慢性精神病人復健潛能與工作適應的關係

THE RELATIONSHIP BETWEEN REHABILITATION POTENTIAL AND WORK ADJUSTMENT IN CHRONIC SCHIZOPHRENIC INPATIENTS

本研究採用「日常生活功能表」、「手部協調度測驗」、「注意力測驗」及「工作場綜合表」等量表，來測定慢性精神病人的復健潛能與工作適應情形，並分析量表彼此之間的關係。研究對象取自於省立桃園療養院的63位接受復健工作訓練之病人，男佔29位、女佔34位。年齡分佈24－65歲之間，平均為44.58歲。診斷別均為慢性精神分裂病，住院期平均約為13年2個月。結果顯示：1.本研究所使用之各種量表之再測信度r值為0.719－0.811，均達顯著正向相關。2.分析各種量表彼此之關係r值為0.296－0.902，均達顯著正向相關。而「復健潛能」、「病情穩定度」與工作場之行為表現及工作產量有密切關係。3.病人的復健潛能及工作適應經復健工作訓練一年後，均呈統計上顯著改善。但仍有75%病人的復健潛能落在中、重度障碍。50%病人的病情穩定度落在中、重度障碍。這個現象將是影響其復健成效之最大阻障。4.綜合「復健潛能」、「工作場綜合表」及「病情穩定度」評量等級為整體性復健評估指數，以用於預測復健成效，擬定適切復健計劃之指標。

In order to investigate the relationship between rehabilitation potential and work adjustment and to establish an index of rehabilitabilty in psychiatric patients, ''Daily Life Functioning Scale'', ''Hand Dexterity Test'', ''Attention Test'', and ''Training workshop Evaluation Scale'' were applied to 63 chronic schizophrenic inpatients (29 males and 34 females), who were trained for a year under the rehabilitation program designed at the Provincial Tao-yuan Mental Hospital. The age ot the experimental subjects ranged from 24 to 65 years with the mean of 44.6 years and the mean duration of their hospitalization periods was 13.2 years. The analysis of data indicated that: 1) The test and retest reliability of four scales used ranged from 0.719 to 0.811 (P<0.001); 2) The correlation among these scales ranged from 0.296 to 0.902 (P<0.001). There is a close interrelationship among rehabilitation potential, stability of mental condition and work adjustment; 3) The experimental patients showed much more improvement (P<0.05) in the rehabilitation potential and work adjustment after the one-year training. However, 75% of this group of patients display moderate or severe impairment in their rehabilitation potential and 50% still moderate or severe impairment in the stability of mental condition. These findings may influence negatively on the rehabilitation effect to some extent; and 4) The total score of ''Rehabilitation potential'', e Training workshop evaluation scale'' and ''Stability of mental condition'' for each patient can determine a comprehensive rehabilitation assessment index to serve as an indicator in offering a suitable rehabilitation program and to predict the rehabilitation effect for the patient concerned.