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研究生:吳希文
研究生(外文):Hsi-Wen Wu
論文名稱:長期收容機構慢性精神分裂症病患的職能參與
論文名稱(外文):Occupational Participation in Persons with Chronic Schizophrenia Who Live in a Long-stay Facility
指導教授:吳錦喻吳錦喻引用關係
指導教授(外文):Chin-Yu Wu
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:職能治療研究所
學門:醫藥衛生學門
學類:復健醫學學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
論文頁數:77
中文關鍵詞:機構化質性研究職能治療
外文關鍵詞:qualitative researchoccupational therapyinstitutionalization
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本研究目的在探討長期收容機構中慢性精神分裂症病患的職能參與經驗,包括病患所從事的職能活動特質、職能參與情形、職能參與和個人健康及安適感間的關係、以及影響病患職能參與的個人因素及環境因素。本研究採紮根理論研究法,研究參與者包括五位男性及一位女性,平均年齡42.4歲,長期收容年數由0.6年到14.3年不等。部分研究參與者接受兩次訪談,總計進行九次訪談。研究結果顯示,研究參與者的職能特質為活動內容缺乏變化、以被動性的活動為主、生活高度群體化、缺少個別活動及隱私;職能參與情形為日常活動的安排高度結構化,但參與態度消極被動,以排遣時間為主;職能參與受到一些個人因素(如:個人的價值觀、對正常化╱退化的覺察等)和環境因素(如:機構制度的限制、家屬支持的低落等)的影響,而這些影響因素的交互作用呈現於研究參與者比較過去與現在的生活經驗後的相對比較結果,比較的結果在經過個人價值觀的調節後對個別收容病患的職能參與產生不同的影響。本研究的結果呼應人—環境—職能模式,支持人類職能表現為個人、環境、及職能活動之動態交織的結果,但本研究結果更具體呈現長期收容的社會文化環境特徵對這群病患的衝擊,以及不同影響因素的交互作用對長期收容病患之職能參與的影響。本研究的發現將有助於精神醫療專業人員對長期收容機構病患之職能參與現象的覺察與瞭解,進而提供實務工作的參考。
The purpose of this study was to explore the experiences of occupational participation in persons with chronic schizophrenia who live in a long-stay facility. It investigated the characteristics of occupations performed, how occupations were participated in the facility, any impact on the health and well-being, and factors that influenced occupational participation. The methods of grounded theory were used. Six participants including 5 male and 1 female were interviewed. Their average age was 42.4 years old, and the length of stay in the facility ranged from 0.6 to 14.3 years. Some of the participants were interviewed twice, and in total nine interviews were completed. The results of this study revealed that the characteristics of occupation performed in the long-stay facility was sameness day after day, and was predominantly composed of passive activities. Patients in the facility lived as a group, and there was a lack of individual activities and privacy. The pattern of occupational participation was highly structured. The participation was passive and for killing time. Occupational participation was affected by personal factors such as personal values or the awareness of normalization/deterioration, and environmental factors such as restrictions of institutional rules or lack of family support. Participants’ comparisons of his or her living status before and after admitted into the facility revealed a phenomenon of relative comparison, which affected occupational participation as well. It was found that factors affecting occupational participation were mediated by personal values, and that the same factor may not affect occupational participation in the same way among different patients. In line with existing literature, the findings of the study supported occupational performance as the product of dynamic and interwoven relationships among person, occupation, and environment. In particular, the study outlined the characteristics of factors in social and cultural environments and their impact on occupational participation. Findings of the study may provide health professionals with useful information about the phenomena of occupational participation and advancing the care of this client population in the long-stay facility.
第一章 緒論--------------------------------------1

第二章 文獻回顧----------------------------------4
第一節 名詞解釋----------------------------------4
第二節 參與職能活動與人類健康的關係--------------6
第三節 影響職能活動的因素:人—環境—職能模式----7

第三章 研究方法---------------------------------13
第一節 研究設計---------------------------------13
第二節 研究參與者-------------------------------13
第三節 研究工具與資料收集過程-------------------14
第四節 資料處理與分析---------------------------15

