以醫院為基礎居家照護服務於精神分裂症病患之成效

目的：本研究旨在評價居家照護服務於精神分裂症病患的實施成效，並與傳統社區精神醫療照護模式進行比較，以作為將後提供社區精神醫療照護之參考。方法:採回溯性雙組後測研究設計；研究對象為北部某醫學中心30位曾接受「以醫院為基礎居家照護服務」的精神分裂症病患（實驗組），並配對選取另外30位僅接受「傳統社區精神醫療照護」之同診斷病患為對照組；運用結構性問卷（包含：疾病維持行為、精神症狀、社會功能、精神醫療照護服務滿意度等四項成效指標）、採面對面訪談法，具體評價與比較兩種照護服務之達成成效。結果：接受「以醫院為基礎居家照護」的病患，除了再住院天數外，於各效果指標之表現皆顯著優於僅接受「傳統社區精神醫療照護」之病患。結論：精神分裂症病患於出院後一年間接受「以醫院為基礎家照護服務」，對其社區適應及整體治療效果皆有正向助益，值得推廣於本國精神醫療照護體系。

關鍵字

以醫院為基礎家照護服務；傳統社區精神醫療照護；精神分裂症

並列摘要

Schizophrenia is a chronic disease that places tremendous costs and burden on patients, families, and communities. The purpose of this study was to compare the effectiveness of the hospital-based home care service and the traditional community care service for schizophrenia in Taiwan. A retrospective research design and face-to-face interviews using the structuralized questionnaires were used to test the four effectiveness indicators on these two groups. In addition to the rehospitalization days, the overall performance of the four indicators in the hospital-based home care service was superior. The results suggest that the hospital-based outreach home care service is an effective approach to care for patients in their own community.