思覺失調症青年重返校園之學校適應歷程

本研究採敘事探究，旨在了解思覺失調症青年罹患疾病後的學校適應情形。邀請四位在中學時期罹患思覺失調症的青年擔任研究參與者，以半結構訪談大綱蒐集其生命經驗，針對研究發現提出以下結論。首先，青年罹患思覺失調症後，因自身及家人缺乏精神醫療概念，治療配合度不佳，生活飽受疾病干擾。同時，學校適應出現許多困難，難以參與課堂活動及遵從規範，無法勝任學習任務，人際關係以負向經驗為主。當其住院治療後，配合藥物治療，情緒症狀改善，精神症狀獲得良好控制，讓其能夠重新開始學習，學習動機及能力皆有所提升。出院重返校園後，持續接受治療，緩解的精神症狀，能因應學校環境與要求，但學業學習是主要壓力，如採取問題解決或自我調適的方式，得以勝任學習任務，而其常規適應普遍良好，人際關係以正向經驗為主。再者，從思覺失調症青年重返校園情形發現，良好疾病控制及正向心理特質是學校適應的關鍵，如採用問題解決或自我調適的因應方式，能促進其學校適應狀況。另外，社會支持是學校適應的助力，家庭支持則是重要基石，家人支持治療的態度，有助其疾病獲得控制。而重返校園前的日間病房醫療教育復健模式，能為其重返校園預作準備，有利出院後的學校適應。最後，從思覺失調症青年重返校園經驗發現，滿意的學校適應經驗，有助其改善內在心理狀態，重新獲得希望感，教育在復健過程扮演重要角色，有助各項社會功能提升。思覺失調症青年在治療後症狀能獲得控制，但治療並非治癒，其會發展出疾病因應方式，學習與疾病共處。基於研究結果，本研究針對思覺失調症青年、思覺失調症青年的家人、學校系統及醫療系統等給予不同建議，期盼思覺失調症青年的需求及復元發展能獲得更多關注。此外，根據本研究限制，亦對未來研究提出相關建議。

關鍵字

青年；重返校園；思覺失調症；復元；學校適應

並列摘要

This research adopted narrative study of qualitative research. The aim of this research analyzed the school adjustment of the adolescents with schi-zophrenia. Four adolescents who suffered from schizophrenia in high school were invited to be research participants. This research collected their life ex-periences with a semi-structured interview. After analyzing the data, the re-sults were as follow: Firstly, the adolescents with schizophrenia received the psychiatric treatment poorly, due to the lack of mental medical concepts. Their life was greatly disturbed by the disease, and they adjusted school hardly. They could’t participate in class and followed the school rules. They were unable to perform learning tasks and had negative experiences with their teachers and classmates. When they received day hospitals care, they received medication steadily. Their emotional symptoms were improved and their mental symptoms were well controlled. They could learn again, and their motivation and abilities of learning were improved. When they returned to school, they still received psychiatric treatment to relieve the mental symptoms. They can deal with the school environments and requirements, but the academic learn-ing was their main pressure. If they choose problem-solving or self-adjustment methods, they will be able to perform learning tasks. They can follow the school rules, and have positive experience with teachers and classmates. Furthermore, according to their experiences of returning to school, this research is found that good disease control and positive psychological traits are the main factors of their school adjustment. If they choose prob-lem-solving or self-adjustment methods, they will promote their school ad-justment. Moreover, social support can critically aid to their school adjust-ment, especially their family support. If their family supports psychiatric treatment, they will get better disease control. Before they return to school, the rehabilitation in the day hospitals helps them to prepare skills to go back to school. It can aid them to adjust school after discharge. Finally, according to the experiences of the adolescents with schizoph-renia, it is found that their good school adjustment can help themselves im-prove their psychological situations and find hope again. Education plays an important role in their rehabilitation process and can help improve their func-tions. After psychiatric treatment, the disease is controlled but not healed. The adolescents with schizophrenia develop their own way to deal with the disease and learn to coexist with the disease. According to the results of this research, the researcher makes different sugges-tions to the adolescents with schizophrenia, their families, schools, and med-ical systems. The researcher hopes that the needs and recovery of the adoles-cents with schizophrenia will receive more attention. Besides, the researcher makes some suggestions for future research based on the limitations of this research.