精神病患復元歷程之相關性研究

A Correlational Study of the Recovery Process in Patients With Mental Illness

背景：復元理念強調精神病患自主權及建立其嶄新生活型態。國內對於精神病患復元歷程以及相關性因素的實證知識仍顯不足。目的：探討精神病患的復元歷程之現況及其相關因素。方法：採橫斷面相關性研究設計，以方便取樣，選取某精神科專科醫院精神病患250位。研究工具為復元歷程、精神疾病污名感受，以及個人與社會功能量表。以描述性統計、卡方檢定、變異數及線性複迴歸統計進行資料分析。結果：研究對象多數為男性、中年、未婚、高中畢、就業中、接受居家治療及思覺失調症病患。無工作、接受康復之家照護模式及居住於社區之病患，具有較佳復元歷程表現（p<.05）。病患復元歷程總分及三個次量表，與污名感受呈現顯著負相關（p<.01），也與社會功能表現呈現顯著正相關（p<.05）。以復元歷程為依變項進行複迴歸分析，結果發現教育程度、工作狀態、精神復健模式及污名感受為顯著的預測因素，高中（含）以上、無工作、接受康復之家照護模式及精神疾病污名感受愈低，則復元歷程表現愈佳。結論：社區精神衛生護理人員應提供就業精神病患工作壓力調適之照護，並且強化其對於污名化感受因應之策略，同時推動全民心理健康促進，提高對心理疾病的認識與接納，消弭精神疾病污名，以利病患復元。

Background: The ideology of recovery addresses the autonomy of patients with mental illness and their ability to reconstruct a normal life. Empirical knowledge of this process of recovery and related factors remains unclear. Purpose: To assess the process of recovery and related factors in patients with mental illness. Methods: This cross-sectional, correlational study was conducted on a convenience sample in a psychiatric hospital. Two-hundred and fifty patients with mental illness were recruited and were assessed using 3 instruments: Questionnaire about the Process of Recovery (QPR), Perceived Psychiatric Stigma Scale (PPSS), and Personal and Social Performance Scale (PSP). Data were analyzed using descriptive statistics, χ2 , analysis of variance, and multiple linear regression analysis. Results: Most of the participants were male, middle-aged, unmarried, educated to the senior high school level, employed, receiving home-care treatment, and diagnosed with schizophrenia. Those who were unemployed, living in a community rehabilitative house, and living in the community, respectively, earned relatively higher recovery scores (p < .05). The total scores of QPR and the 3 subscales were negatively correlated with PPSS (p < .01) and positively correlated with PSPS (p < .01; p < .05). Multiple regression analysis indicated that the factors of education, employment, having received community rehabilitative models, and stigma, respectively, significantly explained the recovery capacity of patients with mental illness. Conclusion: Community psychiatric nurses should provide care to help employed patients adapt to stresses in the workplace, strengthen their stigma-coping strategies, and promote public awareness of mental health issues by increasing public knowledge and acceptance of mental illness in order to minimize patient-perceived stigma and facilitate their recovery.