Introduction et recension des écrits : Récemment, les suicides de vétérans et d’athlètes professionnels ont attiré l’attention sur l’association entre le TCC et le suicide. Les lignes directrices concernant la prise en charge en santé mentale dans cette population demeurent fragmentaires. Les objectifs de cette thèse sont de 1) déterminer si une association existe entre le TCC subi dans l’enfance et le suicide futur, 2) explorer si les personnes qui se sont suicidées ont consulté un psychiatre dans l’année précédant le suicide et évaluer si cela diffère selon que la personne ait eu un TCC ou non, 3) décrire et qualifier l’offre québécoise de santé mentale offerte en réadaptation aux enfants et aux adultes ayant subi un TCC. Méthodologie : Le volet épidémiologique consiste en une étude de cohorte rétrospective sur un échantillon de 135 703 enfants ayant reçu des services médicaux au Québec en 1987 et suivis jusqu’en 2008. Le volet qualitatif comprend un sondage auprès des gestionnaires des programmes de réadaptation TCC du Québec, des groupes de discussion avec des cliniciens et des entrevues avec des survivants de TCC et leurs proches. Résultats : Notre étude épidémiologique confirme une association significative entre le TCC subi dans l’enfance (HR 1,49 IC95% 1,04- 2,14), dans l’adolescence (HR 1,57, IC 95% 1,09-2,26) et à l’âge adulte (HR 2,53, IC95% 1,79-3,59) et le suicide. Malgré un risque de suicide plus élevé, les personnes avec un TCC et qui se sont suicidées n’ont pas consulté de psychiatre plus fréquemment que les personnes sans TCC (OR 1,29, IC 95% 0,75- 2,24). Par ailleurs, notre étude qualitative révèle que les forces du système actuel incluent une bonne qualité des services, mais qu’il existe des faiblesses au niveau de l’accès aux médecins spécialisés, du dépistage systématique et de l’accès aux services à long terme. Nos recommandations incluent le développement d’une approche coordonnée en santé mentale, l’implication automatique d’un gestionnaire de cas et l’amélioration des mécanismes d’accès après le congé. / Introduction and Literature Review: Recent suicides of veterans and professional athletes have signalled a possible association between traumatic brain injury (TBI) and suicide. Guidelines for management of mental health and suicide prevention in this population remain fragmentary. The objectives of this thesis are to 1) determine whether there is an association between childhood TBI and future suicide, 2) explore whether persons who committed suicide consulted with a psychiatrist in the year prior to suicide and if persons with a TBI consulted more than those without a TBI 3) describe mental healthcare provided in rehabilitation in Quebec to children and adults TBI survivors. Methodology: The epidemiological component consists of a retrospective cohort study of 135,703 children receiving medical services in Quebec in 1987 and followed until 2008. The qualitative component includes a survey of managers of Quebec TBI rehabilitation programs, as well as focus groups with clinicians and interviews with TBI survivors and their caregivers. Results: Our epidemiological study confirms a significant association between TBI suffered in childhood (HR 1.49, 95% CI 1.04, 2.14) in adolescence (HR 1.57, 95% CI 1.09, 2.26) and in adulthood (HR 2.53, 95% CI 1.79, 3.59) and suicide. Despite a higher risk of suicide, people with a TBI who committed suicide did not consult a psychiatrist more often than people without TBI (OR 1.29, 95% CI 0.75- 2.24). According to our qualitative findings, current strengths include good quality of services, but there are weaknesses in access to specialized physicians, routine screening and access to long-term services. Our recommendations include the development of a coordinated approach to mental health, automatic involvement of a case manager and improvement of access to follow-up services after discharge. Conclusion: The risk of suicide is increased in young persons with TBI compared to those without. Well-coordinated and long-term monitoring should be promoted.

