慢性精神病人主觀身心健康的相關因素探討

Factors Associated with Subjective Health’s Outcome among Patients with Severe Mental Illness

目的：本研究的目的在探討慢性精神病人的生活品質與相關因素。方法：我們從高雄 市的大型精神專科教學醫院的個案及家屬裡，總共募集1,215 有效個案（53.9% 男，46.1% 女）。我們使用包括12 項短表健康調查(SF-12)，臨床整體評估表(CGI-S)、照顧者負荷量 表及5 項簡短症狀評估量表(BSRS-5) 來收集個案資料。並且用相關分析及多重回歸分析統 計方法來進行資料分析。結果：嚴重精神病人的心理困窘是與SF-12 的生理與心理面向次總 量表的分數呈現負相關。除此，家屬的負擔則與心理面向的次總量表呈現負相關。年齡與共 病性是與生理面向次總量表呈現負相關。然而精神分裂病與社區／社會功能則與生理面向呈 現正相關。結論：當要改善慢性精神病人的生活品質時，臨床、家庭及社會因素皆需要納入 考量。

Objective: The purpose of this study was to compare the subjective quality of life (QoL), and to study associated factors among chronic inpatients with severe mental illnesses (SMI). Methods: We recruited 1,215 (53.9% male and 46.1% female) patients with SMI and their caregivers from a large teaching psychiatric hospital in Kaohsiung, Taiwan. Then, we collected and analyzed their demographic information with sets of the questionnaires of the 12-Item Short-Form Health Survey (SF-12), the fi ve-item Brief Symptom Rating Scale (BSRS-5), the Caregiver Burden Scale, and the Clinical Global Impression-severity (CGI-S) scale. Results: We found that the psychological distress of patients with SMI was signifi - cantly negatively related to both the mental (p < 0.001) and physical (p < 0.001) subscales of SF-12. In addition, family burden was found to be signifi cantly negatively related to mental component summary (MCS) scores (p < 0.001) . Age (p < 0.001) and comorbidity (p < 0.05) were also found to be both signifi cantly negatively related to physical component summary (PCS) scores, whereas schizophrenia (p < 0.05) and community/social functioning (p < 0.05) were found to be signifi cantly positively related to PCS scores. Conclusions: Based on those results from this study, we suggest that a wide range of clinical, family and social factors should be considered when attempting to improve the health related qualify of life (HRQoL) among patients with SMI.