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دکتر محمد کمالی -1386.

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1 دکتر محمد کمالی -1386

2 استاديار دانشکده علوم توانبخشی دانشگاه علوم پزشکی ايران
دکتر محمد کمالی استاديار دانشکده علوم توانبخشی دانشگاه علوم پزشکی ايران تهران - صندوق پستی دکتر محمد کمالی -1386

3 دکتر محمد کمالی -1386

4 دوره بازآموزی اصول توانبخشی سازمان بهزیستی کشور آذر ماه 1386
ارزیابی در توانبخشی دوره بازآموزی اصول توانبخشی سازمان بهزیستی کشور آذر ماه 1386 دکتر محمد کمالی -1386

5 تعاریف دکتر محمد کمالی -1386

6 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 دکتر محمد کمالی -1386

7 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 ) دکتر محمد کمالی -1386

8 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 دکتر محمد کمالی -1386

9 تعریف ارزیابی ارزیابی ، عمل یافتن ارزش و بهای هر چیز ، بخش و بررسی حدود هر چیز و برآورد کردن ارزش آن کلمه ارزیابی حاصل مصدر است. فعالیتی است که ماهیت آن آموزشی ، اقتصادی ، اجتماعی و فرهنگی می‌باشد. از این رو به کمک ارزیابی باید مقایسه ای میان اهداف ضمنی و اهداف بیان شده از یک سو و نتایج مورد انتظار و نتایج پیش بینی نشده از سوی دیگر به عمل آورد و سپس باید به سنجش تاثیر این نتایج بر محیط اقتصادی ، اجتماعی و فرهنگی پرداخت . دکتر محمد کمالی -1386

10 تعریف ارزیابی هدف ارزیابی گردآوری اطلاعات جهت بهبود بخشیدن به فرآیند برنامه ریزی Process of the planning و در نتیجه بهبود در سطح ملی، منطقه ای و جوامع محلی است. باید توجه داشـت کـه ارزیـابـی فقـط یـک بـار پـس از اجـرای برنامـه Implementation or Execution انجام نمی پذیرد بلکه در طول اجرای برنامه به طور مستمر ارزیابی باید انجام گیرد تا تطبیق عملکرد را با هدف برنامه میسر سازد.(کتاب فرآیند برنامه‌ریزی آموزشی تالیف گروه مشاوران یونسکو) دکتر محمد کمالی -1386

11 تعریف ارزیابی در کتاب اصلاح نظام‌های مدیریتی جلد سوم از 7 برنامه تحول در نظام اداری آمده است: ارزیابی : فرآیند سنجش ، ارزش گذاری و قضاوت (مصوب هیات وزیران در تاریخ 28/10/81 طی شماره 44642/ت ه- ارزیابی فرآیندی است که سنجش و اندازه گیری ، ارزش گذاری و قضاوت در خصوص عملکرد طی دوره ای معین می پردازد. (کتابچه راهنمای ارزیابی عملکرد دستگاههای اجرایی از انتشارات سازمان مدیریت و برنامه ریزی کشور) ارزیابی امری است پیچیده و به منظور مقایسه بین نتایج حاصل و هدف های تعیین شده برنامه انجام می پذیرد. نتایج حاصل از برنامه میتواند کاملاٌ با آنچه انتظار می رفته است مغایر باشد. (کتاب فرآیند برنامه ریزی آموزشی) دکتر محمد کمالی -1386

