目的:復元的精神,強調精神病人雖受疾病限制,仍可過有意義與滿足的生活,然而,當前復元介入模式大多以生活於社區的病人為對象,較少關注長期住院精神病人的復元需求。本研究目的為發展適合長期住院精神病人、以幸福為導向之復元團體,並初步評值其成效。方法:採類實驗研究設計,以方便取樣選取並招募中部某精神專科醫院兩間男性慢性病房內住院達六個月以上之思覺失調症病人,實驗組及對照組各30人,兩組均接受慢性病房之常規照護,實驗組則額外接受6次以幸福為導向之復元團體(每次60分鐘,每週一次),內容涵蓋復元秘笈、保持希望、找尋優勢、跨越疾病障礙、自我健康管理、幸福生活,以「中國人幸福感量表簡明版」為成效評量工具。結果:研究對象以國中學歷、未婚者多,兩組差異檢定僅有職能工作(10.0% vs.60.0%)具顯著差異(p < 0.001),其餘各變項之表現均未達統計顯著差異。經過廣義估計方程式檢定,以職能工作為共變項,顯示實驗組在社會承諾、正向情感、掌控感、自我滿足及幸福感總分均優於對照組,且達統計顯著性。結論:以幸福為導向之復元團體能提升長期住院思覺失調症病人之幸福感受。建議未來可推廣此復元團體於臨床照護,培訓精神衛生護理人員提供相關照護,以增進長期住院病人之照護品質。
Objectives: The recovery model emphasizes that patients with mental illness can flourish even while living with illness. Recovery interventions have been largely implemented for people living in communities but do not address the needs of long-stay patients with schizophrenia. This preliminary study developed a happiness-oriented recovery group for long-stay patients with schizophrenia and examined the effects of this group intervention. Methods: This quasi-experimental research was conducted in two chronic wards of a psychiatric hospital in central Taiwan. Male inpatients with schizophrenia who had been admitted for more than 6 months were recruited. In total, 30 patients were assigned to an experimental or control group, respectively. Both groups received routine care, and the experimental group received six happiness-oriented recovery group sessions (60 minutes/session, once a week). The sessions included activities for improving personal wellbeing. The Chinese Happiness Inventory was used to assess outcomes. Result: Most patients were unmarried with a maximum education level of junior high school. The two groups had similar distributions in all baseline characteristics except for employment status (10.0% vs. 60.0%, p < 0.001). Results obtained from a generalized estimating equation analysis after employment status was controlled for, scores on perceived happiness, including social commitment, positive affect, mastery, and self-fulfillment, were significantly higher in the experimental group than in the control group. Conclusion: The happiness-oriented recovery group intervention increased perceived happiness among long-stay patients with schizophrenia. We suggest incorporating recovery groups into clinical care and training psychiatric nurses to provide related care to enhance outcomes for long-stay psychiatric patients.