Introdução: A prevalência de condições crônicas em todo o mundo vem apresentando significativo crescimento, todavia os serviços de saúde, ainda, encontram-se, majoritariamente, organizados para o atendimento de condições agudas de saúde. Na saúde suplementar essa lógica não é diferente e considerando que o mercado de saúde suplementar responde, atualmente, pelo atendimento de parcela expressiva da população brasileira torna-se relevante a compreensão da qualidade nesse cenário. Objetivo: Compreender a percepção acerca da qualidade de um serviço de saúde suplementar, perspectiva do usuário. Caminho metodológico: Estudo de abordagem qualitativa, cujo cenário foram os serviços próprios de saúde de uma empresa de autogestão. Os participantes foram usuários desse serviço, localizado em Brasília-DF. Os dados foram coletados após anuência do Comitê de Ética, por meio de entrevista associada à estratégia da observação, no período entre agosto e outubro de 2014. O corpus de dados foi apresentado em forma de narrativas e analisados segundo a análise de conteúdo. Achados: A partir das narrativas foram estabelecidas cinco categorias de análise que possibilitaram ampliar a compreensão, a saber: o vínculo como elemento de liga na qualidade do cuidado; a família como cimento do cuidado da condição crônica; a relação biopolítica do cuidado; a percepção da condição crônica; e a integralidade e continuidade do cuidado. As categorias foram discutidas à luz da sociologia do quotidiano, proposta por Maffesoli, possibilitando a compreensão da construção do imaginário de qualidade e do cuidado dos participantes. Para análise interpretativa dos dados foi utilizado o referencial da Trajetória da Doença Crônica, apresentada por Bury. Considerações finais: O estudo permitiu compreender o imaginário de qualidade compartilhado por usuários de um serviço de autogestão, que apresentam características próprias no consumo e acesso a serviços de saúde, em muito relacionadas à cultura organizacional compartilhada. Assim, a qualidade para o usuário de uma autogestão apresenta como elementos fundamentais o vínculo, a integralidade solidariedade orgânica. / Introduction: The prevalence of chronic conditions around the world has shown significant growth, however health services also are, mostly, organized for the care of acute health conditions. In the health insurance that logic is no different and considering the supplementary health market is now responsible for a significant portion of care of the population becomes relevant to understanding the quality in this scenario. Aim: To comprehend the perception of the quality of a supplementary health service user perspective. Methods: A qualitative study, whose scenario was the very health services in a self-management company. The participants were users of that service, located in Brasilia. Data were collected after approval of the Ethics Committee, through interviews associated with the observation strategy in the period between August and October 2014. The data corpus was presented as a narrative and analyzed according to content analysis. Findings: From the narratives were established five categories of analysis that enabled broaden the understanding, namely: the link as an alloying element in quality of care; the family as cement care of chronic conditions; biopolitics relationship of care; the perception of chronic condition; and the completeness and continuity of care. The categories were discussed in light of everyday sociology proposed by Maffesoli, enabling the understanding of the quality of imaginary construction and care of the participants. For interpretative analysis of the data it was used the reference of Trajectory of Chronic Disease, presented by Bury. Final considerations: The study permitted to comprehend the quality of imaginary shared by users of a self-management service, which has specific characteristics in consumption and access to health services, closely related to the shared organizational culture. Thus, the quality for the user of a self-management features as fundamental elements the bond, integrality and organic solidarity.

