精神科日間留院病人選擇團體活動相關因素之探討

本研究的目的是在探討日間留院病患在參與由護理人員所帶領的各種不同性質之治療性團體活動：活動式團體心理治療、生活討論會、衛教團體、獨立生活訓練團體、自管藥訓練團體，五個團體治療中影響病患選擇參與治療性團體活動的因素及在團體治療活動中所獲得之療效因素為何？此研究以目的選樣，由日間留院（一）及（二）病態中選出全程參與護理人員所帶領的治療性團體活動已三個月之病患，共選出樣本數為60人。研究工具一、為Yalom所製團體療效因素量表，此量表於病患參與團體每三個月由病患依幫助程度順序排列出，共排列兩次；二、日間留院病患選擇參與治療性團體活動問卷表，此量表為自擬結構式問卷，於病患參與團體每三個月予填寫，共評估兩次。研究結果發現：1、影響病患選擇治療性團體活動的因素，依序為團體的學習（平均值31.40）病患期望能經由團體經驗的學習更瞭解自己的症狀及增加對自我的了解；自我的學習（平均值31.84）病患希望能學習人際互動的技巧及生活作息的安排；團體的類別（平均值32.90）病患會考慮此團體進行的方式、治療者個人的風格、參加團體是自願參與的。2、病患參與不同性質的治療性團體活動其療效因素會因團體活動的設計、目的、形式及帶領的方式是有所差異的；整體而言，病患感受到最有幫助的療效因素為（希望灌注）、（外現性人際學習）及（家庭重現）；而較沒幫助療效因素為（仿同）及（指導）。

Objective: To assess the influencing factors that affect the patient's selectivity to participate various nurse-leading therapeutic activity groups on the day hospital and the therapeutic factors among them. These groups include activity group therapy, community meeting, psycho-education group, life-independence training group, medication self-management training group. Method: The sampling of this study was goal -directed. Sixty psychiatric patients who continuously participate various nurse-leading therapeutic groups more than 3 months on day-hospital ward I and ward II were enrolled. All subjects underwent 1) group therapeutic factors rating scale(Yalom), which was rated by ranking according to patient's subjective feeling of benefit and 2) day-hospital patient's opinion questionnaire for assessment of their selectivity of therapeutic group, a self-designed questionnaire o months, totally two times. Result: We have the two finding: First ,the factors that affect the patient's selectivity to participate the groups are in order of group learning (mean:31.40), that is, patient's expectation to understand their symptoms and themselves more through learning from the group experiences; self learning (mean:31.84), that is, patient's expectation to learn the skill of personal interaction and the arrangement of daily life; characteristics of groupEach one was rated every three (mean:32.90), patient would consider group process, therapist's personal style, and that whether they are volunteers or not o Second, the therapeutic factors among different groups varied with the activity-designed, goal, form, and the leading way. In total, the most beneficial factors that the patient experienced are 「Instillation of hope」「Interpersonal Learning, ''Output''」「Family Reenactment」; and the least beneficial factors are 「dentification」 and 「Guidance」