精神分裂症患者主要家屬照顧者之溝通訓練效果研究

鄭夙芬

指導教授 ： 吳就君

國立臺灣師範大學/教育學院/衛生教育學系/博士(2000年)

摘要

本研究旨在探討精神分裂症患者主要家屬照顧者接受溝通訓練的效果與探討教案實施之團體動力因素。研究方法以23名主要家屬照顧者為研究對象，分為實驗組與控制組，實驗組接受六個單元的溝通訓練，資料蒐集分為量化與質化兩部分，量化部分透過自製溝通問卷與「中國人五分鐘演說樣本」測量而得，分別在教案實施前後一個月進行施測，以進行統計分析，質化部分包括透過情緒表露逐字稿、團體過程記錄逐字稿收集而得並加以探討。研究結果發現：(一) 溝通訓練有效維持低情緒表露或降高情緒表露。（二）經溝通訓練後，原先「表達正向感受」得分高之實驗組成員，在該技巧之習得有顯著改善。（三）實驗組成員溝通技巧的習得，有助於降低高情緒表露，但對維持低情緒表露者則不盡然；從質化資料中，發現情緒表露降低者，其表達負向感受技巧明顯改善；維持低情緒表露者在做正向要求技巧較有進步。（四）影響教案實施的動力因素包括：團體前的準備、教案與教材的設計執行、團體目標與個人需求、成員互動溝通、團體規範與價值觀及領導者介入。最後，研究者對於精神分裂症患者主要照顧家屬之溝通訓練介入效果、溝通與情緒表露變化之現象、有利的衛教團體動力因子、家屬溝通現象的展現、伙伴關係、家屬充權的潛能等部分提出討論，並形成建議。 The purpose of this study was to investigate the effects of communication training program on family caregivers of Schizophrenic patients’. Methods A total of 23 family caregivers were included in the study and divided into two groups, which were experimental and control groups. Individuals in the experimental group received six sessions of communication training program whereas the ones in the control group did not. Quantitative and qualitative methods were performed to all participants one month before and after the conduction of the communication training program. The Chinese Five Minutes Speech Sample (CFMSS) and a communication questionnaire designed by our lab were used as the quantitative methods. Qualitative methods were based on the transcripts of CFMSS and of group process records. The study data were analyzed by SPSS statistic model. Results and conclusions Results indicated that (1) the communication-training program decreased high expressed emotion (EE) and maintained low EE. (2) The scores of Expressing Positive Feelings (EPF) were significantly increased on the individuals who had higher scores of EPF before the conduction of the training program in the experimental group. (3) There was relationship between the changes of communication skill and the variance of EE in the experimental group. The qualitative data showed that individuals changing from high EE to low EE had markable improvement on Expressing Negative Feeling. Individuals maintaining low EE had improvement on Making Positive Requests . The dynamic factors that influenced the education of the communication-training program were discussed.

關鍵字

精神分裂症 ； 溝通訓練 ； 情緒表露 ； 衛生教育團體 ； 主要家屬照顧者

並列摘要

The purpose of this study was to investigate the effects of communication
training program on family caregivers of Schizophrenic patients’.
Methods
A total of 23 family caregivers were included in the study and divided into
two groups, which were experimental and control groups.　Individuals in the
experimental group received six sessions of communication training program
whereas the ones in the control group did not.　Quantitative and qualitative
methods were performed to all participants one month before and after the
conduction of the communication training program.　The Chinese Five Minutes
Speech Sample (CFMSS) and a communication questionnaire designed by our lab
were used as the quantitative methods. Qualitative methods were based on the
transcripts of CFMSS and of group process records. The study data were
analyzed by SPSS statistic model.
Results and conclusions
Results indicated that (1) the communication-training program decreased high
expressed emotion (EE) and maintained low EE.
(2) The scores of Expressing Positive Feelings (EPF) were significantly
increased on the individuals who had higher scores of EPF before the
conduction of the training program in the experimental group.
(3) There was relationship between the changes of communication skill and the
variance of EE in the experimental group.　The qualitative data showed that
individuals changing from high EE to low EE had markable improvement on
Expressing Negative Feeling.　Individuals maintaining low EE had improvement
on Making Positive Requests　.
The dynamic factors that influenced the education of the communication-
training program were discussed.