pending, or routine. Dental Dictionary


Assessment Assessment is the process of documenting, usually in

measurable terms, knowledge, skills, attitudes and beliefs. Children's Health Encyclopedia

The act or result of judging the worth or value of something or someone:(Thesaurus )


Description Assessment is used in both an educational and

psychological setting by teachers, psychologists, and counselors to accomplish a range of objectives. These include the following: to learn more about the competencies and deficiencies of the

individual being tested to identify specific problem areas and/or needs to evaluate the individual's performance in relation to others to evaluate the individual's performance in relation to a set of

standards or goals to provide teachers with feedback on effectiveness of

instruction to evaluate the impact of psychological or neurological

abnormalities on learning and behavior to predict an individual's aptitudes or future capabilities


ارزیابی تعریف ، ارزیاب*ی ، عم*ل یافت*ن ا*رزش* و بهای* ه*ر چیز

بخ*ش و بررس*ی حدود ه*ر چیز و برآورد* کردن* ارزش آن کلمه ا*رزیابی حاصل م*ص*در است*.

، آم*وزشی آ*ن ماهی*ت* ک*ه اس*ت* فعالیت*ی اقتص*اد*ی* ، اجتماع*ی و فرهنگی می باشد. از ای*ن رو ب*ه کم*ک ارزیاب*ی بای*د مقایس*ه ا*ی* م*یان اهداف ضمن*ی و اهداف بیان* شده* از ی*ک س*و و نتای*ج م*ورد* انتظ*ار و نتای*ج پی*ش* بینی نش*ده* از س*وی* دیگ*ر ب*ه عم*ل آورد* و س*پس بای*د به س*نجش تاثی*ر ای*ن نتای*ج بر م*حی*ط* اقتص*ادی* ،

اجتماع*ی و فرهنگی پرد*اخت .


ارزیابی تعریف جهت اطالعات گردآوری ارزیاب*ی هد*ف

ریزی برنامه فرآین*د ب*ه بخشیدن بهبود Process of the planning و در نتیجه بهبود در

محلی* جوام*ع و ای م*نطق*ه مل*ی، س*طح ارزی*اب*ی ک**ه داش**ت توج*ه بای*د* اس*ت*. برنام*ه اج**رای از پ**س* ب**ار ی**ک فق**ط

Implementation or Execution *نمی انجام پذ*یرد بلک*ه در طول اجرای* برنام*ه به طور مس*تمر ارزیاب*ی* بای*د* انجام گیرد ت*ا تطبیق س*ازد. میس*ر برنام*ه هد*ف ب*ا را عملکرد )کتاب فرآین*د برنامه ریزی* آموزش*ی* تالیف

گروه مشاوران یونسکو( کمالی - محمد 1386دکتر

ارزیابی تعریف از 7در کتاب اص*الح نظام های مدیریت*ی جل*د سوم

برنام*ه تحول در نظام اداری آمده اس*ت: ارزیابی : )مصوب و قضاوت گذاری ارزش ، فرآین*د س*نجش

تاری**خ در وزیران شماره 28/10/81هیات طی ه-27701/ت 44642

، ارزیاب*ی فرآیندی اس*ت ک*ه سنجش و اندازه گیریطی عملکرد خص*وص در قضاوت و گذاری ارزش راهنمای )کتابچه پردازد. م**ی معی**ن ای دوره انتشارات از اجرایی دس*تگاههای عملکرد ارزیاب*ی

سازمان مدیریت و برنامه ریزی کشور( مقایسه منظور ب*ه و پیچیده اس*ت امری ارزیاب*ی

برنامه تعیی*ن شده های هدف و حاص*ل نتای*ج بی*ن میتواند برنام*ه از حاص*ل نتای*ج پذیرد. م*ی انجام باشد. مغایر اس*ت رفت*ه م*ی انتظار آنچ*ه ب*ا کامالٌ

)کتاب فرآیند برنامه ریزی آموزشی(کمالی - محمد 1386دکتر

Types Assessments can be classified in many different ways.