Introdução: As instituições de saúde trabalham, incansavelmente, em prol da melhoria da qualidade dos serviços prestados e a enfermagem, como integrante desses serviços, busca, constantemente, programas que acarretem melhores resultados assistenciais e com isso a segurança do paciente. Dentre esses programas destaca-se o Magnet Recognition Program, desenvolvido pela American Nurses Credentialing Center- ANCC, o qual visa acreditar os estabelecimentos de saúde com excelência na prática de enfermagem. Objetivo: Analisar a produção científica acerca do processo de implementação do Magnet Recognition Program, publicada no período de junho de 2004 a junho de 2014. Metodologia: Trata-se de uma revisão integrativa de literatura, cuja coleta de dados foi realizada de julho a agosto de 2014, no portal de dados BVS que contempla as bases de dados BDENF, LILACS e MEDLINE e na base de dados CINHAL. A amostra constituiu-se de 16 artigos. Resultados: Os resultados evidenciaram que grande parte dos estudos eram oriundos de revistas de enfermagem, no idioma inglês. Quanto ao delineamento do estudo, verificamos que 11 deles eram constituídos por relatos de experiência e cinco compreendiam pesquisas de abordagem qualitativa, com nível de evidência VI. A análise dos estudos possibilitou compreender com maior clareza o processo de implementação do Magnet Recognition Program constituído por seis etapas, a saber: aplicação, avaliação, visita local, premiação, manutenção e redesignação. Os estudos demonstraram que a etapa de aplicação consistia no processo de submissão da instituição à candidatura frente a ANCC. A etapa de avaliação constituiu-se na análise, pelos avaliadores da ANCC, da documentação escrita apresentada pela organização candidata. Após a aprovação, uma visita ao local era agendada. Na ocasião da visita à instituição a ser acreditada eram identificadas a presença das 14 Forças do Magnetismo na organização. Uma vez aprovado, a certificação Magnet era concedida, constituindo a fase de premiação. Decorrido esse processo, havia o início da fase de manutenção da cultura Magnet, para que a redesignação acontecesse após quatro anos. Como facilitador de todo o processo, os estudos evidenciaram a utilização de consultores, a visita a uma organização anteriormente credenciada, a utilização de um profissional experiente para a elaboração do relatório, o envolvimento de todos os profissionais entendendo o Magnet como uma meta organizacional e o apoio do corpo diretivo, a fim de que os recursos financeiros e estruturais fossem providenciados. Os estudos evidenciaram, ainda, aspectos importantes relacionados aos componentes do Magnet Recognition Program os quais versavam principalmente sobre a governança compartilhada, prática profissional exemplar e estrutura de empowerment fundamentais para as organizações. Conclusão: Este estudo propiciou o conhecimento das etapas para a implementação do Magnet e, desse modo, acreditamos que esse resultado possa contribuir com outras organizações que estão pleiteando essa certificação, fornecendo subsídios para o alcance de seus credenciamentos. No entanto, frente aos níveis de evidência dos artigos, torna-se imperativo a realização de estudos com rigor metodológico mais elevados. / Introduction: Health care organizations vigorously work for the improvement of service quality and nursing, as part of these services, always seeking for assistance programs that involve better results and consequently the patient safety. Among these programs, the Magnet Recognition Program, developed by the American Nurses Credentialing Center-ANCC, aims to accredit health facilities with excellence in nursing practice. Objective: To analyze the scientific production on the implementation process of the Magnet Recognition Program, published from June 2004 to June 2014. Methodology: This is an integrative literature review. Data collection was carried out from July to August 2014, through BVS data portal that includes the BDENF, MEDLINE, LILACS and CINHAL databases. The sample consisted of 16 articles. Results: The results showed that most of the studies were from nursing journals in the English language. Regarding design of the study, we found that 11 of them were based on case reports and five researches comprised a qualitative approach, with evidence level VI. The analysis of the studies allowed us to clearly understand the implementation process of the Magnet Recognition Program consisting of six stages, as follows: implementation, evaluation, site visit, awards, maintenance and reassignment. Studies have shown that the application stage consisted of submitting to the institution the process to be elected by the ANCC. The evaluation stage consisted of analysis by the evaluators of the ANCC related to writing documentation presented by the applicant organization. After approval, a visit to the place was scheduled. On the occasion of the visit to the institution to be accredited, it was identified the presence of 14 Magnetism Forces in the organization. Once approved, the Magnet certification was granted, constituting the awards stage. After this process, the culture Magnet maintenance stage was started so that the reassignment could be performed after four years. As a facilitator item of the whole process, the studies showed the use of consultants, the visit to a previously accredited organization, the employment of an experienced professional to prepare the report, the involvement of all professionals understanding the Magnet program as an organizational goal and the support of the governing staff, in order that the financial and structural resources can be provided. The studies also showed important aspects related to the components of the Magnet Recognition Program which were mainly about the shared governance, professional exemplary practice and fundamental empowerment structure for the organizations. Conclusion: This study allowed to identify the steps to implement the Magnet program and the results can contribute to other organizations that are seeking for this certification, providing subsidies to reach their accreditation. However, when comparing the levels of evidence of the analyzed studies, it was observed the need to use a higher methodological rigor for further studies.

