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研究生:施雅雯
研究生(外文):Ya-Wen Shih
論文名稱:探討精神社區復健機構慢性精神分裂病患之充權感受及生活品質
論文名稱(外文):The Exploration of Empowerment Perception and Quality of Life Among Chronic Schizophrenia in Psychiatric Community Rehabilitation Institution
指導教授:謝佳容謝佳容引用關係
指導教授(外文):Chia-Jung Hsieh
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:118
中文關鍵詞:精神社區復健活動充權感受生活品質精神社區復健機構
外文關鍵詞:Psychiatric Community rehabilitationempowerment Perceptionquality of lifecommunity psychiatric rehabilitation institution.
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本研究目的是以社區慢性精神分裂病患為對象,探討其精神症狀、精神社區復活動、充權感受及生活品質情形,更進一步探討其基本屬性與生活品質的差異,並進一步以路徑分析探討重要變項影響生活品質的作用機制,採橫斷性研究設計,以多階段集體隨機抽樣的方式(Probability proportional to size; PPS),自居住在北部地區合法立案之精神社區復健機構(包括社區復健中心、康復之家)病患190名,由研究者親自訪談及收集資料,其研究工具將包括:「病患基本資料」、「社區精神病症狀評量表」、「精神社區復健活動量表」、「充權感受量表」、「精神科病人生活品質量表」。統計方法將包括:描述性統計、t 檢定、變異數分析、路徑分析,所得資料以SPSS 15.0及Amos 7.0套裝軟體進行描述性及推論性統計。
結果如下:
(1)男、女性各95名,年齡平均44.9歲,多數未婚、待業中。
(2)整體精神症狀在輕度範圍,不影響日常生活。
(3)康復之家慢性精神分裂病患之整體精神社區復健活動,以「生活支持」得分最高;社區復健中心慢性精神分裂病患以「生活自主」得分最高。
(4)精神社區復健機構慢性精神分裂病患之整體充權感受以「自尊」得分最高,以「合理表達生氣」得分最低。
(5)精神社區復健機構慢性精神分裂病患的生活品質與個人基本屬性中的「教育程度」、「工作狀況」、「年齡」、「患病時間」有統計上的顯著差異;但與「性別」、「婚姻狀況」之間並無顯著差異。
(6)路徑分析結果顯示,不論是透過直接或是間接的方式,充權感受對於生活品質都具有重要的影響。
期能藉此實證性研究的結果,瞭解慢性精神分裂病患於精神社區復健活動的生活品質與充權感受,讓病患之充權感受獲得重視,同時,研究結果將可提供精神社區復健政策與未來研究的參考。
關鍵字:精神社區復健活動、充權感受、生活品質、精神社區復健機構
The purpose of this study subjects are chronic mental illness to understand the Psychiatric Symptoms, Psychiatric Community Rehabilitation, Empowerment and Quality of life scale for psychiatric patients (QLSP) for chronic psychiatric patients in the community. Moreover, significant variables derived from bivariate analysis were then considered in the path model. A cross-sectional and the sampling will be used by stratified random sampling. The research subjects will selective from 190 subjects institutes of psychiatric rehabilitation in community which in the halfway house and Community rehabilitation Center; the instruments will be including demographic data, Psychiatric Symptoms Scales, Psychiatric Community Rehabilitation Scale, Empowerment Scale, the quality of care scale for psychiatric patient. Descriptive statistics, Independence t test, One-Way ANOVA, Tukey Post Hoc Tests and path analysis were utilized to analysis data. SPSS 15.0 and Amos 7.0 were used to analyze the data.
Research result is as followed:
(1) The gender of Community Psychiatric Rehabilitation Institution patients were about half and half, with mean age of 44.9 years. Most of the patients were unmarried and unemployed.
(2) The overall psychotic symptoms was the mild level, it was not affect people''s daily lives.
(3)The subjects in the halfway house had Psychiatric community rehabilitation, the score of “Life support” concept was the highest, chronic psychiatric subjects in the community rehabilitation center had community rehabilitation, the score of “Independent life” concept was the highest.
(4) The subjects in the community had empowerment perception, the score of “self-esteem” concept was the highest, while “righteous anger” was the lowest.
(5)Among the demographic factors, chronic schizophrenia patients “educational level”, “work status”, “age”, “duration of illness” were significant differance on Quality of Life. No differance were found among the factors related to patients “sex” and “marital status”.
(6) Path analysis showed that overall fit of adjusted model was acceptable, the result of path-analysis indicated that whether through directly or indirectly effect, empowerment perception have important impact to quality of life in community rehabilitation for chronic schizophrenia patients.
By this result of evidence research, we can understand the quality of life and empowerment perception in community rehabilitation for chronic schizophrenia patients. The results of this study may enable the government to adapt mental health policy and in the future.

keywords: Psychiatric Community rehabilitation, Empowerment Perception, Quality of Life, Community Psychiatric Rehabilitation Institution
致 謝Ⅰ
中文摘要Ⅱ
英文摘要Ⅳ
目 錄Ⅵ
圖表目次Ⅷ
第一章 緒論
第一節 研究動機及重要性1
第二節 研究目的4
第三節 名詞定義5
第二章 文獻探討
第一節 社區精神分裂病患之疾病特性與精神社區復健活動7
第二節 慢性精神分裂病患的充權感受12
第三節 慢性精神分裂病患的生活品質16
第四節 慢性精神分裂病患的充權感受與生活品質之相關研究24
第三章 研究方法
第一節 研究架構及假說27
第二節 研究設計30
第三節 研究對象32
第四節 研究工具及信效度檢定33
第五節 研究步驟43
第六節 資料處理及統計分析方法45
第七節 研究倫理考量46
第四章 研究結果
第一節 精神復健機構精神分裂病患基本資料之描述47
第二節 探討慢性精神分裂病患精神症狀、精神社區復健活動、充權感受與生活品質之現況49
第三節 探討研究對象的基本屬性與生活品質之關係57
第四節 影響精神復健機構精神分裂病患生活品質之路徑分析57
第五章 討論
第一節 基本屬性、精神症狀、精神社區復健活動、充權感受及生活品質現況67
第二節 生活品質相關因素之差異性探討74
第四節 生活品質之路徑分析78
第六章 結論與建議
第一節 結論85
第二節 研究限制87
第三節 建議88
參考資料
中文部分92
英文部分96
附錄
附錄一 論文預定進度108
附錄二 研究問卷使用同意書109
附錄三 研究問卷工具113
附錄四 多階段集體抽樣過程一覽表116
圖表目次
圖一 社區慢性精神分裂病患生活品質之概念架構圖28
圖二 研究步驟44
圖三 影響研究對象生活品質路徑分析之路徑圖66
表一 充權感受與生活品質相關研究26
表二 精神社區復健機構之Content Validity Index39
表三 精神社區復健活動之因素分析表40
表四 各量表之信度41
表五 研究工具之信效度42
表六 基本資料變項48
表七 精神社區復健機構精神症狀之得分情形50
表八 康復之家與社區復健中心復健活動之得分情形52
表九 精神社區復健機構之充權感受之得分情形54
表十 精神社區復健機構之生活品質之百分比得分情形56
表十一基本屬性在生活品質評估的差異58
表十二精神症狀、精神社區復健活動、充權感受與生活品質
之相關係數矩陣63
表十三精神症狀、精神社區復健活動、充權感受與生活品質之
模式整體適配度檢定64
表十四路徑分析變項間參數估計影響效果65
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