The most important distinctions are: (1) formative and summative; (2) objective and subjective; (3) referencing (criterion-referenced, norm-referenced ); (4) informal and formal.


Formative and summative There are two main types of assessment: Summative assessment - Summative assessment is

generally carried out at the end of a course or project. In an educational setting, summative assessments are typically used to assign students a course grade.

Formative assessment - Formative assessment is generally carried out throughout a course or project. Formative assessment, also referred to as educative assessment, is used to aid learning. In an educational setting, formative assessment might be a teacher (or peer) or the learner, providing feedback on a student's work, and would not necessarily be used for grading purposes.


Objective and subjective Assessment (either summative or formative) can be

objective or subjective. Objective assessment is a form of questioning which has a

single correct answer. Subjective assessment is a form of questioning which may

have more than one correct answer (or more than one way of expressing the correct answer).


Formal and Informal Formal assessment usually implicates a written

document, such as a test, quiz, or paper. Formal assessment is given a numerical score or grade based on student performance.

Whereas, informal assessment does not contribute to a student's final grade. It usually occurs in a more casual manner, including observation, inventories, checklists, rating scales, rubrics, performance and portfolio assessments, participation, peer and self evaluation, and discussion.


Psychological Assessments Psychological assessment of children is used for a

variety of purposes, including diagnosing learning disabilities and behavioral and attention problems. Psychologists can obtain information about a child in three general ways: observation, verbal questioning or written questionnaires, and assignment of tasks.


و ارزیابی تفاوتارزشی*ابی


و ارزیابی بین نشدن قائل تفاوت نمونهارزشیابی

،هوشی رشد نظر از مددجو فرد رشدی سطح ارزشیابی و بررسیتوسط محدودی8ت‌ها و توانایی‌ها به توجه و شناختی اجتماعی، حركتی،

و استاندارد لیست‌های چك سایر و تست‌ها از استفاده با سنجشرسمیو والدین و آموزشی مربیان ب8ا مصاحبه از استفاده با غیررسمی سنجش

. مددجویان مشاهدةسنجشرسمی سطح در

گشتالت- وبندر ، گودی8ناف ، ریون آزمونهای از هوشی ت8وان ارزیابی برایمی‌شود استفاده

سازشی- رفتار مقیاس و واینلند آزمون از اجتماعی رشد ارزیابی برایAAMR می‌شود استفاده

رسمی غیر سنجش سطح دراطالعات- میزان كه مؤسسه در شده ت8هیه شناختی، رشد لیست چك

/ / / / مشاغل حیوانات رنگها ها میوه مانند موضوعاتی در را جو مددو / / بدن اعضاء هندسی می‌سنجد 11اشكال اولیه و اساسی مفهوم

در- موجود فعلی حرفه چهار نیازهای پیش به مربوط لیست چك - - حبوبات بندی بسته و كردن پاك چوبی پالت ساخت شامل مؤسسه

پاكت – ساخت سنگ قطعات از ترکیبی تایل ساختحركتی- مهارتهای ارزیابی لیست چكفیزیكی- ظرفیت ارزیابی لیست چك


What is the Difference between Assessment and Evaluation?

Assessment is an on-going process aimed at improving student learning, programs, and services that involves a process of 1) publicly sharing expectations, 2) defining criteria and standards for quality, 3) gathering, analyzing, and interpreting evidence about how

well performance matches the criteria, and 4) using the results to documents, explain, and improve

performance. Evaluation appraises the strengths and weaknesses of

programs, policies, personnel, products, and organizations to improve their effectiveness.

Evaluation is to determine significance or worth or judge the effectiveness of educational programs. Assessment is to determine a rate or amount and is used as an activity to measure student learning and other human characteristics.


