綜合醫院實施精神障礙者職業復建方案之成效探討

The Effect of the Application of Supportive Employment Program in Clients with Severe Mental Disorder at a General Hospital

張自強(Tzyh-Chyang Chang) ； 施彥卿(Yen-Chin Shih) ； 陳昭文(Shu-Hui Cheng) ； 劉怡佳(Yi-Chia Liu) ； 溫美芝(Mei-Chih Wen) ； 施春華(Chun-Hua Shih) ； 楊延光(Yen-Kuang Yang) ； 楊明仁(Ming-Jen Yang)

《慈濟醫學雜誌》 16卷1期 (2004/02) Pp. 51-57

https://doi.org/10.6440/TZUCMJ.200402.0051

摘要

目的:本研究在探討綜合醫院實施新的支持性職業復健模式在精障者應用之成效以及所遭遇之問題，期望能增加精障者之成功的就業並促使其早日歸社區中，病人與方法:共有78名精神障礙的個案，參加某醫學中心精神科特別成立之就業門診與支持性職業復健方案。所有個案皆經就業門診後，即進入支持性職業復健方案。結果:本研究執行至今近十個月，共開發六個工作訓練職場，有16名個案持續就業中；並舉辦過多次的教育訓練活動、雇主團體、社區茶會、音樂會、宣傳與聯誼活動、家屬衛教等活動。方案進行中所遭過的困難有：專業與行政整合不易、復健經費與學員薪資無法獲得、工作機會難得、缺乏足夠就業輔導員等。結論：由本研究之經驗得知，完整的支持性職業復健模式對精神障礙者之成功就業是必要的。但在未來的規劃上，仍須重視下列問題:加強專業的整合、簡化評估程序、增加就輔員編制、尋求勞社政資源、建立家屬團體合作的管道與開發志工資源等，以順利推廣社區職業復健。

關鍵字

職業復健 ； 支持性就業 ； 精神障礙者

並列摘要

Objective: The purposes of the study were to explore the effect and difficulties of the application of a supportive employment program in clients with severe mental disorder at a general hospital and to put forward feasible solutions. Patients and Methods: There were 78 participants in this study. All participants received medical and vocational services from an outpatient vocational rehabilitation clinic at a general hospital. Results: Six employment chances were developed, and 16 participants were employed. Difficulties identified by this study were the integration of specialties, limits of medical insurance reimbursement, and few employment opportunities. Conclusions: The results and discussions of this study can be applied to future vocational rehabilitation programs in an attempt to provide better community rehabilitation services for clients with psychiatric disabilities.

並列關鍵字

vocational rehabilitation ； supported employment ； clients with severe mental disorder