第四章 研究發現---------------------------------17
第一節 研究參與者的職能特質及職能參與情形---18
第二節 機構生活對健康及安適感的影響---------20
第三節 影響研究參與者職能參與的因素---------22

第五章 研究討論---------------------------------35
第一節 長期收容機構的社會文化環境特徵-------36
第二節 研究參與者的相對比較經驗-------------38
第三節 臨床應用-----------------------------41
第四節 研究限制-----------------------------45
第五節 未來研究建議-------------------------46

參考文獻-----------------------------------------47

附錄---------------------------------------------59
附錄一 慢性精神病患長期收容養護照顧統計---------59
附錄二 慢性精神病患之職能特質—初探性研究主要內容與結果--63
附錄三 機構同意書-------------------------------68
附錄四 行政院衛生署玉里醫院醫學教育委員會會議紀錄--------70
附錄五 行政院衛生署玉里醫院人體試驗委員會會議記錄--------72
附錄六 研究訪談同意書---------------------------75
附錄七 研究說明書及家屬同意書-------------------76
表目錄
表一 影響職能參與的相關因素---------------------54
表二 研究參與者的人口學資料統計-----------------55
表三 研究參與者的基本資料-----------------------56
表四 長期收容之慢性精神分裂症病患的職能特質及職能參與情形-57
表五 影響長期收容慢性精神分裂症病患職能參與的因素--------58
中文部分
內政部(1990)。低收入戶健康保險暫行辦法。內政部(79)台內社字第八00二六九號令。
立法院(2002)。精神衛生法。總統華總一義字第0九一00一一九一七0號。
行政院身心障礙者權益促進委員會(2004)。身心障礙者權益促進實施方案。台(九三)障權字第00五號函修正。
行政院國軍退除役官兵輔導委員會(2002)。國軍退除役官兵就養安置辦法。行政院國軍退除役官兵輔導委員會(91)輔貳字第0九一000一七六七號令。
行政院衛生署(2001)。行政院衛生署所屬醫院精神疾病養護床收治作業要點。九十衛署中字第一000一九二號公告。
行政院衛生署(2002)。身心障礙等級。衛署醫字第0九一00一四七九九號公告修正。
宋麗玉(1999)。精神病患照顧者之探究:照顧負荷之程度與其相關因素。中華心理衛生學刊,12,頁1-30。
宋麗玉(2000)。建構臺灣慢性精神病患之社區支持體系—醫療模式與社會心理模式之整合。社區發展季刊,92,頁126-140。
林宜輝(2000)。英美社會救助制度難題及其因應策略之研究。未出版之碩士論文,私立東吳大學,台北市。
林美伶(2001)。精神分裂病患烙印之生活經驗。未出版之碩士論文,國立台灣大學,台北市。
胡幼慧(1996)。轉型中的質性研究:演變、批判和女性主義研究觀點。質性研究:理論、方法、及本土女性研究實例(頁7-26)。台北:巨流。
胡幼慧、姚美華(1996)。一些質性方法上的思考:信度與效度?如何抽樣?如何收集資料、登錄與分析?胡幼慧主編,質性研究:理論、方法、及本土女性研究實例(頁141-158)。台北:巨流。
徐宗國 (1996)。紮根理論研究法:淵源、原則、技術。胡幼慧主編,質性研究:理論、方法、及本土女性研究實例(頁47-73)。台北:巨流。
陳向明(2002)。社會科學質的研究。台北:五南。
陳芷如、徐亞瑛(2000)。承命生根之過程—臺灣機構化失能老人遷居的心路歷程。護理研究,8,頁614-627。
陳碧霞(1996)。精神病人吸菸管制問題探討。護理雜誌,43,頁68-72。
陳豐偉(2004)。台灣兩種主要慢性精神分裂症患者長期收容模式成本與照護品質的比較。未出版之碩士論文,國立陽明大學,台北市。
黃嬡齡(2000)。家庭系統作為慢性精神病患照顧主體的省思—論「過度使用家庭能力」與建構「替代性家庭功能」。中華心理衛生學刊,13,頁89-110。
葉玲玲、李玉春、楊明欽、劉絮愷、胡海國(1997)。嚴重精神病患經濟成本之研究。中華心理衛生,3,頁1-15。
劉智民(1999)。精神分裂症。李明濱主編,實用精神醫學(頁123-132)。台北:國立台灣大學醫學院。
謝宏林(1999)。精神分裂症家屬主要照顧者期待病患長期安置之相關因素探討。未出版之碩士論文,國立暨南國際大學,南投縣。
美國心理協會(American Psychiatric Association)(1997)。DSM-IV精神疾病診斷與統計(Diagnostic and statistical manual of mental disorders: Primary care version, 4th ed.)。(孔繁鐘編譯)。台北:合記。
美國心理協會(American Psychiatric Association)(2000)。DSM-IV精神疾病診斷準則手冊(Quick reference to the diagnostic criteria from DSM-IV)。(孔繁鐘、孔繁錦編譯)。台北:合記。
Strauss, A., & Corbin, J. (1997). 質性研究概論(Basics of qualitative research: Grounded theory procedures and techniques)。(徐宗國譯)。台北:巨流。
Strauss, A., & Corbin, J. (2001). 質性研究入門:紮根理論研究方法(Basics of qualitative research: Techniques and procedures for developing grounded theory, 2th ed.)。(吳芝儀、廖梅花譯)。嘉義市:濤石。