Measurement Measurement refers to the process by which the attributes or

dimensions of some physical object are determined. However, when we measure, we generally use some standard instrument to determine how big, tall, heavy, voluminous, hot, cold, fast, or straight something actually is. Standard instruments refer to instruments such as rulers, scales, thermometers, pressure gauges, etc. We measure to obtain information about what is. Such information may or may not be useful, depending on the accuracy of the instruments we use, and our skill at using them. There are few such instruments in the social sciences that approach the validity and reliability of say a 12" ruler. We measure how big a classroom is in terms of square feet, we measure the temperature of the room by using a thermometer, and we use Ohm meters to determine the voltage, amperage, and resistance in a circuit. In all of these examples, we are not assessing anything; we are simply collecting information relative to some established rule or standard . Assessment is therefore quite different from measurement, and has uses that suggest very different purposes.


Assessment Assessment is a process by which information is obtained relative

to some known objective or goal. Assessment is a broad term that includes testing. A test is a special form of assessment. Tests are assessments made under contrived circumstances especially so that they may be administered. In other words, all tests are assessments, but not all assessments are tests. We test at the end of a lesson or unit. We assess progress at the end of a school year through testing, and we assess verbal and quantitative skills through such instruments as the SAT and GRE. Whether implicit or explicit, assessment is most usefully connected to some goal or objective for which the assessment is designed. A test or assessment yields information relative to an objective or goal. In that sense, we test or assess to determine whether or not an objective or goal has been obtained. Assessment of skill attainment is rather straightforward. Either the skill exists at some acceptable level or it doesn’t. Skills are readily demonstrable. Assessment of understanding is much more difficult and complex. Skills can be practiced; understandings cannot. We can assess a person’s knowledge in a variety of ways, but there is always a leap, an inference that we make about what a person does in relation to what it signifies about what he knows.


Evaluation Evaluation is perhaps the most complex and least understood of the terms. Inherent

in the idea of evaluation is "value." When we evaluate, what we are doing is engaging in some process that is designed to provide information that will help us make a judgment about a given situation. Generally, any evaluation process requires information about the situation in question. A situation is an umbrella term that takes into account such ideas as objectives, goals, standards, procedures, and so on. When we evaluate, we are saying that the process will yield information regarding the worthiness, appropriateness, goodness, validity, legality, etc., of something for which a reliable measurement or assessment has been made. For example, I often ask my students if they wanted to determine the temperature of the classroom they would need to get a thermometer and take several readings at different spots, and perhaps average the readings. That is simple measuring. The average temperature tells us nothing about whether or not it is appropriate for learning. In order to do that, students would have to be polled in some reliable and valid way. That polling process is what evaluation is all about. A classroom average temperature of 75 degrees is simply information. It is the context of the temperature for a particular purpose that provides the criteria for evaluation. A temperature of 75 degrees may not be very good for some students, while for others, it is ideal for learning. We evaluate every day. Teachers, in particular, are constantly evaluating students, and such evaluations are usually done in the context of comparisons between what was intended (learning, progress, behavior) and what was obtained


Assessment, Measurement, Evaluation

To sum up, we measure distance, we assess learning, and we evaluate results in terms of some set of criteria.

These three terms are certainly connected, but it is useful to think of them as separate but connected ideas and processes.

Collecting data (assessment), quantifying that data (measurement), making judgments (evaluation), and developing understanding about the data (research) always raise issues of reliability and validity


Summary of Differences

Dimension of DifferenceAssessmentEvaluation

TimingFormativeSummative

Focus‌of‌MeasurementProcess-Oriented

Product-Oriented

Relationship‌Between‌Administrator‌and‌RecipientReflectivePrescriptive

Findings,‌Uses‌ThereofDiagnosticJudgmentalOngoing‌Modifiability‌of‌Criteria,‌Measures‌ThereofFlexibleFixed

Standards‌of‌MeasurementAbsoluteComparativeRelation‌Between‌Objects‌of‌A/ECooperativeCompetitive


Assess

Prioritize

Analyze problem and propose model to

addressDevelop

Intervention goals, objectives,

implementation plan Evaluate

outcomes

Process Evaluation and Adjustment


ارزیابی چراکنیم می


(AAC) Augmentative and Alternative Communication

(AAC) strategies assist people with severe communication disabilities to participate more fully in their social roles including interpersonal interaction, learning, education, community activities, employment, volunteerism, care management, and so on.


