以支持團體探討女性精神病患之生活適應

Investigation of Adjustment to Daily Life in Female Psychotic Patients by Support Group

本質化研究乃利用支持性團體心理治療模式，分析團體過程中女性精神病患呈現的生活適應困擾議題與因應策略。女性精神衛生問題是社會中待重視的問題，但目前仍較少對女性精神病患的生活適應特色有深入探討，因此在臨床照顧與學術研究上需要更多的參考或對照基礎。本研究乃針對精神科日間病房立意取樣的八位未婚女性精神分裂病患，運用兩位女性領導員進行十次支持性團體以協助病患生活適應，再由團體過程收集的紀錄作內容分析、比較、與歸納，以瞭解她們生活適應困考議題與因應策略之特色。研究結果顯現病患生活適應的困擾議題有（1）自我與人際的衝突與協調，（2）與精神病的共存與擺脫，（3）家庭的支持與貶抑，（4）親密感的建立與防衛，以及（5）獨立的渴求與退縮。病患普遍採取情緒導向因應策略，包括：心理調適以舒緩情緒、把問題內化成負向自我概念、避開情境或轉移情感。因應策略綜合來看具被動、壓抑及情緒導向的特色。本研究並提出這些議題與策略的產生與影響因素，以及動態消長觀點與臨床應用之討論，希望研究結果可作為未來精神醫療的臨床服務、教學、與研究之參考。

This qualitative research uses the model of support group psychotherapy to analyze the distress issues and coping strategies of how women psychotic patients adjust themselves to daily life, Women's mental health is an important issue that deserves our deep concern, but there has not been enough effort made to explore the problem. We need more studies on such issues to serve as the reference guides or comparing bases in clinical care and academic research. This study records the ten meetings of a supportive group composed of eight single women patients with schizophrenia in a psychiatric day ward, how they are helped by two female leaders to adjust themselves to their daily life problems. The recorded activities of the group-process meetings are analyzed, compared, and inducted to understand the characteristics of these patients’ distress issues and coping strategies. The results after investigation show that these patients’ distress problems are: 1) conflict and negotiation in interpersonal relationship, 2) company and dismissal with psychotic disorder, 3) support and depreciation from family, 4) development and defense of intimacy, and 5) eagerness and withdrawal of independence. Most patients use emotion-focus coping strategies, such as adapting themselves to release emotions, internalizing problems into negative self-concept, avoiding distress situations, and displacing feelings. In general, their coping strategies are characterized as passive, depressive, and emotionally directed. This study wishes to serve as a reference for clinical care, education, and academic research in psychiatry.