This study sought to identify and explore the contributing factors responsible for the rate of high absenteeism, as a result of sick leave, at the South African Police Service (SAPS) Academy in Paarl. The research also explored international best practices in the management of absenteeism in police organizations. Furthermore, and most importantly, the study puts forward a set of recommendations to the management of SAPS regarding improvements that could address absenteeism and, ultimately, improve service delivery. Data was collected by means of a literature study coupled with semi-structured individual interviews. The interviews were conducted with the most diligent members of the group employees of the SAPS Academy in Paarl who had taken the least sick leave during the 2009-2012 leave cycle. A thorough literature review was conducted; this literature study focused on SAPS directives, inter alia, standing orders, regulations, national instructions and national legislation. In addition, national and international literature on absenteeism in the workplace was consulted. The findings of the study illustrate the impact of absenteeism on service delivery at the SAPS Academy, Paarl. It was established that absenteeism impacts on the morale of diligent members and, in turn, creates innumerable challenges for managers. The recommendations made in this study could contribute towards addressing and alleviating the impact of excessive absenteeism on service delivery at the SAPS Academy, Paarl. In addition, these recommendations could contribute towards addressing these matters within the broader SAPS body in and other government organizations, since absenteeism in the workplace is a general phenomenon. / Police Practice / M. Tech. (Policing)

This research was conducted from the perspective of a positive human behaviour paradigm in the context of human resource management. It investigated the interrelationships between work stress, work engagement and service delivery of academics in a changing distance-learning environment in Zimbabwe, for which there is a paucity of research. A descriptive, cross-sectional survey design was applied to a sample of 83 academics at the largest distance-learning university, against the background of their ever-changing roles. A sample of 101 students was also included, so that the students provided balanced data for analysis regarding their perception of service delivery by academics. Confirmatory and exploratory analysis revealed a four-construct measurement model for work stress, a three-construct measurement model for work engagement and a four-construct measurement model for service delivery. Correlational analysis and structural equation modelling revealed some significant relationships between these constructs. Tests for significant differences among different groups of academics and students based on socio-demographic variables were revealed and showed some interesting differences among these variables. The t-test did not reveal significant differences in service delivery perceptions between the academics and the students on the dimensions of responsiveness and assurance. The study makes a valuable contribution to the organisational behaviour literature in terms of how work stress and work engagement influence academics’ service delivery in a distance-learning university. On a theoretical level, the study did well to expand on available literature on the constructs of work stress, work engagement and service delivery provided by higher education distance-learning universities. The statistical techniques that were utilised expanded previous empirical studies by studying the interrelationship dynamics andoverall relationship dynamics between work stress, work engagement and service delivery provided by distance-learning universities. On a practical level, this study should bring new knowledge to managers at distance- learning universities by improving their understanding of how academics are affected by increasing, new job demands, which in turn increase their workload. Distance- learning universities thus should adapt their people management practices accordingly. Provision of adequate resources at both individual