思覺失調症患者復元與失能程度之探討

Abstract

(一)研究背景與目的︰ 隨著精神障礙者復元運動的興起與發展，思覺失調症者擺脫難以痊癒的刻板印象，達到復元或大幅改善。然而，對於多數的亞洲國家而言，精神障礙者復元的概念仍在萌生階段，臺灣相關的研究亦不多。本研究探討思覺失調症的復元狀況與失能程度，進而運用在思覺失調症者復元導向的服務上。 (二)方法︰ 本研究共有35名思覺失調症者參與，皆來自北部地區某醫學中心之精神科日間病房及門診。研究者以復元階段量表檢視思覺失調症者的復元程度，並利用身心障礙鑑定功能量表7.1成人版評估其失能程度。資料以SPSS 22.0統計套裝軟體進行分析。 (三)結果︰ 思覺失調症者在復元階段量表總分、復元過程分數與身心障礙鑑定功能量表的失能總分無顯著相關。但復元結果分數與失能表現總分 (γ=- 33) 及生活情境下能力總分 (γ=- 34) 達顯著負相關。此外，身心障礙鑑定功能量表中社區參與的表現 (γ=- 39) 與生活情境下能力 (γ=- 41) 和復元結果亦有所相關。 (四)結論︰ 本研究結果顯示思覺失調症者的復元結果與失能程度有關，而社會參與也與復元結果相關。相信運用各種方法改善思覺失調症的失能情形，以及提供社會參與機會，將對其復元有所裨益。

Objective： With the rapid development of the recovery movement, patients with schizophrenia have gotten rid of the prejudice of being recoverably challenged and achieve the state of recovery or remission. However, the concept of recovery is in its infanct in most of Asian countries. In addition, there are few researches related to recovery in Taiwan presently. The current study investigated the relevance of recovery situation and functional disability of patients with schizophrenia, in order to provide recovery-oriented services to patients with schizophrenia.

Method： 35 participants diagnosed as schizophrenia were recruited from day care ward and outpatient department of a medical center in northern Taiwan. Investigators used the ‘Stage of Recovery Scale’ to identify the recoverable state and the ‘Functioning Scale of the Disability Evaluation System 7.1-Adult version’ to explore the functional severity of schizophrenia. Data were analyzed by Statistical Product and Service Solutions (SPSS) 22.0 statistical software.

Results： The scores of overall recovery and process of recovery were not significantly related to the total score of FUNDES7.1-Adult version in people with schizophrenia. However, the score of recoverable outcome is negatively related to the performance (γ=- 33) and capability (γ=- 34) of the total score in FUNDES7.1-Adult version. Besides, it is vivid that performance (γ=- 39) and capability (γ=- 41) of community participation were significantly related to the score of recoverable outcome.

Conclusions： The current study demonstrated that the recoverable outcome was related to disability severity and social participation of people with schizophrenia. Therefore, applying a variety of approaches to improve disability severity and providing opportunities with social participation may benefit the recovery of patients with schizophrenia.