12 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. دکتر محمد کمالی -1386

13 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. دکتر محمد کمالی -1386

14 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). دکتر محمد کمالی -1386

15 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. دکتر محمد کمالی -1386

16 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. دکتر محمد کمالی -1386

17 تفاوت ارزیابی و ارزشیابی
دکتر محمد کمالی -1386

18 نمونه تفاوت قائل نشدن بین ارزیابی و ارزشیابی
بررسی و ارزشیابی سطح رشدی فرد مددجو از نظر رشد هوشی، حركتی، اجتماعی، شناختی و توجه به توانایی‌ها و محدودیت‌ها توسط سنجش رسمی با استفاده از تست‌ها و سایر چك لیست‌های استاندارد و سنجش غیررسمی با استفاده از مصاحبه با مربیان آموزشی و والدین و مشاهدة مددجویان. در سطح سنجش رسمی - برای ارزیابی توان هوشی از آزمونهای ریون ، گودیناف ، وبندر گشتالت استفاده می‌شود - برای ارزیابی رشد اجتماعی از آزمون واینلند و مقیاس رفتار سازشی AAMR استفاده می‌شود در سطح سنجش غیر رسمی - چك لیست رشد شناختی، تهیه شده در مؤسسه كه میزان اطلاعات مدد جو را در موضوعاتی مانند میوه ها/ رنگها / حیوانات / مشاغل / اشكال هندسی / اعضاء بدن / و 11 مفهوم اساسی و اولیه می‌سنجد - چك لیست مربوط به پیش نیازهای چهار حرفه فعلی موجود در مؤسسه شامل ساخت پالت چوبی- پاك كردن و بسته بندی حبوبات- ساخت تایل ترکیبی از قطعات سنگ – ساخت پاكت - چك لیست ارزیابی مهارتهای حركتی - چك لیست ارزیابی ظرفیت فیزیكی دکتر محمد کمالی -1386

19 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. دکتر محمد کمالی -1386

20 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. دکتر محمد کمالی -1386

21 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. دکتر محمد کمالی -1386

22 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 دکتر محمد کمالی -1386

23 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 دکتر محمد کمالی -1386

24 Summary of Differences
Dimension of Difference Assessment Evaluation Timing Formative Summative Focus of Measurement Process-Oriented Product-Oriented Relationship Between Administrator and Recipient Reflective Prescriptive Findings, Uses Thereof Diagnostic Judgmental Ongoing Modifiability of Criteria, Measures Thereof Flexible Fixed Standards of Measurement Absolute Comparative Relation Between Objects of A/E Cooperative Competitive دکتر محمد کمالی -1386

25 Process Evaluation and Adjustment
Assess Prioritize Analyze problem and propose model to address Develop Intervention goals, objectives, implementation plan Evaluate outcomes دکتر محمد کمالی -1386

26 چرا ارزیابی می کنیم دکتر محمد کمالی -1386

27 (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. دکتر محمد کمالی -1386

28 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 دکتر محمد کمالی -1386

29 Purpose of Assessment Purpose 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 دکتر محمد کمالی -1386

30 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 دکتر محمد کمالی -1386

31 Identification of Present Ways of Communicating -> limitations and needs
Oral Speech - actual production of words. Linguistic Knowledge - language reception and expression. Reading & Writing Ability - The interpretation and generation of written symbols. Cognition - ability to recall information, reason, problem solve, and follow directions. Non-Oral Communication - use of gestures, signs, facial expressions, body language, and current augmentative communication usage. Communication Effectiveness - types of messages successfully communicated. Communication Partners - ways to communicate with familiar and unfamiliar partners. Communication Settings - contexts in which communication devices will be used (i.e. school, work, home). Message Needs - Ways to initiate, comment, request, convey, or reply to conversation. Developmental & Educational/Vocational Needs - Literacy development. دکتر محمد کمالی -1386

32 Comprehensive Assessment
Based on the screening, which areas require more indepth information/testing? Where do I need to target my interventions? دکتر محمد کمالی -1386

33 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) دکتر محمد کمالی -1386

34 Productivity Assessment
Paid or unpaid work (job, volunteer work, school, etc) Household management (cleaning, laundry, cooking, etc) Child Care/Parenting دکتر محمد کمالی -1386

35 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) دکتر محمد کمالی -1386

36 Assessment of Environment
Physical environment; possible barriers Consideration of social support systems available Consideration of cultural factors دکتر محمد کمالی -1386

37 Fatigue Assessment MS fatigue Other factors contributing to fatigue
Impact of fatigue Expectations for self دکتر محمد کمالی -1386

38 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 دکتر محمد کمالی -1386

39 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 دکتر محمد کمالی -1386

40 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) دکتر محمد کمالی -1386

41 ابزار های ارزیابی دکتر محمد کمالی -1386

42 Assessing Severity of Illness
A brief method of identifying the severity of the mentally ill suitable for everyday use (‘feasible’) دکتر محمد کمالی -1386

43 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. Moos RH. Psychiatry Serv 2002;53, دکتر محمد کمالی -1386

44 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 دکتر محمد کمالی -1386

45 Diagnostic assessment
Self-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 دکتر محمد کمالی -1386

46 General Health Questionnaire (12 and 26)1
Self completed (3 to 4 minutes) Validated\reliable, “current state”, predictive validity Identifies common underlying elements Focuses: inability to carry out normal functions; appearance of new distressing phenomena “Casernes” varies according to threshold FP (physically ill) and FN (“compared to normal”) 1. Goldberg D P et al Psycho Med 197;27,191-7. دکتر محمد کمالی -1386

