精神病人的日常生活功能狀況研究

RESEARCH FOR BASIC LIVING SKILL OF PSYCHIATRIC PATIENTS

本研究採用作者所設計之「日常生活功能問卷表」探討精神病人日常生活功能狀況，以作為發展適切復健計劃之依據。研究對象取自臺大醫院精神科、臺北市立療養院及省立桃園療養院等3所醫院的精神病人共340名，以及正常成人60名。對象年齡分佈於16~60歲之間，教育程度均在國小畢業以上。研究結果：正常成人的生活功能得分分佈於80~99分之間，均數為90.6分，顯示正常人確具有基本生活功能，並且彼此之差異不大。而精神病人的生活功能得分分佈在10~96分之間，均數為65.4分，較之正常人為差。其中有102名（30%）病人得分落在正常均數加減2倍標準差之間，屬正常範圍。238名（70%）病人得分落在正常範圍之外，顯示其輕、重度生活功能障碍。分析門診、日間留院、短期住院及長期住院等精神病人彼此之差異，結果以門診、日間留院及短期住院病人之生活功能障碍程度較輕，而長期住院病人之生活功能障碍程度較為嚴重。日後治療者將可參考病人的生活功能測試結果，依其障碍程度給予擬定合適之訓練計劃，以協助病人復歸社會。

The Comprehensive Evaluation of Basic Living Skill questionaire (CEBLS) was given to a group of 340 psychiatric patients, including out-patients and in-patients of Taipei City Psychiatric Center, National Taiwan University Hospital and Provincial Taoyuan Mental Hospital, and to the other group of 60 normal persons for exploring their functional performance of daily living. Within the patients group, two hundred and fifty subjects with diagnosis of Schizophrenia and ninety patients with diagnosis of Affective Disorder. The age of range for the patients were 16-60 years old respectively. Both the patients and normal groups were at least graduate from primary school. Result of the average test scores were significantly differences between patient group and normal person group. Mean scores of the normal subject group was 90.6 ±5.2 (80-99) and 65.4±19.7 (10-96) for the patient group. 70% (238) Of the patients showed mild to severe deficiency in basic living skill performance. In this study we used the F-test to compare the scores of patient group from out-patient department, day care, acute ward and chronic ward. The result indicated that scores of patients from the chronic ward was the lowest, but difference of outpatient, day care patient and acute ward patient groups were not statically significant. Outpatients with diagnosis Of Schizophrenia performed more unappropriately in the basic living skills than Affective Disorder, and the average score of CEBLS of the patients with college educational level were higher than those of senior high school and junior high school patients. Our experience at CEBLS questionaire suggests that we can use it to evaluate the basic living skills of psychiatric patients, for the result of the test indicates the patient's functional status. Therefore CEBLS questionaire was recommended to evaluate psychiatric patient as to set up further rehabilitation milestone.