Current Assessment Theory Moved from candidacy criteria to focusing on an

individual’s need for improved communication Communication Needs Model (Beukelman,

Yorkston, & Dowden, 1985) Examines individual’s natural environment, and

recommends implementation of AAC intervention when unmet communicative needs are present


Purpose of AssessmentPurpose of assessment

Determine the skills that an individual has or needs to develop in order to communicate effectively

Identify communication system individual currently uses

Determine effectiveness Refine current methods & identify new methods Determine optimal way to configure system

Goal of AAC assessment & intervention Independent, functional interactive

communication Achieved through assessment, system trials,

instruction


Main Function of AAC Assessment

to determine whether an individual with communication impairment requires augmentative communication intervention

During an assessment, an individual's communication needs, as well as his or her capabilities, are evaluated in order to implement the assistive technology as soon as possible to enable the individual to begin immediate communication interaction.

The appropriate augmentative communication system is selected to meet the needs of the individual, and an intervention plan is developed


Identification of Present Ways of Communicating -> limitations and needs

1. Oral Speech - actual production of words. 2. Linguistic Knowledge - language reception and expression. 3. Reading & Writing Ability - The interpretation and generation of

written symbols. 4. Cognition - ability to recall information, reason, problem solve, and

follow directions. 5. Non-Oral Communication - use of gestures, signs, facial expressions,

body language, and current augmentative communication usage. 6. Communication Effectiveness - types of messages successfully

communicated. 7. Communication Partners - ways to communicate with familiar and

unfamiliar partners. 8. Communication Settings - contexts in which communication devices

will be used (i.e. school, work, home). 9. Message Needs - Ways to initiate, comment, request, convey, or reply

to conversation. 10. Developmental & Educational/Vocational Needs - Literacy

development.


Comprehensive Assessment

Based on the screening, which areas require more indepth information/testing?

Where do I need to target my interventions?


Self Care Assessment Personal care (feeding, bathing, grooming, dressing,

toileting) Community management (shopping, finances,

transportation/driving) Functional mobility (transfers, current aids used -

home and community, seating and positioning needs)

Functional communication (writing or computer use, telephone use)


Productivity Assessment Paid or unpaid work (job, volunteer work, school,

etc) Household management (cleaning, laundry, cooking,

etc) Child Care/Parenting


Leisure Assessment Activities enjoyed previously and currently

Socialization (visiting, phone calls, correspondence, etc) Quiet recreation (hobbies, reading, crafts, etc) Active recreation (sports, outings, travel, etc)


Assessment of Environment Physical environment; possible barriers Consideration of social support systems available Consideration of cultural factors


Fatigue Assessment MS fatigue Other factors contributing to fatigue Impact of fatigue Expectations for self


Cognitive Screening Primarily assess functional cognition

Attention Ability to follow directions Memory difficulties Executive function

If more indepth assessment needed then refer on to Neuropsychology


Assessment of Physical Status

U/E tone U/E ROM U/E strength U/E sensation U/E coordination Functional balance (more of a screen) Pain (more of a screen)* Often work together with PT on this area


How do I use the assessment data?

To decide on approach to treatment (restoration/remediation, adaptation, compensation)

To determine at which level I intervene (impairments, occupational tasks/abilities, participation/roles)

To make recommendations (eg, referrals, workplace accommodations, followup care)


های ابزارارزیابی


Assessing Severity of Illness

A brief method of identifying the severity of the mentally ill

suitable for everyday use (‘feasible’)


Global Assessment of Function (GAF)

Clinician’s judgment of overall level of functioning

Guide treatment need and planning (DSM-IV)

Rating - clinical dx and sx stronger predictor of than social or occupational functioning1