Submitted by Marcia Silva (marcia@latec.uff.br) on 2015-10-29T13:59:08Z No. of bitstreams: 1 Dissert Maria Bernarda Teixeira Duarte.pdf: 1549437 bytes, checksum: b3804fd76a14ca74fbb23e29a0439967 (MD5) / Made available in DSpace on 2015-10-29T13:59:08Z (GMT). No. of bitstreams: 1 Dissert Maria Bernarda Teixeira Duarte.pdf: 1549437 bytes, checksum: b3804fd76a14ca74fbb23e29a0439967 (MD5) Previous issue date: 2012-11-27 / Comissão Nacional de Energia Nuclear / Esta pesquisa tem por objetivo a proposição e aplicação de um modelo para a avaliação da satisfação dos usuários de uma biblioteca especializada, com respeito aos serviços prestados pela mesma. Uma extensa revisão da literatura nas bases Scientific Electronic Library Online - SciELO, Scopus e ISI Web of Science foi desenvolvida a fim de dar suporte à construção de um modelo para a avaliação dos serviços oferecidos por bibliotecas. Esta revisão foi especialmente útil para definir o conjunto de critérios de avaliação e para a elaboração do questionário aplicado em uma amostra composta por usuários de uma biblioteca especializada na área de tecnologia nuclear, neste caso, a do Instituto de Engenharia Nuclear – IEN. Como consequência, este trabalho pretendeu analisar os resultados visando a melhoria da qualidade dos serviços oferecidos. A amostra desta pesquisa foi composta por 117 respondentes dentre os quais retornaram 94 formulários. Como resultado, os dados coletados indicaram que os critérios nos quais a biblioteca teve melhor desempenho foram a conservação e a adequação do acervo. Por outro lado, os resultados também mostraram que os critérios atualização e cobertura internacional do acervo foram os que demandaram maior prioridade de ações de melhoria, visto que tiveram baixo desempenho e foram considerados de alta importância para os respondentes. / This research aims to propose a model for evaluating the satisfaction of the users of a specialized library, regarding the library services. An extensive literature review on the bases Scientific Electronic Library Online - SciELO, Scopus and ISI Web of Science was developed to support the construction of a model for the evaluation of the services offered by libraries. This review was especially useful to define the set of evaluation criteria and to prepare the questionnaire on a sample of users of a library specialized in the field of nuclear technology, in this case, the Institute of Nuclear Engineering – IEN. Consequently, this work intended to analyze the results to improve the quality of offered services. The sample was composed of 117 respondents of whom 94 returned forms. As a result, the collected data have indicated that the criteria on which the library best performed were the conservation and adequacy of the collection. Moreover, the results also have shown that the update criteria and international coverage of the collection are the ones have greater priority while promoting improvement actions, since they were perceived as having low performance and high importance by the respondents.

The main objective of this study was to critically investigate the mediating role that the use of mobile technology plays in the linkage between customer satisfaction and customer loyalty in a semi-urban environment. The research problem focused on the application of mobile technology in the linkage between customer satisfaction and customer loyalty in the clothing industry in King Williams Town. In accomplishing this objective, this research study hypothesised that mobile technology plays a mediating role in the linkage between customer satisfaction and customer loyalty of customers of clothing retailers in South Africa. Multiple regression was conducted to test for the first hypothesis. The first secondary objective aimed at establishing if there is disconfirmation between customer expectations and the performance of clothing retail outlets in King Williams Town. In exploring this objective, it was hypothesised that there is negative disconfirmation between customer expectations and performance. A paired sample test was conducted to test for this hypothesis. In addition, the influence of service quality and customer satisfaction on customer loyalty was explored. To accomplish these, it was hypothesised that both service quality and customer satisfaction have an influence on customer loyalty. Pearson’s Correlation and the Chi-Square Test were applied to test the influence of service quality and Customer satisfaction on Customer loyalty. Data was analysed using the Statistical Package for Social Sciences (SPSS) statistical software. Regression analysis, chi-square tests, Paired sample tests and correlation reports were used to analyse data inferentially. Reliability and validity of the research was also tested using Cronchbach’s alpha test. The results show that mobile phones have become a basic necessity for customers and that mobile technology plays a mediating role in the linkage between customer satisfaction and customer loyalty; however, the mediation is partial. The results also show that there is positive disconfirmation between customer expectations and retailer performance; that both service quality and customer satisfaction have a positive correlation with customer loyalty and that mobile technology enhances customer loyalty. Finally, the results show that the total service experience of customers is favourable vii because the five components of service quality were rendered at a high level of service quality. The study offers several managerial recommendations. Firstly, retail managers should make strategic investments in mobile technology and use this technology to the full to reap the benefits of technologically advanced mobile communication. Secondly, managers should be creative in their use of this mobile technology to enhance customer satisfaction and, hence, customer loyalty. Thirdly, managers should prioritise the improvement of all five components of service quality in order to enhance customer loyalty. Finally, managers should provide a customer-centred service experience that exceeds customer expectations for service quality and mobile communication, one that maximises customer satisfaction and loyalty. The implementation of these recommendations could result in clothing retailers providing a customer-focused service experience in all five aspects of service quality. To successfully implement these recommendations, clothing retailers should: ensure that expectations created, could be accomplished or exceeded to build and enhance customer satisfaction; create expectations that are realistic to avoid negative disconfirmation and hence customer dissatisfaction; implement innovative and creative mobile communication strategies to build and enhance customer loyalty; and finally, improve loyalty programmes to enlarge the customer base.