and organisational levels should be prioritised in order to minimise work stress and improve work engagement, and subsequently service delivery. / Hierdie navorsing is vanuit die perspektief van ’n positiewe menslike-gedragsparadigma in die konteks van menslikehulpbronbestuur uitgevoer. Dit het die onderlinge verhoudings tussen werkstres, werksbetrokkenheid en dienslewering van akademici in ’n veranderende afstandsleeromgewing in Zimbabwe, waaroor daar ’n gebrek aan navorsing is, ondersoek. ’n Beskrywende, deursnee-ondersoekontwerp is op ’n steekproef van 83 akademici by die grootste afstandsleeruniversiteit, teen die agtergrond van hulle voortdurend veranderende rolle, gedoen. ’n Steekproef van 101 studente is ook ingesluit sodat die studente gebalanseerde data vir ontleding rakende hulle persepsie van dienslewering deur die akademici kon verskaf. Bevestigende en verkenningsontleding het ’n vierkonstruk-metingsmodel vir werkstres, ’n driekonstruk-metingsmodel vir werksbetrokkenheid en ’n vierkonstruk-metingsmodel vir dienslewering aangetoon. Korrrelasie-ontleding en strukturele vergelykingsmodellering het betekenisvolle verhoudings tussen hierdie konstrukte uitgewys. Toetse vir beduidende verskille tussen die verskillende groepe akademici en studente, gegrond op sosio-demografiese veranderlikes, het interessante verskille tussen hierdie veranderlikes aangetoon. Die t-toets het nie beduidende verskille ten opsigte van diensleweringspersepsies tussen die akademici en die studente oor die dimensies van gevoeligheid en gerusstelling aangetoon nie. Die studie het ’n waardevolle bydra gelewer tot die literatuur oor organisatoriese gedrag en oor hoe werkstres en werksbetrokkenheid akademici se dienslewering by ’n afstandsleeruniversiteit kan beïnvloed. Op ’n teoretiese vlak het die studie ’n goeie viii bydra gelewer tot die beskikbare literatuur wat betref die konsepte van werkstres, werksbetrokkenheid en dienslewering wat deur hoëronderwys-afstandsleeruniversiteite verskaf word. Die statistiese tegnieke wat gebruik is, het voortgebou op vorige empiriese studies deur die onderlingeverhoudingsdinamika en algehele verhoudingsdinamika tussen werkstres, werksbetrokkenheid en dienslewering wat deur afstandsleeruniversiteite verskaf word, te bestudeer. Op ’n praktiese vlak behoort hierdie studie nuwe kennis verskaf aan bestuurders by afstandsleeruniversiteite deur hulle begrip te verbeter van hoe akademici deur toenemende, nuwe eise by die werk, wat op hulle beurt hul werkslading verhoog, beïnvloed word. Afstandsleeruniversiteite moet dus hulle mensebestuurspraktyke ooreenkomstig aanpas. Om voorsiening te maak vir voldoende hulpbronne op individuele sowel as organisatoriese vlakke, moet prioriteit daaraan gegee word om werkstres te verminder en werksbetrokkendheid, en uiteindelik dienslewering, te verbeter. / Lolu cwaningo lwenziwa ngokohlelo lomqondo wokuziphatha kahle komuntu, lokhu kwenzeka ngaphansi kohlelo lwezokuphathwa kwabasebenzi. Ucwaningo luye lwaphenya izinhlelo zobudlelwano obuphakathi kwengcindezi yomsebenzi, ukusebenza ngokuzikhandla kanye nokuhlinzeka ngemisebenzi yezifundiswa mayelana nesimo esiguqukayo sohlelo lokufunda ukude eZimbabwe, naphezu kokwentuleka kocwaningo. Idizayini yesaveyi echazayo naleyo yohlobo lwe-cross-sectionalzasetshenziswa kusampuli yezifundiswa ezingama-83 yezifundiswa enyuvesi enkulu yohlelo lokufunda ukude, phakathi kwezindima zenyuvesi ezihlala ziguquka njalo. Kuye kwafakwa isampuli yabafundi aba 101, ukuze abafundi banikeza uhlaziyo lwedatha elingene mayelana nomqondo wezokuhlinzeka ngezinsiza wezifundiswa. Izinhlelo zokuhlaziya eziqinisekisayo kanye nalezo ezihlolayo ziye zaveza imodeli elinganisayo yokwakha embaxa-zinne, okuyimodeli yokuhlinzeka ngezinsiza. Izinhlelo zokuhlaziya, phecelezi (correlation analysis) kanye nohlelo lokumodeli, phecelezi, (i-structural equation) ziye zaveza ubudlelwano obusemqoka obuphakathi kwalezi zakhiwo. Kuye kwavezwa izinhlelo zokuhlola ezahlukahlukene hlangana namaqembu ahlukahlukene ezifundiswa nabafundi, lokhu kususelwe phezu kwezimpawu zedemogilafi yezenhlalakahle yabantu, kanti lokhu kukhombise umehluko ohehayo hlangana nalezo zimpawu. Uhlelo lokuhlola, phecelezi i( t-test) aluzange