Minimally associated with treatment outcome1

No robust association btwn GAF and clinician interview or patient self report1

1 .Moos‌RH.‌Psychiatry Serv‌2002;53,‌730-7.کمالی - محمد 1386دکتر

Threshold Assessment Grid

Assesses severity of person’s mental health problems

Referrals to “routine” community mental health service

One page assessment - 7 domains- 4 to 5 point scale for each domain

Second page provides evidence-based criteria for each domain


Diagnostic assessmentSelf-administered tool that: help identify and diagnose patients with mental

illnesses commonly encountered in a primary care practice

allow for reporting of associated stressors practical reasonable performance characteristics easy to average literacy level useful in both initial management decisions and

monitoring treatment outcome


General Health Questionnaire )12 and 26(1

Self‌completed‌(3‌to‌4‌minutes) Validated\reliable,‌“current‌state”,‌predictive‌validity

Identifies‌common‌underlying‌elements‌ Focuses:‌inability‌to‌carry‌out‌normal‌functions;‌appearance‌of‌new‌distressing‌phenomena

“Casernes”‌varies‌according‌to‌threshold FP‌(physically‌ill)‌‌and‌FN‌(“compared‌to‌normal”)

1 .Goldberg‌D‌P‌et‌al‌Psycho Med‌197;27,191-7.


Patient Health Questionnaire )PHQ(

Instrument‌based‌on‌psychiatric‌disorder‌criteria‌(reference‌symptom‌count)

Not‌dependent‌on‌threshold‌of‌symptom‌severity

Offset‌potential‌for‌symptom‌count‌not‌reliable‌indicator‌of‌impairment‌by‌having‌scale‌mode


زندگی کیفیت ارزیابی های شاخصEQ-5Dمعیارهای

در انجام برای فردی بعد 5توانائیتحرک رنج و درد مراقبتی خود افسردگی و اضطراب معمول فعالیتهای


Functional assessment tools

That I use: Canadian Occupational

Performance Measure (COPM)

Functional Independence Measure (FIM)

Multiple Sclerosis Self Efficacy Scale (MSSE)

Doron Simulator Interview/observation

That others use:Functional Assessment

Measure (FAM)Kohlman Evaluation of

Living Skills (KELS)Self Reported Functional

Measure (SRFM)Worker Role Inventory

Checklist


Environmental/Community assessment tools

That I use:Home assessment

form developed by our Home Service OT

That others use:Reintegration to

Normal Living IndexSAFER


Fatigue assessment tools

That I use:Daily activity diaryFatigue

questionnaireFatigue Impact

Scale (FIS)

That others use:Modified FISFatigue Severity

Scale (FSS)Fatigue

Assessment Instrument (FAI)


Cognitive assessment tools

That I use:CognistatRivermead

Behavioural Memory Test (RBMT)

Cognitive Competency Test (CCT)

That others use:Behavioral Assessment

of Dysexecutive Syndrome (BADS)

Pepper Visual Skills for Reading Test

Test of Directed Attention


U/E measurement toolsThat I use:Nine Hole Peg Test

(9-HPT)Manual Muscle TestDynamometerPinch meterSensation kitHandwriting sample

That others use: Jebson Hand Test U/E Performance Test for the

Elderly (TEMPA) Arm Motor Ability Test

(AMAT) Action Research Arm Test Purdue Pegboard Arthritis Hand Function Test Box and Block


حیطه در ارزیابیمختلف های


Objectives

Describe the impact of spasticity on function Evaluate spasticity using the Modified Ashworth

Scale Understand what makes a patient, a good candidate

for ITB Recognize ITB withdrawal


Spasticity Assessment



Motor Testing: 0 = No movement1 = Trace contraction2 = Full AROM gravity eliminated .3 = Full AROM against gravity4 = Full AROM against gravity with resistance5 = Normal power



Modified Ashworth Scale: 0 = no increase in muscle tone1 = slight increase in muscle tone (catch or min

resistance at end range)1 + = slight increase in muscle resistance throughout the

range.2 = moderate increase in muscle tone throughout ROM,

PROM is easy3 = marked increase in muscle tone throughout ROM,

PROM is difficult4 = marked increase in muscle tone, affected part is

rigid



Spasm Frequency Scale: How many spasms in the last 24 hours in the affected extremity?