M.Inf. / Users of geographic information systems (GIS) are often faced with a challenge with regard to identification, location and overall access to digital data used in the application of GIS. The selection of the appropriate data from the large volumes available, also gaining access to available data and the establishment of the distribution of data from one central source are necessary tasks in order to improve the dissemination of GIS data. However, these are difficult tasks due to many users being unaware of the full range of available digital GIS data. A mechanism that could assist in improving access to digital GIS data is the Webbased GIS clearinghouse. This study was initiated to determine the requirements of GIS clearinghouses for optimum accessibility to digital GIS data. A literature study was conducted to investigate the nature of data that is used in GIS clearinghouses, the current trends in GIS data on the Web and the unique characteristics of the Web that can increase accessibility to digital GIS data. A selection of clearinghouses was made and these were evaluated in order to determine variables that can be translated into criteria from which a model for the evaluation of GIS clearinghouses could be established. This model can act as a working document or check-list for users to evaluate GIS clearinghouses, or for designers to create new or improve existing GIS clearinghouses.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-14T15:24:46Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Dissertação de Maristela - completo (4).pdf: 1666360 bytes, checksum: 6326d5af06a488722ac05a5564cac305 (MD5) / Made available in DSpace on 2017-07-14T15:24:46Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Dissertação de Maristela - completo (4).pdf: 1666360 bytes, checksum: 6326d5af06a488722ac05a5564cac305 (MD5) Previous issue date: 2016-03-31 / PPGES / Esta pesquisa teve como objetivo analisar a eficiência das especialidades médicas na média complexidade em seis Policlínicas na cidade do Recife-PE. Estudo de abordagem quantitativa, descritiva, tendo como objeto os custos das consultas ofertadas/programadas e executadas no ano de 2014. Avaliou-se o desempenho de cada unidade quanto à produtividade profissional por especialidade médica e a eficiência microeconômica pelo valor monetário das consultas ofertadas e programadas e não realizadas. Os dados primários foram obtidos em entrevista com os gestores locais e os secundários de relatórios dos sistemas de informações SIA/SUS, CNES e outros municipais. Utilizou-se para análise estatística descritiva: frequências absolutas, relativas e médias de consultas programadas, realizadas e aprovadas e valores monetários por especialidade médica e por unidade. Os resultados estão apresentados em tabelas e figuras. As unidades não atingiram o valor monetário estimado segundo a capacidade ofertada e obtiveram índice de desempenho que variou de 47% (mínimo) a 67% (máximo), classificando os serviços em pouco eficientes ou ineficientes quanto à produção. Identificou que a programação orçamentária das unidades está aquém da capacidade produtiva dos profissionais e que a avaliação da eficiência não integra as atividades da auditoria municipal de saúde. Faz-se necessário sua incorporação desse tipo de auditoria para que se possa informar ao gestor sobre a produtividade e eficiência a fim de contribuir para o planejamento e reorganização das redes municipais, visando à melhoria do desempenho e da qualidade dos serviços. / The aim of this research was to analyze the efficiency of the median complexity in six Polyclinics in the city of Recife-PE using information from specialized medical consultations. This was a descriptive study with a quantitative approach and as tracers the programmed and performed consultations in 2014. The performance of each unit was evaluated regarding the professional´s productivity in his/her medical specialty and the microeconomic efficiency through the difference in the monetary value of programmed but unperformed programmed consultations. Primary data were obtained from interviews with local managers in order to confirm secondary data collected from information systems reports at SUS – Brazil's Public Health System: outpatients clinics (SIA), The National Register for Health Facilities (CNES), the Budget Programming File (FPO) and others municipal systems. The absolute and the relative frequencies, the annual mean programmed, performed and approved consultations, in addition to the monetary values paid by SUS were used for the descriptive analysis per medical specialty and per unit. The results are presented in tables and figures. The units did not reach the expected monetary value according to the offered capacity and few medical specialties fulfilled the number of programmed consultations. The performance index ranged from 47% (minimum) to 67% (maximum). It was identified that the Budget Programming for the units was lower than the productive capacity of the professionals involved and that routine evaluation of efficiency is not an activity undertaken by the municipal health audits. It is necessary to incorporate this type of audit so as to inform the health authorities, in order to plan and reorganize municipal networks, aiming to improve the quality and performance of the services. In order to monitor this activity we have proposed a measure based on the compliance of the consultations goals and a classification system for the units as being efficient, slightly efficient or inefficient, according to the percentage scores obtained, so as to stimulate both professionals and managers to achieve their best performances.

