康復之家慢性精神病人復原力之探討

Resilience Among Patients With Chronic Mental Illnesses Residing in Halfway Houses

背景：復原力概念在精神疾病領域愈來愈重要，是精神病者積極適應疾病逆境的過程中，幫助病人與社會接軌，重返社區的重要力量。新冠疫情時，康復之家受到人員管控等諸多影響，疫後康復之家病人復原力與影響因素需實證研究再次驗證。
目的：探討社區康復之家思覺失調病人的復原力及其重要影響因素。
方法：本研究採橫斷式問卷調查研究設計，對象為社區康復之家思覺失調症者，以方便取樣在北台灣收案，總收案數為228位。研究工具含個人屬性、精神症狀、認知功能、藥物治療態度、社會支持和復原力量表。所得資料以SPSS 25.0中文版統計套裝軟體進行分析。
結果：本研究社區康復之家思覺失調症病人復原力平均為21.87分（SD = 8.24），62.7%屬低度復原力。復原力顯著關聯於年齡分組、教育程度分組、能否自行排藥、參與電腦文書團體復健、認知功能、藥物治療態度和社會支持程度，顯著預測因子為藥物治療態度、能否自行排藥和參加電腦文書團體復健。
結論／實務應用：疫後社區康復之家思覺失調症病人的復原力多數屬低度。這值得社區精神衛生的個管師或康復之家護理人員陪伴病人共同努力。照護康復之家病人復原力必須特別重視住民能否自行排藥、藥物治療態度與參加電腦文書團體復健等因素之影響。

Background: Resilience, an increasingly important concept in the field of mental illness, refers to the active process by which individuals with mental illness positively adapt to adversity, facilitating their reintegration into society and return to the community. However, the recent pandemic has significantly impacted rehabilitation facility operations, affecting rehabilitation processes and personnel management. Thus, in the post-pandemic period, there is a need for empirical studies to revalidate the resilience of patients in halfway houses and the factors influencing it.
Purpose: The aims of the study were to explore the resilience and important factors of influence in patients with schizophrenia residing in halfway houses.
Methods: A cross-sectional survey design was employed, targeting individuals with schizophrenia residing in community rehabilitation homes in northern Taiwan. A convenience sampling method was used and 228 participants were enrolled. Research tools used in this study included measures of personal demographics, psychiatric symptoms, cognitive functions, attitudes towards medication, social support, and resilience.
Results: The average resilience score was 21.87 (SD = 8.24), with 62.7% of the participants classified with low resilience. Resilience was found to correlate significantly with age group, educational level, ability to self-administer medication, participation in computer-based rehabilitation programs, cognitive functions, attitudes towards medication, and level of social support. However, the factors identified as statistically significant were limited to attitudes toward medication, ability to self-administer medication, and participation in computer-based rehabilitation programs.
Conclusions/ Implications for Practice: A majority of the participants, patients with schizophrenia residing in community rehabilitation homes, exhibited low resilience. This highlights the need for community mental health case managers and rehabilitation home nursing staff to work closely with these patients to enhance their resilience. Particular attention should be paid to patients’ability to self-administer medication, their attitudes toward medication, and their participation in computer-based rehabilitation programs.