某精神專科醫院住院病人2010～2014職能治療五階分佈之描述世代研究

A descriptive cohort study of progression across the five-stage occupational rehabilitation among the inpatients of a psychiatric hospital in 2010~2014

林育璿(Yu-Shian Lin) ； 李慧玲(Hui-Ling Lee)

《醫保研究雜誌》 4卷1期 (2020/01) Pp. 1-13

https://doi.org/10.29827/YBYJZZ.202001_4(1).0001

摘要

目的：了解2010年4月至2014年12月期間各階之進階率、分率、花費時間及進階後維持時間與階段維持率、分率及其各階段維持時間。方法：本研究係屬回溯之描述世代研究；資料來源為職能治療服務品質系統，收案條件為接受某精神專科醫院職能治療服務之病友（共2,605人；108萬人次）且保留每年皆有至少連續3個月階段記綠資料，共得樣本794人。結果：2階進3階為最高進階率（佔8.1%），進階者的進階花費時間介於6至53個月，進階後維持時間介於3至50個月。2階為最高維持階段率（佔33.2%），平均維持時間介於10.8至14.4個月。結論：五年期間總進階率22.8%，總維持階段率56.2%，因病情不穩退階者佔21.0%。各階進階平均花費皆在3.5年以上，成功進階者維持在進階之階段平均皆超過10個月以上，故成功進階個案之合理停留時間可定10個月。

關鍵字

職能治療 ； 慢性精神病友 ； 服務品質系統

並列摘要

Objective. The study investigated the outcome of the Five-stage Occupational Rehabilitation Service (FsORS) for the inpatients of a psychiatric hospital in central Taiwan during April 2010 and December 2014. Method. This retrospective descriptive cohort study screened data collected through an occupational therapy service data system over 2,605 inpatients (approximately 1,080,000 data entries). A sample of 794 participants who met the inclusion criterion (FsORS records available for a minimum of three consecutive months per year) were selected. Data analysis examined the progression, retention and duration across the different stages of the FsORS. Results. A total of 794 participants progressed to a higher FsORS stage, yielding an overall progression rate of 22.8%. The highest progression proportion was found in the FsORS stage 2 to 3 progression (8.1%). The overall retention rate was 56.2%, time required for stage progression varied from 6 to 53 months and the duration of retention post-progression was between 3 to 52 months. The highest retention rate found in the FsORS stage 2 (33.2%), the duration of participants' retention in their original FsORS stage ranged from10.8 to14.4 months. Conclusion. Occupational therapy using the FsORS model helps promote and retain psychiatric clients' functional level. Training emphasized in different FsORS stages can foster the clients' function required for progression. The average time for stage progression is 3.5 yr. Upon a successful progression, a client can retain the higher stage and function for 10 months or longer.

並列關鍵字

occupational therapy ； chronic psychiatric patients ； rehabilitation service

參考文獻

蔡佳瑜, & 曾瓊瑤. (2019). 中部某精神專科醫院工作復健服務探討～職能復健模式五階層之第三階與第四階工作訓練分析. 臺灣職能治療研究與實務雜誌, 15(1), 15-27. doi:10.6534/jtotrp.201906_15(1).0002

Arbesman, M., & Logsdon, D. (2011). Occupational Therapy Interventions for Employment and Education for Adults With Serious Mental Illness: A Systematic Review. The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 65, 238-246. doi:10.5014/ajot.2011.001289

Harada, N., Sofaer, S., & Kominski, G. (1993). Functional status outcomes in rehabilitation. Implications for prospective payment. Med Care, 31(4), 345-357. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/8464251

Chen, S.-P. (2003). Vocational integration for mentally ill clients in a public psychiatric center. Paper presented at the The 3rd Asia Pacific Occupational Therapy Congress., Singapore.

Hamilton, B. B., Granger, C. V., Sherwin, F. S., Zielezny, M., & Tashman, J. S. (1987). A uniform national data system for medical Rehabilitation. In Rehabilitaion outcomes: Analysis and measurement (Fuhrer MJ (ed) Rehabilitation ed.).