In this thesis, we consider how service platforms can provide personalized service to incoming consumers in order to improve ease and convenience for their users, or to enhance their own revenues. With an increasing trend toward digitalization, there is now a massive amount of data that can be leveraged to accomplish this goal. In this thesis, we explore how to leverage feature data about the consumers and products, as well as the way consumers interact with the platforms, in order to make better operational decisions, such as pricing, ranking, and recommendations of products and services. In Chapters 1 & 2, we study platforms in which consumers' purchasing decisions are strongly influenced by reviews that are posted by previous consumers. In Chapter 1, we consider how a platform can learn from the choices that consumers make, as well as the reviews they leave, in order to form increasingly accurate estimates about product quality and consumer preferences, so that the platform can provide better personalized product rankings. In Chapter 2, we focus on platforms where each consumer forms an impression of a product by browsing the available reviews in a chosen order following a cascade click model. We consider how to rank the reviews as well as how to price a product given the reviews, in order to maximize short- and long-term revenue. In Chapter 3, we study a platform that offers a menu of memberships of different durations to a pool of heterogeneous consumers. A consumer's choice depends on both the menu prices and his personal intended usage time. The platform wants to maximize the long-term revenue while considering the choices made by heterogeneous customers. We show insights into the optimal solution of each problem when all the parameters are known. For the case where some parameters are initially unknown, we propose a joint learning and optimization algorithm, and provide theoretical guarantees for its performance.

Submitted in partial fulfilment of the requirements for the Degree of Master of Arts (Counselling Psychology) at the University of Zululand, 2006. / The problem of career development in disadvantaged communities in South Africa is a product of historical discriminatory practices that have resulted in large numbers of young people not having access to appropriate career guidance services. As a solution to mass career guidance needs, a non-profit, self-help career guidance program serves as a supplement to curriculum based school programs and provides people with the opportunity to access career guidance services in an empowering environment. This case study qualitatively describes the development and evaluation of a career guidance centre as a resource for large numbers of learners, educators and unemployed youth. Specifically, the role that the hands-on permanent career exhibition plays in a self-help career choice model is discussed, together with the subjective experience of the centre by a number of people who used the services provided by the Zululand Career Centre in Richards Bay, South Africa. A logic model provides a view of the resources, influencing factors, implementation activities and outputs that make up the development of the centre. The design of the career centre embodies several relevant psychological theories and is essentially a self-help exhibition-led process. Its development provided an opportunity for the innovative application of existing trait and type, life-span, constructivist, social learning, decision-making and socio-economic approaches within the South African context. The life-span and decision-making approaches provided the theoretical background for the problem-solving exploration processes used in the centre, while the trait and factor theories provided techniques for self-knowledge acquisition and career information classification. Social learning theory provided insight into the pivotal role the staff members of the centre would have to play in the learning processes, while the constructivist theories led to an understanding that users of the centre would be able to construct their knowledge of careers from their experiences with the centre displays and their own lived experiences. The importance of up-to-date, contextually relevant information was highlighted by the socio-economic approaches. The centre provided insights into how exhibition-led learning is able to assist a large number of people to access career and labour market information and actively participate in the career decision-making process. / National Research Foundation

The goal of this dissertation is to examine the utility of screening for common mental disorders in primary care in low and middle income countries. Screening for common mental disorders in primary care is often considered as an important step in addressing the mental health treatment gap in low and middle income countries. Nevertheless, there is insufficient evidence to support routine mental health screening in primary care in these countries. Even in high income countries, there is a lack of consensus on the effectiveness of routine mental health screening in primary care, especially screening for depression. Challenges to screening include the high rates of false positive diagnosis, poor evidence on outcomes for people identified by screening, and potential harms due to screening. The specific aims of this dissertation are to: 1) synthesize evidence from low and middle income countries on the current practices of screening for common mental disorders in primary care and the use of screening instruments; 2) understand the significance of a positive