luveze izimpawu ezehlukile ezimayelana nemiqondo yokuhlinzekwa ngezinsiza phakathi kwezifundiswa kanye nabafundi mayelana nemikhakha yendlela yokuphendula kanye nokuqinisekisa. Ucwaningo lwenze umsebenzi omkhulu omuhle mayelana nombhalo wokuziphatha kwenhlangano, mayelana nokuthi ingcindezi yomsebenzi kanye nokusebenza ngokuzikhandla kunomthintela muni phezu kokuhlinzeka ngomsebenzi kuzifundiswa enyuvesi yohlelo lokufunda ukude. Ngokwesigaba esiphathekayo, lolu cwaningo kufanele lulethe ulwazi olusha kubaphathi emanyuvesi ohlelo lokufunda ukude ngokuthuthukisa ulwazi lwabo mayelana nokuthi izifundiswa zithinteka kanjani ngokwengeza, izidingo ezintsha zomsebenzi, eziphinde zingeze umthwalo womsebenzi. Wazo. Ngalokho-ke, amanyuvesi ohlelo lokufunda ukude, kufanele ajwayele izingqubo zawo zokuphathwa kwabantu ngendlela efanele. Ukuhlinzekwa ngemithombo eyanele ezigabeni ezimbili, somuntu ngamunye nesigaba senhlangano kufanele kuqalwe ngakho ukuze kuncishiswe ingcindezi yomsebenzi kanye nokuthuthukisa indlela yokusebenza ngokuzikhandla, kanye nangokuhlinzeka ngezinsiza. / Business Management / D. Com. (Business Management)

Learners experiencing barriers to learning often require intervention and support from multiple professionals with different areas of expertise. Collaboration between professionals is important in avoiding fragmented and incoherent service delivery. Transdisciplinary service delivery allows for maximum integration among the various role players. Disciplinary boundaries are transcended through a process of skills transference and sharing of roles and provide child-centred, coordinated and collaborative support. This study investigates professionals in the Western Cape’s perceptions of a transdisciplinary service delivery approach for supporting learners experiencing barriers to learning. A sequential mixed method approach was utilized to gain an in depth understanding of professionals’ perceptions. Data were collected in two phases. During the first phase, a quantitative questionnaire was sent to various professional categories in the Western Cape who are expected to provide services to learners experiencing barriers to learning. The aim of the quantitative study was to provide background information for the second phase in which professionals’ perceptions of a transdisciplinary approach for supporting learners experiencing barriers to learning were obtained through eight focus group discussions. Four focus groups consisted of professionals who had not previously been exposed to a transdisciplinary approach. These professionals attended a two hour informative workshop on a transdisciplinary service delivery approach prior to the focus group. The remaining four focus groups consisted of professionals who had previously been exposed to transdisciplinary service delivery. Data were systematically analysed through a hybrid process of inductive and deductive analysis. Findings indicate that professionals providing services to learners experiencing barriers to learning perceive a transdisciplinary approach as useful and much needed for services provided both in schools and in private practice. Certain aspects of the transdisciplinary approach are perceived as more or less valuable, depending on the context and specific category of learning barrier. Although professionals acknowledge all aspects of the approach as valuable, multiskilling and role release are viewed as most needed. The transference of skills among therapists, teachers, parents and caregivers is perceived to contribute to effective and feasible service delivery. / Psychology of Education / D. Ed. (Psychology of Education)

多層次傳銷近年成長快速，目前國內已有200 餘家的傳銷公司，每年銷售額高達百億以上，預期未來將持續快速成長。當有上百萬人加入傳銷公司，成為「直銷商」的今天，對於此種攸關民生發展的新型態服務業，實有必要加以深入研究，以掌握時代脈動，本研究希望能夠從服務傳送系統的角度發覺其實際的運作方式。 　　本研究希望能達至的目的為： 　　1.探討多層次傳銷其服務傳送系統的內涵，即傳銷公司、直銷商與顧客之間的互動關係。 　　2.了解在其服務傳送系統中，哪些環節是其關鍵成功之處。 　　3.分析在此服務傳送系統中的潛在問題，及其可能的解決之法。 　　此一研究乃是以個案訪談的探索性實證方式進行，選擇安麗、丞燕、雙鶴作為個案訪問的公司，據此來發展相關命題，及提出結論建議。 　　文中將服務傳送系統分成前場及後場，前場包含產品、相關服務、服務人員、及顧客，後場則為後勤系統、激勵制度、教育訓練及理念灌輸，以及廣告、形象等八大構面，來分析多層次傳銷的運作方式，把多層次傳銷的產品特色、直銷商角色、獎金制度、榮譽階級等，都做了一個簡單的介紹，盼能夠對於從事相關行業及對多層次傳銷有興趣的人提供些許的幫助。

