日間留院慢性精神病人需求評估及介入措施成效之探討

Effects of Need Assessment and Interventions on Chronic Mental Illness Patients in a Day Care Unit

本研究目的在探討慢性精神病人之生活品質、需求之相關性，瞭解介入措施實施對慢性精神病人復健護理及需求處置之成效。研究設計係以類實驗性之兩組後測時間序列設計；選取北部某醫學中心精神科日間留院慢性精神病人為研究對象，共納入84位個案，其中對照組41人，實驗組43人。研究結果發現Camberwell需求評估，實驗組的後測分數減少幅度顯著地高於對照組(-1.26±.73vs.-.49±.71)，並達到統計上顯著意義；需求項目經由護理措施處置後改善之前三位依序為「社交」共12人次佔14.30％，第二位為「福利金」共9人次佔10.71％，第三位共二項分別為「資訊(關於病情、治療)」「親密關係」各有7人次，佔7.14％；實驗組之Camberwell需求評估分數與BPRS呈現正相關(r=.268)，與生活品質滿意呈現負相關，r=-.301，且達到統計上顯著意義。研究結果顯示Camberwell需求評估可提供護理人員有效評估精神病人需求問題，引導同仁重視精神病人個別化需求，改進照護計畫之訂定與措施之執行，藉以提昇精神復健及社區照護品質。

The purposes of this study were to investigate the quality of life and needs of patients with chronic illness, Furthermore, it sought to investigate the effects of psychiatric nursing intervention for these two issues. Aquasi-experimental study design with time series of the post-test was implemented. The result showed that the decrease of Camberwell’s Assessment of Need (CAN) total score in the study group was significantly more than the control group. Among the various CAN subscores social relationship, welfare, information and intimate relationship showed more improvement than others as a result of the psychiatric nursing intervention. Bivariate correlational analysis showed that CAN scores and BPRS were both significantly and negatively correlated to the quality of life.The results of this study provide evidences for psychiatric nurses to use CAN questionnaires to effectively assess patients with chronic mental illness.By using the CAN questionnaire, it can lead to better care of patients’ individual needs, improvement of care planning, and an increase in the quality of psychiatric rehabilitation and communitymental health care.