使慢性精神分裂病人免於機構化照顧的可能因素

THE POSSIBLE FACTORS EXEMPTING-CHRONIC SCHIZOPHRENICS FROM INSTITUTIONALIZED CARE

本研究採用配對選樣法，在過去三年中，蒐集了三組慢性精神分裂病樣本：兩組遭受長期養護機構化照顧（LHT組，N=112和JAH組，N=117）；另一組則留在社區，接受精神科門診或短期住院治療（KMC組，N=106），加以比較分析，以便尋找影響機構化與否之可能因素。配對所根據之條件為：精神醫學診斷、性別與年齡。結果發現：(1)社會經濟因素；(2)精神病理因素；(3)認知因素；(4)政府因素等許多變項在兩種樣本之間具有顯著差異。本文作者分別就上述四方面因素加以討論，並指出使慢性精神分裂病人免於機構化之可能因素是多方面的，且可能是相互依賴、交互作用的。對此課題，本文可能已提供若干答案，但仍有許多相關變項值得進一步研究。

The purpose of this research is to differentiate the possible factors leading or relevant to the way either to instutionalization or de-institutionalization. Three samples of chronic schizophrenic patients were matched and selected in the past three years, two of which had received long-term institutionalized care (LHT, N=112, and JAH, N=117); and the third had stayed in the community and received mainly ambulatory psychiatric care (KMC, N=106). The matching was made according to the following independent variables: DSM-III diagnosis of chronic schizophrenic disorders, age, and sex. In summary, four groups of variables concerning whether instutionalization or not are elicited, which include: (1) socioeconomic factors; (2) psychopathological factors; (3) cognitive factors; and (4) governmental factors. These variables may be interdependent and interactional, and worthy of furher research.