47 Patient Health Questionnaire (PHQ)
Instrument based on psychiatric disorder criteria (reference symptom count) Not dependent on threshold of symptom severity Offset potential for symptom count not reliable indicator of impairment by having scale mode دکتر محمد کمالی -1386

48 شاخص های ارزیابی کیفیت زندگی معیارهای EQ-5D
توانائی فردی برای انجام در 5 بعد تحرک درد و رنج خود مراقبتی اضطراب و افسردگی فعالیتهای معمول دکتر محمد کمالی -1386

49 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 دکتر محمد کمالی -1386

50 Environmental/Community assessment tools
That I use: Home assessment form developed by our Home Service OT That others use: Reintegration to Normal Living Index SAFER دکتر محمد کمالی -1386

51 Fatigue assessment tools
That I use: Daily activity diary Fatigue questionnaire Fatigue Impact Scale (FIS) That others use: Modified FIS Fatigue Severity Scale (FSS) Fatigue Assessment Instrument (FAI) دکتر محمد کمالی -1386

52 Cognitive assessment tools
That I use: Cognistat Rivermead 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 دکتر محمد کمالی -1386

53 U/E measurement tools That I use: Nine Hole Peg Test (9-HPT)
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 That I use: Nine Hole Peg Test (9-HPT) Manual Muscle Test Dynamometer Pinch meter Sensation kit Handwriting sample دکتر محمد کمالی -1386

54 ارزیابی در حیطه های مختلف
دکتر محمد کمالی -1386

55 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 دکتر محمد کمالی -1386

56 Spasticity Assessment
دکتر محمد کمالی -1386

57 Spasticity Assessment
Motor Testing: 0 = No movement 1 = Trace contraction 2 = Full AROM gravity eliminated . 3 = Full AROM against gravity 4 = Full AROM against gravity with resistance 5 = Normal power دکتر محمد کمالی -1386

58 Spasticity Assessment
Modified Ashworth Scale: 0 = no increase in muscle tone 1 = 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 easy 3 = marked increase in muscle tone throughout ROM, PROM is difficult 4 = marked increase in muscle tone, affected part is rigid دکتر محمد کمالی -1386

59 Spasticity Assessment
Spasm Frequency Scale: How many spasms in the last 24 hours in the affected extremity? 0 = no spasms 1 = 1 / day 2 = 1-5/ day 3 = 5-9 / day 4 = >10/day دکتر محمد کمالی -1386

60 Spasticity Assessment
Adductor Tone Rating: 0 = no increase in muscle tone 1 = increased tone, hips easily abducted 45 degrees by one person 2 = hips abducted 45 degrees by on person with mild effort 3 = hips abducted 45 degrees by one person with moderate effort 4 = two people are required to abduct the hips 45 degrees دکتر محمد کمالی -1386

61 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: دکتر محمد کمالی -1386

62 Organisational assessment tool
دکتر محمد کمالی -1386

63 Organisational assessment tool
Using methods of full staff participation, partner organisations are encouraged to carry out a detailed self-assessment. An assessment tool guides partners to: Identify institutional strengths, areas for improvement, opportunities and threats Assess capacity for effective & efficient operation Monitor institutional progress Identify resources & other support requirements دکتر محمد کمالی -1386

64 The tool focuses on self assessment of:
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65 Vocational Rehabilitation
دکتر محمد کمالی -1386

66 An Alternative: client by client
Triage Commissioning Assessment Action Plan Authorisation Case management Service Provision Review دکتر محمد کمالی -1386

67 Rehabilitation Triage Commissioning CLIENT Identify clients in need
Refer for rehabilitation دکتر محمد کمالی -1386

68 Rehabilitation Assessment: Personal life balance
Health / Internal Social / external Work / Institutional دکتر محمد کمالی -1386

69 Co-ordinating medical and vocational support
Rehabilitation Co-ordinating medical and vocational support Medical assessment Vocational assessment Is there a medical problem? Is there a vocational problem? Identify & remove the Medical barriers to work Identify & remove the Vocational barriers to work Job search دکتر محمد کمالی -1386

