探討社區精神復健機構專業人員於促進復元專業才能之現況和其影響因素

An Examination of the Recovery-Promoting Professional Competency of Professionals Working at Community Psychiatric Rehabilitation Centers

研究目的：台灣在1980年代開始引入精神復健與復元之觀點，使得精神醫療處遇焦點逐漸由關注精神疾病狀態移轉朝向恢復個人在社區之能力。過往研究發現與服務對象之專業關係為促成復元的重要因素，然而在國內少有研究以精神復健專業人員為對象，更無研究探討其在促進復元過程中所具備之專業關係才能，因此本研究旨在探討專業人員之促進復元專業關係才能（簡稱促進復元才能）之現況與影響因素。研究方法：本研究以橫斷式研究設計及自填問卷進行調查，對象是來自31個日間型精神復健機構的122位專業人員。以信度分析、t檢定、單因子變異數分析、相關分析與複迴歸分析進行統計檢定。研究結果：我國精神復健專業人員促進復元的平均能力較常模略高；精神復健專業人員認為機構內外環境欠缺足夠資源與經費，同時機構間復元之專業訓練與督導落差甚大。複迴歸分析的研究結果顯示，越高的組織支持程度，以及服務項目中體能訓練所佔比重越高，與專業人員促進復元才能程度有正相關。研究結論：研究建議精神復健機構強化其組織支持，透過強化主管人員對於精神復健與復元的理念、強化復元之教育訓練等方式，塑造支持實踐精神復健與復元的環境，充實專業人員的促進復元才能。

Purpose: In the 1980s, Taiwan’s government, NGOs, and academics began introducing the perspective of psychiatric rehabilitation and recovery, which shifted the focus of mental health treatment from addressing the symptoms of mental illness to promoting individuals’ abilities in the community. Previous studies have found that the relationship between psychiatric rehabilitation professionals (e.g., occupational therapists, social workers, nursing staff, and clinical psychologists) and service users is an important factor in facilitating recovery. However, only limited research in Taiwan has specifically targeted these professionals and examined their overall professional competency in promoting recovery. The goal of this study is to investigate the overall recovery-promoting relationship competency of professionals and identify factors that influence that process at community psychiatric rehabilitation centers. Methods: We applied a cross-sectional research design to conduct a structured self-administered survey. Professionals from 31 day care psychiatric community rehabilitation centers completed 122 questionnaires, which were analyzed with t-tests, one-way analysis of variance (ANOVA), as well as reliability, correlation, and multiple regression analyses. Results: The average competency in recovery-promoting relationships of psychiatric rehabilitation professionals in Taiwan is slightly above the norm. There is a gap in professional training and supervision across community psychiatric rehabilitation centers due to a perceived lack of resources and funding. We identified 2 influencing factors. The results of the multiple regression analysis showed that a higher level of organizational support from the day care center and a greater emphasis on physical training programs for the service users were both positively associated with the overall level of recovery-promoting relationship competency. Conclusions: Day care centers should establish a supportive environment for recovery, provide adequate internal and external supervision, and address recovery values and attitudes and interpersonal skills within recovery competencies through targeted training programs.