民國77年，服務業佔GDP 之49.3％，佔三級產業之首。而78年，前三 季服務業佔GDP 之比重更突破50％的大關，顯示服務經濟的時代已來臨。 「服務傳送系統」之任務為傳遞服務品質。並使顧客期望與知覺的品 質水準能夠一致。而服務業與製造業最大的不同處即在於「生產與消費的 不可分離」，故產銷配合分外重要。本研究以關鍵成功因素來整合產╱銷 兩大變數，並認為服務傳送系統之設計應與關鍵成功因素配合才可創造良 好的績效。 因此，本研究目的有四：１．服務業應以何種分類方式來 分類才可順利地找關鍵成功因素﹖２．在上述分類下，各類型之服務業其 關鍵成功因素的內涵為何﹖３．服務傳送系統之設計應如何配合關鍵成功 因素﹖４．服務傳送系統之本質與內涵為何﹖ 本研究採個案研究法， 以「技術特性」與「交易複雜度」兩構面分析，不同的產業脈絡下，其關 鍵成功因 素之差異，並據此發展命題。 此外，本研究之結論有：１ ．服務業之分類方式應以「技術特性」與「交易複雜度」兩構面來分析， 才可達成產銷配合之任務。依此分類方式可將服務區分成專業服務、間斷 式服務與大量服務。２．不同之服務型態，其關鍵成功因素有所不同：（ １）專業服務之ＫＳＦ為：專業能力、形象、團隊合作、界面管理與分權 。（２）間斷式服務之ＫＳＦ為：形象、聲譽、品牌、規模、業務能力、 設計╱多樣化的能力。（３）大量服務之ＫＳＦ為：標準化的制度、產銷 配合、採購能力、顧客關係、等候線管理、立地與遞送。３．專業服務為 產品導向，著重效能的服務傳送系統。４．大量服務為過程導向，著重效 率的服務傳送系統。５．間斷式為一著重彈性、過程與產品兼具的服務傳 送系統。

「馬上關懷急難救助」開辦以來，已成為了我國社會救助政策中一項重要措施，也為社會救助政策注入了異於傳統的複雜性與動態性。福利輸送體系的規畫與執行為社會政策的重要一環，當福利輸送體系出現了轉變，其中的參與者，不論是政府部門、執行單位、甚至是接受福利服務的案主，其角色與功能也因此異於以往。 據此，本研究從福利輸送觀點來檢視馬上關懷此項方案，針對其福利輸送體系作一步的探討與分析。透過本研究期待可瞭解：一、瞭解馬上關懷急難救助的福利輸送體系之運作過程與組成結構；二、探討馬上關懷急難救助的福利輸送體系對於福利接受者的影響；三、探討馬上關懷急難救助的福利輸送體系在實務上的相關問題，以提供政策制定者為參考。 依據研究問題與目的，本研究採質性研究方法，邀請台北市文山區九位執行人員與五位福利接受者進行深度訪談，研究結果茲分述如下： 一、 馬上關懷急難救助福利輸送體系之改革 首先，就其運作過程而言，在輸入階段有多元且深入社區的入口管道、具包容性的申請門檻、仰賴通報人員等特色；在轉化階段有僵化的書面審查、實地訪視、明文化的裁量空間、政治壓力的介入等特色；在輸出階段有可及性的協助、尚未能整合社區資源、福利銀行機器等特色。 其次，就其組成結構而言，在重新建構福利輸送體系的面向，有聯邦模式的協調方式、公民參與等特色；在重新分配福利輸送體系任務分工的面向，有多元化的執行者、專業的撤離等特色；重新建構福利輸送體系組成的面向，有多元且即時的求助管道、補充性的福利措施等特色。 二、 對於福利接受者的影響 馬上關懷急難救助對於福利接受者的正面影響主要有提升可近性與可及性，而負面影響為整合性、連續性、公平性、可責性等方面的不足，有待改善。 / Ever since the start of Emergency assistance, it has become an indispensable assistance policy in our society and it helps our social assistance policies with new mobility and elaborateness. The program and the execution of the service delivery system are considered the most important links for the social policies; when service delivery system shifts, every part of its participator, such as the government, the executive board, or the clients functions differently. According to the fact mentioned above, this research attempts to scrutinize the Implementing Urgent Caring System with a service delivery system perspective, especially focusing on the further analysis of its service delivery system. The paper would be divided into three parts: 1. Understanding the operational process and the structure of the service delivery system of the Implementing Urgent Caring System. 2. Discussing the influence of the welfare receivers’ of the emergency assistance of the service delivery system. 3. Discussing the problems regarding the emergency assistance of the service delivery system and offering suggestions for the policy makers for reference. This research adopts qualitative research methods to invite nine executive social workers of Wenshan District, Taipei City and five welfare receivers (clients) to do the depth interviews, and the research results are as follows: 1. The reformation of the emergency assistance of the service delivery system of the Implementing Urgent Caring System: Foremost, in the preliminary process of the reformation, the diverse entrance, the loose application restrictions, and the evaluation system of professional informers play very significant roles. Second, on the middle of the reformation, the ossified application form examination and inquiry, the transparent measurement of evaluation, and politic interference are the evident conditions in executing the emergency assistance. In the last phase of the emergency assistance, there we can find the accessible assistance ,the disorganization of community resources, and welfare bank apparatus are the main characteristics of this part. Moreover, when it comes to the structure of the emergency assistance,we can find its features sit on the modes of federation and the citizen participation. Next, in distributing the whole project, the executives and the professional evacuators take charge of the service delivery system. In the final process of the emergency assistance, immediate and diverse assistance, supplementary welfare measures make the emergency assistance more beneficial. 2. The Influence on the Clients: The positive influences of emergency assistance of the Implementing Urgent Caring System toward the clients are uprising the accessibility and availability while the negative influences are the lack of integration, continuity, equality, and accountability.

