共同提供在職訓練服務後思覺失調症之同儕工作者的成效

An Examination of Outcomes for Peer Support Workers with Schizophrenia Participating in an Extended Vocational Rehabilitation Services Program

研究目的：同儕支持服務是精神病人復元導向之社會心理介入之一，本研究探討與職能治療師共同提供在職訓練後，服務使用者之滿意度以及同儕工作者之成效改變。研究方法：2017年9月至2018年12月間，於某社區復健中心舉辦由6位同儕工作者與2位職能治療師共同帶領46位服務使用者，16週的長照工作訓練課程（每週2小時）和職場問題解決團體（每2週1.5小時），資料收集使用社會支持、簡明精神症狀、華人健康、整體功能、華人社會功能量表與就業資料，每一堂工作訓練後皆進行服務滿意度調查。研究結果：服務使用者對同儕工作者提供之長期照顧工作訓練服務感到很滿意，平均服務滿意度為4.7 ± 0.6（1 - 5），同儕工作者來自同儕或朋友之社會支持與平均週薪有明顯增加（P < 0.05）。研究結論：同儕工作者於共同提供在職訓練服務後，部分社會支持與就業有改善，未來須更多樣本數之研究來證實這個結果。

Purpose: Peer support service is a recovery-oriented intervention for persons with mental illness. In this pilot study, we investigated an extended vocational rehabilitation service that is co-delivered by trained peers and occupational therapists. We assessed the outcomes for the peer support workers as well as the satisfaction of the people who used this service. Methods: In a community rehabilitation center, six trained peers with schizophrenia and 2 occupational therapists cooperated to provide long-term care skill training services for 46 persons with schizophrenia (2 hours every week) and a workplace problem-solving group (1.5 hours every 2 weeks) for 16 weeks between September 2017 and December 2018. Before and after providing services, the 6 trained peers completed measures related to their perceived social support, psychiatric symptoms, mental health, and social and global functioning. They also provided employment data. After each skill-training session, the service users assessed the attitude and performance of their peers, and also rated the impact of and their satisfaction with the program. Results: The service users rated their peers highly, with a mean service satisfaction score of 4.7 ± 0.6 (1 - 5). The 6 peer support workers experienced a significant increase in social support from friends or peers and increased weekly income (both p< 0.05). The other variables examined (psychiatric symptoms, mental health, and global functioning) did not show a significant change. Conclusions: The peer support services program examined had an overall positive impact on the peer service providers. These results need further evaluation with a larger scale study on a longer time frame to determine whether benefits not observed in this study may be obtained over a longer time period or with more participants in the program.