0 = no spasms1 = 1 / day2 = 1-5/ day3 = 5-9 / day4 = >10/day



Adductor Tone Rating:0 = no increase in muscle tone1 = increased tone, hips easily abducted 45

degrees by one person2 = hips abducted 45 degrees by on person with

mild effort3 = hips abducted 45 degrees by one person

with moderate effort4 = two people are required to abduct the hips

45 degrees


Spasticity Assessment Tardieu: An ordinal rating of tone which

measures the angle which the catch is first felt (the threshold angle).

Oswestry: Ordinal which rates stage and distribution of tone that is addressed by a generalized grade of either useful or non-useful movement.

ASIA Examination:Functional Independence Measure:Community Integration Questionnaire:


Organisational assessment tool


Organisational assessment tool

• Identify institutional strengths, areas for improvement, opportunities and threats

• Assess capacity for effective & efficient operation

• Monitor institutional progress

• Identify resources & other support requirements

Using methods of full staff participation, partner organisations are encouraged to carry out a detailed self-assessment. An assessment tool guides partners to:


The tool focuses on self assessment of:


Vocational Rehabilitation


An Alternative: client by client

TriageCommissioningAssessmentAction PlanAuthorisationCase managementService ProvisionReview


RehabilitationTriageIdentify clients in need

CommissioningRefer for rehabilitation

CLIENT


Social / external

Health / Internal

Work / Institutional

Rehabilitation Assessment:Personal life balance


RehabilitationCo-ordinating medical and vocational support

Medical assessment Vocational assessment

Is there a vocational problem?

Is there a medical problem?

Identify & remove theMedical barriers to work

Identify & remove theVocational barriers to work

Job search کمالی - محمد 1386دکتر

The disability assessment


Disability pension in Iceland Disability is assessed by physicians of the State Social Security Institute according to paragraphs 12 and 13 in the National Social Security Act.

Higher level: >75% (full disability pension)[All Work Test = Personal Capability Assessment]

Lower level: 50-65% (partial disability pension)


The disability assessmentis based on the British “Personal Capability Assessment” (previously called the “All work test”).

Function is evaluated by assessing the ability to perform various activities of body and mind.


This functional evaluation is intended to reflect the applicant´s ability to perform all types of work.

The statements of functional ability - the descriptors - are graded according to importance, giving high points for major and low points for minor functional impairment.


Part one: Physical and sensory functionThreshold‌15 points

Part two: Mental healthThreshold‌10 points

Combined threshold: 6 points from each part


Part one: Physical and sensory function

Sitting Standing‌Walking‌Walking‌up‌and‌down‌stairs‌‌Rising‌from‌sitting‌Bending‌and‌kneeling‌Manual‌dexterity‌Lifting‌and‌carrying Reaching Speech Hearing Vision Continence Remaining‌conscious


Part two: Mental health

Completion‌of‌tasksDaily‌livingCoping‌with‌pressureInteraction‌with‌other‌people


General Information Welcome to the Home Page for the World Health Organization Disability Assessment Schedule II )WHODAS II(. This

site provides information relevant and useful to researchers, clinicians, and administrators who are interested in learning about and using this instrument for assessing levels of functioning .

The WHODAS II has been under development by WHO for several years. Final versions are expected to be released in 2001. Currently, the WHODAS II is available in eleven versions and sixteen languages. Available versions include self-administered, interviewer-administered, and proxy-reported .

The WHODAS II provides a profile of functioning across six activity domains, as well as a general disability score. This information can be used to

•Identify needs •Match patients to interventions

•Track functioning over time •Measure clinical outcomes and treatment effectiveness

Return to this page often to receive the latest information and updates regarding the WHODAS II, including semi-structured versions of the instrument and publications.