摘要 分類是研究的第一步，服務業理必須基於有意義的分類，才 可能提出規範性的結論。此外，服務業的無形產出，必須透過細緻的 服務傳送系統設計來傳遞給顧客。因此服務業的研究首要工作，在從 抽象的層次中提出對服務業無形特性的有效分類。經由文獻檢討及實 務觀察，本文提出三項服務業的產出分類構面:經濟性、社會性及心 理性利益，稱之為服務核心。以此三構面將台北市的服飾零售業分為 四種類型:經濟心理性、心理性、混雜性及經濟性零售店。各類型零 售店中較績優者，相互之間服務傳送系統的差異非常明顯，顯示績效 的殊途同歸性是明顯的。用一類型零售店組內的比較分析中，以類神 經網路求得影響績效最重要的服務傳送系統項目:經濟心理性最重要 的活動與商品無直接的關連;心理性零售店最重要的是人員專業性與 商品風格與品味;經濟性零售店的服務傳送系統則是愈簡單愈好。文 末並提出相關的討論是建議。 / ABSTRACT keywords: service industry, service core, service delivery system, retail industry， neural network Classification is the first step for research. Normative suggestions cannot be provided unless meaningful classification is available in service management. Meanwhile, intangible output in service organizations usually is transferred to customers through delicate service delivery system. Therefore the primary task in service management research is to devise efficacious, theoretical classifications to govern inherent intangibility in service management. Through literature review and field study, this paper proposed three classifying dimensions for fashion retailing, which were termed service cores consisting of economic , social , and psychological benefits. Based on these three dimensions, four types of retailing firms were derived with clustering analysis: eco-psychological, psychological, and economic types. Between groups, better performers were extracted to compare with each other， which demonstrated the significances of equifinality towards performance and differences between these four retailing types. Within groups, neural network analysis was employed to determine important factors in service delivery system. In eco-psychological type, important factors were irrelevant to merchandises. Professional salespersons and special merchandise were critical to psychological stores. Better economic stores were all rated low in most delivery activities. Relevant suggestions and discussions were given to conclude the findings.

