精神病患社區適應力之探討

COMMUNITY FUNCTIONING OF PERSONS WITH SCHIZOPHRENIC DISORDERS AND AFFECTIVE DISORDERS

精神病患出院後在社區中適應能力，一直是研究者十分感興趣的課題，而且是職能治療師為病患擬定社會心理治療與復健計劃的重要參考資料。本文以74年7月初至75年3月中，曾經住過臺北市立療養院，住院期間曾接受職能治療兩週以上，年齡在16歲至55歲之間，識字的77名精神分裂病患與54名情感性精神病患為對象。追踪他們出院三個月後，在社區中症狀穩定度、自我照顧、家務處理、家庭適應、人際關係、就業狀況及休閒娛樂參予等情形。結果顯示：精神分裂病患與情感性精神病患出院後自我照顧能力、人際適應及就業狀況有顯著不同，但症狀穩定度、家務處理、休閒娛樂參予，及與家屬相處等方面並無顯著差異。此外，亦發現「職能治療綜合評量表」及「日常生活功能問卷表」能對精神病患社區適應力作預測。

The purpose of this article is to evaluate the community functioning of psychotics. The subjects, aged from 16 to 55, consist of 77 schizophrenics and 54 affective disorders hospitalized at Taipei City Psychiatric Center during the period from July 1, 1985 to March 15, 1986. The 3-month follow up study of psychoses were performed. Results showed that affective disorders performed significantly better than schizophrenic patients on self care, social adjustment and occupational status. There were no significant differences on severity of symptoms, housekeeping, leisure and self-improvement activities, as well as relationship with families between affective disorders and schizophrenic disorders. Besides, the scores on the Comprehensive Occupational Therapy Evaluation Revised Scale at discharge by occupational therapists' ratings could explain 58.48 percent of the global outcome variance. The scores on the Comprehensive Evaluation of Basic Living Skill Questionaire at discharge by patients' self-rating could explain 26.78 percent of the self care outcome variance. According to these findings, occupational therapists may provide efficient and realistic psychosocial intervention and rehabilitation program for psychotics to a functional state in the community.