西文部分
Addington, J. (1998). Group treatment for smoking cessation among persons with schizophrenia. Psychiatric Services, 49, 925-928.
Asbring, P. (2001). Chronic illness-a disruption in life: Identity-transformation among women with chronic fatigue syndrome and fibromyalgia. Journal of Advanced Nursing, 34, 312-319.
Bane, M. J., & Ellwood, D. T. (1994). Welfare realities: Form rhetoric to reform. Cambridge, MA: Harvard University.
Barris, R. (1986). Activity: The interface between person and environment. Physical & Occupational Therapy in Geriatrics, 5, 39-49.
Baum, M. C. (2003). Participation: Its relationship to occupation and health. Occupation Therapy Journal of Research, 23, 46-47.
Blake, K. (1995). The social isolation of young men with quadriplegia. Rehabilitation Nursing, 20, 17-22.
Carlson, M. (1996). The self-perpetuation of occupations. In R. Zemke & F. Clark (Eds.), Occupational science: The evolving discipline (pp. 143-157). Philadelphia: F. A. Davis.
Christiansen, C. H. (1999). Defining lives: Occupation as identity: An essay on competence, coherence, and the creation of meaning. American Journal of Occupational Therapy, 53, 547-558.
Christiansen, C., & Baum, C. (1997a). Person-environment occupational performance: A conceptual model for practice. In C. Christiansen & C. Baum (Eds.), Occupational therapy: Enabling function and well-being (2nd ed., pp. 47-70). Thorofare, NJ: Slack.
Christiansen, C., & Baum, C. (1997b). Understanding occupation: Definitions and concepts. In C. Christiansen & C. Baum (Eds.), Occupational therapy: Enabling function and well-being (2nd ed., pp. 3-25). Thorofare, NJ: Slack.
Glaser, B. G., & Strauss, A. (1967). The discovery of grounded theory. Chicago: Aldine.
Hammersley, M. (1989). The dilemma of qualitative method: Herbert blumer and the Chicago tradition. London: Routledge.
Hasselkus, B. R. (2002). The meaning of everyday occupation. Thorofare, NJ: Slack.
Helson, H. (1964). Adaptation-level theory: An experimental and systematic approach to behavior. New York: Harper & Row.
Idler, E. L., & Kasl, S. V. (1997). Religion among disabled and nondisabled persons I: Cross-sectional patterns in health practices, social activities and well-being. Journal of Gerontology, 52B, S294-S305.
Kaplan, S. (1983). A model of person-environment compatibility. Environment and Behavior, 15, 311-332.
Kielhofner, G., Mallinson, T., Forsyth, K., & Lai, J. S. (2001). Psychometric properties of the second version of the occupational performance history interview (OPHI-II). American Journal of Occupational Therapy, 55, 260-267.
King, G., Law, M., King, S., Rosenbaum, P., Kertoy, M. K., & Young, N. L. (2003). A conceptual model of the factors affecting the recreation and leisure participation of children with disabilities. Physical & Occupational Therapy in Pediatrics, 23, 63-90.
Lamb, H. R. (1997). The new state mental hospitals in the community. Psychiatric Services, 48, 1307-1310.
Law, M. (2002). Participation in the occupations of everyday life. American Journal of Occupational Therapy, 56, 640-649.
Law, M., Cooper, B., Strong, S., Stewart, D., Rigby, P., & Letts, L. (1996). The person-environment-occupation model: A transactive approach to occupation performance. Canadian Journal of Occupational Therapy, 63, 9-23.
Law, M., Polatajko, H., Baptiste, S., & Townsend, E. (1997). Core concepts of occupational therapy. In E. Townsend (Ed.), Enabling occupation: An occupational therapy perspective (pp. 29-56). Ottawa, ON: CAOT Publishers, ACE.
