出院精神病患於重返社區過程中,經常面臨許多阻礙與困難,而導致適應不良、再度發病與再度入院。本研究乃以質性研究方法探究出院精神病患重返社區所面臨之阻礙,藉由「焦點團體(focus group)」,以半結構式訪談指引分別訪談出院精神病患(八位)與主要照顧者(十位),將兩觀點之訪談結果相互驗證、分析與歸納,發現出院精神病患重返社區所面臨的阻礙可歸類為三個層次及七項類目:個體層次(症狀纏擾、自我認同因疾病經驗而混淆、社會功能的退化)、家庭層次(家人的不解與排拒、家庭角色與關係面臨衝擊)、社會層次(對精神疾病之烙印觀感、貧乏的社區照護網絡)。本研究可作為未來設計精神病患重返社區相關照護處置以及規劃社區醫療照護政策的本土化知識依據。
The mentally ill persons always encounter many barriers and difficulties as reintegrating to community. Poor adaptation in community will then cause them relapsed and rehospitalized. This qualitative study aims to explore those barriers that the mentally ill patients encounter in the community. By using the semi-structural interview guide and data triangulation, eight mentally ill patients and ten families were separately interviewed in focus groups. After comparing, analyzing, and categorizing these two perspectives, three levels containing seven themes were identified: individual level (be harassed with symptoms, confused self-identity owing to illness experience, regressive social function), family level (been misunderstood and expelled by families, facing the impact on family roles and relations), and societal level (stigma for mental illness, insufficient community care). Our findings illustrated those obstacles that mentally ill outpatients in Taiwan experienced could enlighten for service planning, policy making in the future and may increase psychiatric nurses and related professionals’ knowledge to approach this vulnerable population.