影響庇護工作坊之精神分裂症患者工作行為的因素

The Factors that Affect the Work Behaviors of Clients with Schizophrenia in Sheltered Workshops

研究目的：本研究之目的在於探討參與庇護性工作坊的精神分裂症患者，其病前工作史、教育程度、自我效能以及疾病管理對工作行為的影響。研究方法：本研究訪談131位目前參與庇護性工作訓練的精神分裂症患者，由研究參與者填寫「自我效能量表」來評量其自我效能，並以「精神疾病症狀知識量表」、及「藥物態度量表」兩份問卷，評量研究參與者之疾病管理。此外，研究者以「工作行為評量表」評估研究參與者參與庇護性工作坊的工作行為。資料收集後，以SPSS12.0統計軟體加以分析，以描述性統計、皮爾森積差相關和逐步複迴歸等統計方式，進行資料分析。研究結果：參與庇護性工作坊的精神分裂症患者：（一）自我效能以及疾病管理中的藥物態度，兩者皆與工作行為達顯著相關。（二）自我效能、病前工作史，以及藥物態度等變項，可以有效解釋精神分裂症患者的工作行為，依序為自我效能、病前工作史，以及藥物使用態度，解釋之總變異量達23.7%。研究結論：職業重建人員，在提供精神分裂症患者就業服務時，應增強案主職前社交與技能訓練的自我效能，且持續提供疾病管理與復元的概念，使職業輔導的服務更具全面性。

Purpose: The purpose of this study was to explore the effects of self-efficacy, illness management, education, and employment history on the work behaviors of clients with schizophrenia in sheltered workshops. Methods: A total of 131 clients with schizophrenia participated in this study. Participants completed 3 self-report questionnaires: the Self- Efficacy Scale (SES), the Knowledge for Illness Scale (KIS), and the Drug Attitude Inventory (DAI). In addition, the Work Behavior Inventory (WBI) was administrated to evaluate participants’ work behaviors. Work behavior scores were obtained via observing clients and interviewing their therapists. Data were analyzed via descriptive statistics, Pearson correlation, and stepwise multiple regression analysis. Results: The analysis indicated that self-efficacy, employment history, and attitude toward drug treatment were significant predictors of the work behaviors of clients with schizophrenia in sheltered workshops. Conclusions: Vocational rehabilitation practitioners should utilize the concept of self-efficacy in prevocational programs to improve schizophrenic clients’ confidence in their social skills and work behaviors. In addition, group therapy can be applied to teach clients illness management skills to enhance drug compliance and recovery concepts.