screen for common mental disorder in primary care, specifically the distribution and the stability of ICD-10 diagnosis for screened positive patients, their clinical course over a period of one year, and the factors associated with the clinical course; 3) examine the factors associated with antidepressant prescriptions for patients screened positive for common mental disorders in primary care and evaluate the appropriateness of antidepressant prescriptions following screening. Based on our review of literature, evidence to support routine screening for common mental disorders in primary care in low and middle-income countries is inadequate. We highlight concerns about the fidelity with which screening is implemented, especially the flawed use of screening instruments. Introducing depression screening and physician notification in these settings seldom results in improved access to care or appropriate care. The majority of patients identified by screening in primary care have contextual, and probably non-pathological psychological distress (see page iii, for definition of key terms) which is often temporary and self-limiting. Patients with persistent distress symptoms identified by repeated screening, and those with moderate to severe depression may benefit from screening in the presence of evidence based stepped care interventions that are easily accessible and acceptable. Although, the long term effects of these interventions and the sustainability of such primary care based programs in low and middle income countries are uncertain. Our analysis of data from a cluster randomized control trial in India confirmed that a significant proportion of patients screened positive for common mental disorders in primary care has psychological distress that is temporary and self-limiting. However, a smaller, albeit important share of patients also experienced psychological distress that persisted throughout one-year follow-up. Persistent distress was predicted by psychosocial and economic disadvantage. Thus, psychosocial support systems and structural interventions have a larger role to play in addressing psychological distress. We found poor diagnostic stability for ICD-10 based diagnoses, and the most stable and prevalent diagnosis was mixed anxiety and depressive disorder. Further, we found that antidepressants are widely prescribed following screening especially for women and older adults. While many patients with moderate to severe depression could benefit from antidepressants, it is problematic that a significant proportion of patients with less severe disorders also received anti-depressant prescription despite the availability of non-pharmacological treatment options. In summary, there is a lack of empirical evidence to support routine screening for common mental disorders in primary care in low and middle income countries as an effective strategy to identify those in need of treatment; instead screening could lead to over diagnosis and inappropriate antidepressant prescriptions. To address psychological distress in primary care and the unmet need for treatment in low and middle income countries, there is an urgent need to focus on locally driven and culturally relevant approaches to case finding and intervention.

The purpose of the study was to explore the inter-rater reliability of the Multi-Dimensional Outcome Measure (MDOM) in the following areas: overall reliability, differences in reliability between samples, differences in reliability between scales, and increasing reliability over time. The study was to assist mental health professionals by clarifying the technical properties of an evaluation tool which could be used to document program outcomes for policy makers and to develop more effective treatment methodologies. The MDOM was administered to two groups, a mentally and emotionally disturbed sample of thirty-five Subjects from an inpatient facility and a normal sample of thirty-three community college Subjects. The MDOM was given in back-to-back interviews by two interviewers alternating in first interviewer, second interviewer roles. The data indicated acceptable inter-rater reliability for the Multi-Dimensional Outcome Measure. For anyone sample, all twelve scales showed acceptable reliability according to the criterion of a .75 product moment correlation coefficient. However, four scales did not meet the .75 level: Productivity I (.55), Productivity II (.74), Interpersonal Isolation--Family (.71) when administered to the inpatient sample, and Drug Abuse (.74) when administered to the community college sample. Assessment of the differences in reliability between samples showed higher reliability for the community college sample than for the inpatient sample with the exception of the Drug Abuse scale. Exploration of the differences in reliability between scales showed some scales contained items which were more relevant for the college student than for the inpatient. Other scales included items which were ambiguous or worded in an awkward manner which may have contributed to their lower reliability. Reliability could be increased as a result of the increased skill and clarification of questionable items. Scales which demonstrated unacceptable reliability the first weeks of the study indicated an acceptable level the last week. The data suggested that interviewers should be trained to insure acceptable reliability. The MDOM was seen to be suitable for monitoring the functioning of a community based sample; however, consideration should be given to the inherent limitations before administering the instrument to an inpatient sample.