70 The disability assessment
دکتر محمد کمالی -1386

71 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) دکتر محمد کمالی -1386

72 The disability assessment
is 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. دکتر محمد کمالی -1386

73 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. دکتر محمد کمالی -1386

74 Part one: Physical and sensory function Threshold 15 points
Part two: Mental health Threshold 10 points Combined threshold: 6 points from each part دکتر محمد کمالی -1386

75 Part one: Physical and sensory function Sitting Standing Walking
Walking up and down stairs Rising from sitting Bending and kneeling Manual dexterity Lifting and carrying Reaching Speech Hearing Vision Continence Remaining conscious دکتر محمد کمالی -1386

76 Interaction with other people
Part two: Mental health Completion of tasks Daily living Coping with pressure Interaction with other people دکتر محمد کمالی -1386

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

78 WHO-DAS Used in the physically ill
Rheumatology-Ann Rheum Dis 2003: Pulmonary Rehab-Chest 2002: SMI-Acta Psych Scand 2002: And 2000: Cost effectiveness- Medical Care Vol.41.2: Developing Countries-Soc Psychiatry Psychiatry Epid (1997) 32: دکتر محمد کمالی -1386

79 WHO-DAS Six Domains Understanding and communicating Getting around
Self care Getting along with others Life activities Participation in society دکتر محمد کمالی -1386

80 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 دکتر محمد کمالی -1386

81 WHO Slides: Participation and Environment in measurement of disability
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 دکتر محمد کمالی -1386

82 CIHI Health Indicators Framework
Acceptability Satisfaction 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 Efficacy Effectiveness PHQ WHO-DAS II Safety Treatment outcome دکتر محمد کمالی -1386

83 Migraine Disability Assessment Scale (MIDAS)
دکتر محمد کمالی -1386

84 Migraine Disability Assessment Scale (MIDAS)
دکتر محمد کمالی -1386

85 دکتر محمد کمالی -1386

86 Community Assessment دکتر محمد کمالی -1386

87 Community Assessment 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 دکتر محمد کمالی -1386

88 Community Assessment Process
WHY?? To identify and document the opportunities, challenges, strengths, and needs of a specific geographic community and its residents. دکتر محمد کمالی -1386

89 Community Assessment Process
WHY?? To build and strengthen relationships among community leaders, service providers and most importantly, community residents. دکتر محمد کمالی -1386

90 Community Assessment Process
WHY?? To have the information needed to make good decisions for a community collaborative strategic planning. دکتر محمد کمالی -1386

91 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. دکتر محمد کمالی -1386

92 Community Assessment 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. دکتر محمد کمالی -1386

93 Steps to Assessment Convene a planning group Define community
Identify Community Assets Identify Perceived Needs Build Demographic Profile Analyze Community Health Status Analyze Community Nutrition Status Identify Community Resources and Service Utilization Identify common issues and unmet needs Prioritize دکتر محمد کمالی -1386

94 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). دکتر محمد کمالی -1386

95 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 Phase Define general purpose of the NA (Focus for the NA & 3. Begins to develop an understanding of the existing problem or treatment to needed solve the problem. Assess the current situation. 2. Identify major need areas and/or issues 3. Identify existing information regarding need areas 4. Determine: Data to collect, Sources, Methods, Uses of data. OUTCOMES: Preliminary management plan for Phases 2 and 3, and preliminary plan for evaluating the NA Phase Determine context, scope, and boundaries of the NA. 2. Gather data on needs 3. Set preliminary priorities on needs. Level 1: (primary) - service receivers: students, clients, patients, information users, etc 4. Perform causal analyses at Level 1 and Level 2: (secondary) - service providers and policy makers: teachers, parents, administrators, caseworkers, professional staff, support staff, etc. and Level 3: (tertiary) resources or solutions: buildings, facilities, equipment, supplies, technology, programs, delivery systems, working conditions, time allocations, etc. Examine external environment (external factors), Examine internal environments (mission & goals). Analyze and synthesize data. Look for gaps, faults, failures, etc., at all levels. Look for causes of performance gaps. OUTCOMES: Criteria for action based on priorities Phase Set priorities on needs at all applicable levels. Consider alternative solutions. Develop action plan to implement solutions, to improve performance. Look to the future. Evaluate the NA Communicate results... OUTCOMES: Action plan(s), written and oral briefings, and reports دکتر محمد کمالی -1386

96 Needs Assessment Tools
Surveys Questionnaires Interviewing Focus Groups Observations Performance Measures Ranking Grading Scoring Rating دکتر محمد کمالی -1386

97 پرسش؟ دکتر محمد کمالی -1386


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