慢性思覺失調症患者生活品質的因素

Factors of the Quality of Life Among Patients with Chronic Schizophrenia

盧淑敏(Shu-Min Lu) ； 張秀如(Hsiu-Ju Chang)

《新臺北護理期刊》 23卷1期 (2021/03) Pp. 20-32

https://doi.org/10.6540/NTJN.202103_23(1).0003

摘要

背景：慢性思覺失調症人數逐年增加，為了強化健康康復過程，釐清影響生活品質的因素成為重要一環。目的：探討影響慢性思覺失調症患者生活品質的因素。方法：以橫斷面研究設計，採方便取樣方式。藉由簡短精神症狀量表（BPRS）、焦慮量表（SAI）及世界衛生組織生活品質（WHOQOL-BREF）量表，收集完成某精神醫院97位慢性思覺失調症患者資料。以獨立樣本t檢定（Independent Sample t test）和變異數分析（Analysis of Variance, ANOVA）、皮爾森積差相關以及多元線性迴歸（Multiple linear regression）進行統計分析。結果：共有97位慢性思覺失調症患者參與本研究，平均年齡為49.79 ± 9.11歲，個案基本屬性、疾病特徵與主要研究變項之間具同質性（p＞ .05）。多元線性迴歸分析顯示，一般的精神病理症狀是身體、心理、社會和環境層面生活品質顯著的預測因素，而負性症狀也是心理層面生活品質的重要影響因素，焦慮狀態對整體生活品質的影響力最大。結論：慢性思覺失調症患者的一般精神病理症狀、負性症狀、焦慮狀態與生活品質顯著相關，因此，定期評估監測精神病症狀及焦慮狀態對生活品質的影響至關重要。未來需要對慢性精神病患者開發多元的護理照護計劃，如放鬆訓練計畫，減輕患者的焦慮並改善精神症狀，進而提升他們的生活品質。

關鍵字

思覺失調症 ； 焦慮狀態 ； 精神病症狀 ； 生活品質

並列摘要

Background: The number of chronic schizophrenia is increasing year by year. In order to facilitate recovery process, it is urgent to clarify the factors affecting the quality of life (QOL). Purpose: We explored factors that affected the QOL among patients with chronic schizophrenia. Methods: This is a cross-sectional design using convenience sampling. A total of 97 patients with chronic schizophrenia in a psychotic hospital completed the brief Psychiatric Symptom Scale (BPRS), State Anxiety Inventory (SAI), and World Health Organization Quality of Life (WHOQOL-BREF) scale. We used the Independent t-test and ANOVA to examine the distribution and differences in demographic and disease characteristics, anxiety state, and psychotic disorders. Then we used multiple linear regressions to analyze the main predictors of QOL. Results: Ninety-seven subjects who had a mean age of 49.79 (SD=9.11) years were recruited in the study. There were no significant differences between the demographic characteristics of the case, the characteristics of the disease, and the main study variables (p＞0.05). Multiple linear regression analysis showed that general psychopathological symptoms were significantly and negatively associated with physical, psychological, social, and environmental dimensions of the QOL. Negative symptoms were a significant factor in the psychological dimension of the QOL. Finally, anxiety state has the greatest influence on the overall QOL. Conclusions: The results of this study show that general psychopathology, negative symptoms, and anxiety state have a significant impact on the QOL among patients with chronic schizophrenia; it is crucial to regularly assess and monitor them. There is a need to develop a holistic multidisciplinary nursing management program that involves relaxation training for chronic schizophrenia patients to help lower their anxiety and ameliorate psychotic disorders to improve their QOL.

並列關鍵字

chizophrenia ； anxiety state ； psychotic disorders ； quality of life

參考文獻

姚開屏（2002）。台灣版世界衛生組織生活品質問卷之發展與應。台灣醫學，6（2）, 193-200.

胡海國（1995）。精神分裂症的精神症狀量表評分。當代醫學，264，867-871.

衛生福利部（2020，1月）‧107年度衛生福利部統計專區身心障礙者人數慢性精神病患者‧取自 https://iiqsw.mohw.gov.tw/InteractiveIntro.aspx?TID=80949B23DCD13AB6。

鍾思嘉、龍長風（1984）。修訂情境與特質焦慮量表之研究。中國測驗學會測驗年刊，31，27-36.

Achim, A. M., Maziade, M., Raymond, E., Olivier, D., Mérette, C., & Roy, M. A. (2011). How prevalent are anxiety disorders in schizophrenia? Ameta-analysis and critical review on a significant association. Schizophrenia Bulletin, 37(4), 811-821.