Download WHODAS II

Download I-Shell - WHODAS Manuals & Software*

Upload WHODAS data* List of Centers

Translations

Ongoing Field Trials Scoring

Frequently Asked Questions Contact information

Related Links

WHO Home Page

Send your comments and feedback about this site to [email protected]

*Available only to WHODAS-II Centers and requires a user-id and password.کمالی - محمد 1386دکتر

WHO-DAS

Used in the physically ill Rheumatology-Ann Rheum Dis 2003:62.140-145

Pulmonary Rehab-Chest 2002:122.948-954

SMI-Acta Psych Scand 2002:105.196-201. And 2000:102.26-31

Cost effectiveness- Medical Care Vol.41.2:208-217

Developing Countries-Soc Psychiatry Psychiatry Epid (1997) 32: 387-390


WHO-DAS Six Domains

Understanding and communicating Getting around Self care Getting along with others Life activities Participation in society


WHO-DAS Versions. Self-Administered

36 Item. All domains, overall score

12 Item. Helpful esp. when domain specific information is not required. OUR VERSION

Other as INTERVIEW and PROXY versions


ICF Checklist

One component- One page Salient Categories (169 out of 1494)

at-a-glance-Impairments with Body Functions-Impairments with Body Structures-Capacity and Performance in Activity and Participation Domains-Environmental Factors-Other Contextual information

Additional notes Available for Clinicians


CIHI Health Indicators Framework

AcceptabilitySatisfaction questionnaire• patients•GPs•psychiatrist

Accessibility• Time to first contact, counseling, psychiatrist• Crisis access• Phone avail.• Indirect care

Appropriateness• TAG• # of visits

Competence• adequate skill set• feed back, retreat• fidelity items• academic detailing

Continuity• f\u clinicians• disposition after episode of care

EfficacyEffectiveness• PHQ•WHO-DAS II

Safety• TAG• Treatment outcome


Migraine Disability Assessment Scale )MIDAS(


Migraine Disability Assessment Scale )MIDAS(


کمالی - مح8مد 1386دکتر

Community Assessment


Community‌Assessment Includes a data gathering process

about the community, including all aspects and not necessarily related to health issues only.

Is larger than a community health assessment )sometimes called a community health needs assessment(

Frequently done city governments to look at many issues including environment, housing, economics, education, land use , etc.,etc., and often includes health status and needs


Community Assessment Process

WHY??

To identify and document the opportunities, challenges, strengths, and needs of a specific geographic community

and its residents.



WHY??

To build and strengthen relationships among community leaders, service providers and most

importantly, community residents.



WHY??

To have the information needed to make good decisions for a community collaborative strategic

planning.


How is the Community Assessment Process Different from a Traditional Needs Assessment

Process is as important as the product. Residents are involved in design and implementation,

not just as respondents. Assessment focuses not only on needs, but also on

assets and resources. Assessment is multifaceted and uses multiple data

collection strategies. Assessment is about dialogue and consensus building

as well as information gathering. It is not just about social services. It is not an academic process.



Form planning and implementation committee.Review secondary data.Determine need for primary data.Develop methods for new data collection.Collect new data.Analyze data collected.Create report using secondary and primary data.Share information with the community.


Steps to AssessmentConvene a planning groupDefine community Identify Community Assets Identify Perceived NeedsBuild Demographic ProfileAnalyze Community Health StatusAnalyze Community Nutrition Status Identify Community Resources and

Service Utilization Identify common issues and unmet needsPrioritize


Needs Assessment

In general, a needs assessment is a systematic approach to identifying social problems, determining their extent, and accurately defining the target population to be served and the nature of their service needs (Rossi, P. H., Freeman, H. E., & Lipsey, Mark, W. L., 1998).


Three-Phase Plan for Conducting a Needs Assessment

Phase 1 - Pre-assessment (exploration)

Phase 2 - Assessment (data gathering)

Phase 3 - Post-assessment (utilization)

Within, B. R., & Altschuld, J. W., (1995). Planning and conducting needs assessments: A practical guide. Newbury Park, CA: Sage Publications


Needs Assessment Tools

1) Surveys2) Questionnaires3) Interviewing4) Focus Groups5) Observations6) Performance Measures

a) Rankingb) Gradingc) Scoringd) Rating


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Documents

دکتر محمد کمالی