精神病患門診復健計劃之評估

Assessment of a Rehabilitation Program: A Proposal for Psychiatric out-Patients

周美華(Mei-Hua Chou) ； 高麗芷(Lee-Jyy Kau)

《職能治療學會雜誌》 5期 (1987/09) Pp. 15-20

https://doi.org/10.6594/JTOTA.1987.05.03

摘要

台北市立療養院復健科於民國74年12月開始實行「病患門診復健計劃」，本文為了解該計劃實施一年多的結果，把民國74年12月至76年3月間，年齡在16至50歲，診斷為精神病之68位北市療復健病患，分為實驗組與對照組，比較兩組病患各方面資料，結果如下：(1)兩組的性別、年齡、診斷分類、醫療路程和復健動機上，則有顯著差異。(2)初期職能評費用來源及治療項目，都沒有顯著差異；但在往返鑑中，兩組的精神症狀穩定度、工作能力、及人際關係無顯著差異；但在自我照顧能力、藥物服用能力、及工作動機三方面，都有顯著差異。(3)職能追蹤時，兩組的就業狀況精神症狀穩定度沒有顯著差異，但治療組中，復健動機強者，接受治療時間長，且與復健動機弱者有顯著差異。分析結果，選案標準應強調病患之復健動機，如此治療關係方能維持，繼而改善病患自我照顧能力及就業能力。

並列摘要

In modern psychiatry, the out-patient's treatment model is highly recommended. Even when patients need hospitalization, the duration of hospitalization is much shorter than before. The goal is to help psychiatric patients to return to the community as soon as possible. After a short-term hospitalization, most patients need occupational or industrial therapy to elevate their ability to adapt community life. The Department of Rehabilitation at Taipei City Psychiatric Center implemented the rehabilitation program for stabled out-patients since December 1985. The Occupational evaluation, occupational therapy, and industrial therapy were provided in order to promote self- recognition, to train basic independent living skills, to develop social skills, to strengthen work motivation, to elevate work ability and rebuild their confidence of returning to the community. The purpose of this article is to retrospect the implementation of the rehabilitation proposal for out-patients at Taipei City Psychiatric Center during past 16 months. Sixty-eight psychiatric out-patients between 16 and 50 years of age, who were referred to the Department of Rehabilitation by psychiatrists from December 1985 to March 1987, were subjects. They were divided into the experimental group and the control group. The former had continued rehabilitation programs over 2 weeks, the latter had discontinued their programs within 2 weeks. Results of this study by comparing with two groups indicated that there were no siginificant differences in the sex, age, diagnosis, sources, of medical expenses, treatment programs, stability of psychiatric symptoms, work abilities, and the interpersonal relationships, but there were significant differences in the distance from their home to TCPC, motivation to the hospital, self-care abilities, taking medicines ability, and work motivation on the initial evaluation. The 3-month follow-up study after referral showed that there were no siginificant difference in the stability of psychiatric symptoms, but there was a significant difference in their occupational status in community. Therefore, the criteria of selecting patients should emphasize on the patients' rehabilitation motivation.

並列關鍵字

occupational assessment ； rehabilitation program ； psychiatric occupational therapy ； industrial therapy