Law, M., Steinwender, S., & Leclair, L. (1998). Occupation, health and well-being. Canadian Journal of Occupational Therapy, 65, 81-91.
Magnus, E. (2001). Everyday occupations and the process of redefinition: A study of how meaning in occupation influences redefinition of identity in women with a disability. Scandinavian Journal of Occupational Therapy, 8, 115-124.
Meyer, A. (1922). The philosophy of occupational therapy. Archives of Occupational Therapy, 1, 1-10. [Reprinted (1977) In: American Occupational Therapy Journal, 31, 639-642.]
Murray, C. (1984). Losing ground: American social policy, 1950-1980. NY: Basic Book.
Norman, I., & Parker F. (1990). Psychiatric patients’ views of their lives before and after moving to a hostel: A qualitative study. Journal of Advanced Nursing, 15, 1036-1044.
Passmore, A. (1998). Does leisure have and association with creating cultural patterns of work? Journal of Occupational Science, 5, 161-165.
Pierce, D. (2001). Untangling occupation and activity. American Occupational Therapy Journal, 55, 138-146.
Posner, J. K., & Vandell, D. L. (1999). After-school activities and the development of low-income urban children: A longitudinal study. Developmental Psychology, 35, 868-879.
Rebeiro, K. L., & Cook, J. V. (1999). Opportunity, not prescription: An exploratory study of the experience of occupational engagement. Canadian Journal of Occupational Therapy, 66, 176-187.
Schultz, S., & Schkade, J. K. (2003). Occupational adaptation. In E. B. Crepeau, E. S. Cohn, & B. A. B. Schell (Eds.), Willard and Spackman''s occupational therapy (10th ed., pp. 220-223). Philadelphia: Lippincott, Williams & Wilkins.
Smith, N. R., Kielhofner, G., & Watts, J. H. (1986). The relationships between volition, activity pattern, and life satisfaction in elderly. American Journal of Occupational Therapy, 40, 278-283.
Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park, CA: Sage.
Suto, M., & Frank, G. (1994). Future time perspective and daily occupations of persons with chronic schizophrenia in a board and care home. American Journal of Occupational Therapy, 48, 7-18.
World Federation of Occupational Therapists (2004). WFOT Definition of Occupational Therapy. Retrieved May 26, 2004, from http://www.wfot.org/officefiles/final%20 definitionCM2004.pdf.
World Health Organization (1946). Constitution of the World Health Organization. Retrieved May 26, 2004, from http://policy.who.int/cgi-bin/om_isapi.dll?hutsperheading= om&infobase=basicdoc&record={9D5}&softpage=Document42.
World Health Organization. (2001). International classification of functioning, disability and health. Geneva, Switzerland: Author.
Yerxa, E. J. (1994). Dreams, dilemmas, and decisions for occupational therapy practice in a new millennium: An American perspective. American Journal of Occupational Therapy, 48, 586-589.
Yerxa, E. J., Clark, F., Frank, G., Jackson, J., Parham, D., Pierce, D., et al. (1989). An introduction to occupational science: A foundation for occupational therapy in the 21st century. Occupational Therapy in Health Care, 6, 1-17.
Ziedonis, D. M., & George, T. P. (1997). Schizophrenia and nicotine use: Report of a pilot smoking cessation program and review of neurobiological and clinical issues. Schizophrenia Bulletin, 23, 247-254.
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