跨機關服務協力合作網絡的有效形成，在官僚體制漸漸無法發揮績效的情況下，更顯得重要。為了探討在機關間協力合作的種種問題，本研究以公共網絡管理文獻建構跨機關間協力合作的模型。公共網絡管理的文獻，主要在探索公共管理者的行為與角色，以及機關間的協力合作行為，如何貢獻於服務傳遞協力合作網絡績效，而這兩個研究問題，也存在於本論文的觀察單位-臺北市政府戶政業務之中。資料來源主要是以問卷方式調查臺北市政府負責戶政業務戶政人員的主觀認知性資料。研究方法則是透過描述性統計、相關係數、信度考驗、確認性因素分析(Confirmatory Factor Analysis, CFA)、迴歸分析、迴歸診斷與結構方程式（Structural Equation Model, SEM）。 本研究的問卷抽樣數共524份，有效問卷為338份，回收率為64.5％。在統計分析上，無論在因素負荷量、信度考驗、迴歸模型解釋比率，以及結構方程式的模型適配度皆符合或接近標準。而多元迴歸分析（OLS）與結構方程式（SEM）亦顯示機關之間的資源分享與協助並無助於戶政服務傳遞協力協力合作網絡間的績效，這也解釋部分理論文獻對協力協力合作網絡過於樂觀的質疑。本研究亦發現網絡管理文獻所建構的特定因素如核心機關（民政局）的協調，以及策略與結構的協調與整合是有助於戶政服務傳遞協力協力合作網絡績效。在研究貢獻上，期許檢驗研究問題與研究假設，以及這些規範性理論應用至政府實務的深度。 / The efficient formation for interagency service delivery network is comparatively important when the bureaucracy falis to make it well in public affairs. This research employs the literatures of public network management to construct the model of interagency collaborations. Two research are discussed in public network management and our research with the observed unit of the household registration of Taipei City Government: how the behaviors and roles of public network managers and collaborative behaviors among public agencies contribute to the network performance of interagency service delivery network. The data sources are draw from subjective perceptive data of public managers and public administrators who response for household registration services in Taipei City Government. The research method employs descriptive statistics, correlations, reliability, confirmatory factor analysis, regression analysis, regressive dignosis and structural equation model. The response rates in this research are 64.5%(338/524). In statistics, the the factor loadings, reliability, R2 for the regression model, and the goodness of the fit for structural equation model(SEM) also show that the resources-sharing among the agencies does not benefit the netwotk performance in household service-delivery network, which doubt the celebratory viewpoints from some public network management literatures. This research also finds some factors such as the coordination of network core administrative agency (the Bureau of Civil Affairs), the integration and coordination of strategies and structures, are helpful for network performance in collaborative network of household service-delivery network. For the contributions of research, this research expects to examine our research questions and research hypotheses and then applies these normative theories to the depths of government practices.

Cette étude de cas vise à comparer le modèle de soins implanté sur le territoire d’un centre de santé et des services sociaux (CSSS) de la région de Montréal aux modèles de soins en étapes et à examiner l’influence de facteurs contextuels sur l’implantation de ce modèle. Au total, 13 cliniciens et gestionnaires travaillant à l’interface entre la première et la deuxième ligne ont participé à une entrevue semi-structurée. Les résultats montrent que le modèle de soins hiérarchisés implanté se compare en plusieurs points aux modèles de soins en étapes. Cependant, certains éléments de ces derniers sont à intégrer afin d’améliorer l’efficience et la qualité des soins, notamment l’introduction de critères d’évaluation objectifs et la spécification des interventions démontrées efficaces à privilégier. Aussi, plusieurs facteurs influençant l’implantation d’un modèle de soins hiérarchisés sont dégagés. Parmi ceux-ci, la présence de concertation et de lieux d’apprentissage représente un élément clé. Néanmoins, certains éléments sont à considérer pour favoriser sa réussite dont l’uniformisation des critères et des mécanismes de référence, la clarification des rôles du guichet d’accès en santé mentale et l’adhésion des omnipraticiens au modèle de soins hiérarchisés. En somme, l’utilisation des cadres de référence et d’analyse peut guider les gestionnaires sur les enjeux à considérer pour favoriser l’implantation d’un modèle de soins basé sur les données probantes, ce qui, à long terme, devrait améliorer l’efficience des services offerts et leur adéquation avec les besoins populationnels. / The purpose of the present study was to compare the care model of one Montreal local territory to the stepped-care model and to investigate factors influencing the implementation of this model. A qualitative case-study approach was employed involving 13 semi-structured interviews with services providers and managers from primary and specialist mental healthcare. Results showed that the hierarchical care model in place in this territory is compared in several points with the stepped-care model. However, some elements of these models have to be integrated to improve efficiency and quality of care, including the introduction of objective evaluation criteria and the specification of evidence-based interventions. Furthermore, some factors influenced the implementation of this hierarchical care model. Thus, the presence of collaborative working and learning strategies were identified to be a key condition. However, some elements must be considered to facilitate its success like the standardization of the referral criteria and process, the clarification of the mental health guichet d’accès (centralized access point) roles and the general practitioners' adherence to the care model. In conclusion, the use of the reference and analysis frames of this study may guide managers on issues to be considered to support the implementation of an evidence-based care model which may facilitate mental healthcare efficiency and its adequacy with the population needs.