臺灣長期照護機構慢性精神分裂症病患的職能活動參與

本研究目的爲探討長期照護機構精神分裂症病患職能活動參與的經驗。本研究以東部某長期照護機構爲例，採質性研究法中之紮根理論研究法，透過深度訪談及逐字稿分析其生活經驗。研究參與者包括五位男性及一位女性。平均年齡爲42.4歲，長期收容年數由0.6到14.3年不等。研究結果顯示機構的團體生活缺乏隱私，且影響個案的主觀安適感。個案對職能活動的看法爲高度結構化，且缺少個別性。然而個案職能參與情形的個別差異則受其比較過去與現在生活經驗差異的影響。在進入機構前後的相對感受會影響個案的安適感。而個案對生命或生活的價值觀或對疾病退化過程的覺察也會影響其調適過程。研究結果呈現長期收容的社會文化環境特徵對這群病患的衝擊，故職能治療師或相關醫療專業人員可針對此現象，在環境、個人因素或職能活動方面提供專業建議。

關鍵字

活動參與；機構化；質性研究；職能治療

並列摘要

This study explored the experiences of occupational participation in chronic schizophrenia patients in a long-term institution in east Taiwan. A qualitative study was performed using grounded theory method. The research method was in-depth interviews and analysis of interview transcripts. Six participants, including five males and one female, were interviewed. The average age was 42.4 years old. Time of stay at the long-term institutional facility ranged from 0.6 to 14.3 years. The analysis results revealed that the participants led a group life in the institution which privacy was deprived and subjective well-being was affected. The participants felt that their occupational participation was daily routine, predictable and lack of personal preferences. Individual differences in participation were associated with differences in living status before and after admission to the facility. The feeling of relative differences between living situations before and after admission to the institution thus affected participant's well-being. Additionally, personal factors such as life values and awareness of deteriorating illness course had mediating effects on the adaptation process. The study identified the aspects of their social and cultural environments that impacted occupational participation. Occupational therapists and other health professionals may give professional advice aimed at improving environment, individual factors, or occupational activities.