- 期刊
某日間型精神復健機構治療模式效果之評價研究
An Evaluation Study on the Effectiveness of the Treatment Model in a Daytime Mental Rehabilitation Institution
摘要
目的：比較某日間型精神復健機構治療模式前後12項獨立日常生活功能等級之變化情形，以作為後續調整復健目標、計劃及服務內容之依據。方法：日間型精神復健機構治療之介入期間為112年1月到6月並請學員於介入前、介入後三個月、六個月等（分別為民國112年1月、112年4月與112年7月等）填寫三次邁向復元自評表（含12項獨立日常生活功能），研究樣本數依不同之題目有所差異；分別獲得11-14位樣本。效果評價採分析性統計之Proportional Test與McNemar Test分析12項需求改變之差異情形。結果：12項獨立日常生活項目當中有10項學員有復健需求，在樣本11-14位學員中其有需求項目與人數分別為起床3位、處理餐食1位、交通6位、服藥2位、與他人互動1位、與家人互動2位、工作能力3位、金錢管理7位、運動習慣8位、休閒3位；在刷牙及洗澡屬於無他助需求（即可以獨立完成）。整體而言，樣本日間型精神復健機構服務成效好之項目為刷牙、洗澡、服藥、工作能力、金錢管理、運動習慣、休閒等7項；成效待改善者為起床、處理餐食、交通、與他人互動、與家人互動等5項。結論：樣本日間型精神復健機構治療模式（即需求評估、提供服務、評價效果與執行改善）之整體效果良好並擬推廣該模式至全國「社區支持」服務；該模式之邁向復元自評表（12項）已具取代現行日常生活功能評量表（題數86項）之必要性，故擬於民國114年於某精神專科醫院附設之四家日間型精神復健機構執行該推廣計畫。
並列摘要
Objective. This study aims to evaluate changes in 12 independent daily living function levels before and after the implementation of a treatment model at a daytime psychiatric rehabilitation institution. The findings will serve as a basis for adjusting rehabilitation goals, plans, and service content. Method. The intervention period at the daytime psychiatric rehabilitation institution spanned from January to June 2023. Participants were asked to complete the self-reported " Journey to Wellness Scale" form (including 12 independent daily living functions) at three time points: before the intervention, three months after the intervention, and six months after the intervention (January, April, and July 2023, respectively). The number of samples varied across items, ranging from 11 to 14 participants. Effectiveness was evaluated using analytical statistics of Proportional Tests and McNemar Tests to analyze changes in needs across the 12 items. Results. Among the 12 independent daily living functions, 10 items showed rehabilitation needs. The number of participants requiring assistance in each category ranged as follows: waking up (3), meal preparation (1), transportation (6), medication adherence (2), social interaction (1), family interaction (2), work ability (3), money management (7), exercise habits (8), and leisure activities (3). Tasks such as brushing teeth and bathing were identified as independent, requiring no external assistance. Overall, the most effective outcomes were observed in brushing teeth, bathing, medication adherence, work ability, money management, exercise habits, and leisure activities (7 items). Areas requiring improvement included waking up, meal preparation, transportation, social interaction, and family interaction (5 items). Conclusion. The treatment model (including needs assessment, service provision, effectiveness evaluation, and improvement implementation) of the daytime psychiatric rehabilitation institution demonstrated overall effectiveness. It is recommended to promote this model to nationwide "community support" services. Additionally, the "Journey to Wellness Scale" (12 items) has shown potential to replace the current daily living function evaluation form (86 items). A promotion plan is scheduled for implementation in 2025 at four daytime psychiatric rehabilitation institutions affiliated with a psychiatric center.