改善精神科日間病房病人交通意外發生之專案

Project to Improve Traffic Accident Incidents Among Patients in Psychiatry Day Ward

目的：本專案旨在降低精神科日間病房病人交通意外發生事件之件數。
方法：調查2021年3月至2022年2月發生的交通事故6件，違規舉發7件。分析原因為：道路風險感知不足、交通法規認知不足、未定期保養檢修車輛、對自身疾病症狀認知不足、未察覺藥物副作用、缺乏交通安全教育課程、不會搭乘公共交通工具。改善措施：舉辦交通安全教育課程、執行基本保養檢定表、製作藥卡及執行自我察覺表、安排機車健檢活動、輔導減少騎車頻率改搭公車、操作行駛道路風險感知訓練。
結果：策略實施後交通認知測驗由57分提升至88分，2022年10月至2023年9月交通意外件數由6件減少至1件，違規舉發由7件減為0件。
結論：國內目前還沒有合適的評估方法可以準確預測精神疾病人者的駕駛能力，建議國內相關機構能發展一系列評估方法，包含結合醫學、職能評估和認知心理測試等以確認患者駕駛風險，過程仍須兼顧病人之需求及自主權力以達到雙贏之局面。有鑑於國內相關研究探討之甚少，但降低精神病人道路交通事故之風險甚為重要，期待藉由此專案可作為國內參考文獻之先鋒，讓更多專業人士關注此議題。

The aim of this project was to reduce the number of traffic accidents among patients in a psychiatric day ward after an initial investigation between March 2021 and February 2022 revealed six traffic accidents and seven violations. A root-cause analysis identified several contributing factors, including patients' insufficient perception of road risks, low awareness of traffic regulations, neglect of regular vehicle maintenance, poor self-awareness of illness symptoms, unrecognized medication side effects, a lack of institutional traffic safety education, and a low rate of public transit use. To address these gaps, a comprehensive set of interventions was implemented from October 2022 to September 2023, which included conducting traffic safety education courses and road risk perception training, implementing basic motorcycle maintenance checklists and inspection activities, creating medication cards and symptom self-awareness charts, and providing targeted counseling to reduce motorcycle use while promoting bus transportation. Following these strategies, the patients' average traffic safety test scores increased significantly from 57 to 88, while traffic accidents dropped from six to one and violations decreased from seven to zero. Given the scarcity of domestic research on this topic, this project serves as a pioneering reference to reduce road risks among individuals with mental illness, and it concludes by recommending that domestic institutions develop integrated driving assessment methods—combining medical evaluations, occupational assessments, and cognitive psychological testing—while balancing patient autonomy and safety to achieve a win-win outcome.