精神科病患於日間病房之預後分析

Outcome Analysis of a Day Care Ward for Clients with Psychiatric Disabilities

王文志(Wen-Chih Wang) ； 張自強(Tzyh-Chyang Chang) ； 文榮光(Jung-Kwang Wen)

《臺灣職能治療研究與實務雜誌》 1期 (2005/11) Pp. 36-43

https://doi.org/10.6534/jtotrp.2005.1(1).36

摘要

目的：精神病患的日間照顧服務模式目前已經被應用的相當普遍，但其服務範圍與成效之探討較欠缺。本研究將探討日間病房的歷史背景與相關之研究，並進一步分析國內之現況及精神科病患於國內某醫學中心日間病房之預後，以做為未來規劃精神科病患日間病房之復健參考。方法：本研究對象以1991年2月至2001年4月，南部某醫學中心之日間病房642名病患為研究對象。平均年齡約為30歲，大多數未婚，學歷以高中職居多，診斷以精神分裂症78%佔多數，其次為情感性精神病14%。此醫學中心日間病房成立至今已有十一年，並經多次擴床計劃。本研究將這11年分為四期，並作不同時期之討論。結果：研究結果發現，慢性精神病患會出現長期滯留日間病房之問題，而合併智能不足之病患可能會遇到住院受限的問題。此外，對於個案高度重複住院率因素的分析以及日間病房之自殺問題探討，也將在本研究中討論。結論：未來在規劃精神科日間病房的復健計劃上，可連結地區性之康復之友協會等民間自助團體，並設置個案管理員（如：導師制度），以使病人得到全面性的、整體性的醫療照顧，協助有就醫困難的病患就醫，並加強病患的社區復健、就業安置、回歸社區，減少醫療資源的浪費。

關鍵字

精神障礙者 ； 日間照護 ； 預後

並列摘要

It is popular to clients with psychiatric disabilities at day care ward, but there is less analysis of the effects of the day care function. The purposes of this study are to review the development and research related to the day care, and to analyze the prognosis of clients with psychiatric disabilities in order to plan the day care ward in the future. Methods: There are 642 clients with psychiatric disabilities at day care ward of a medical center in this study. The average of all participants was about 30 years old and the main diagnosis of them was schizophrenia. The day care ward in this study was for 11 years and divided into four stages that would be analyzed and discussed here. Results: The results of this study is to show that chronic psychiatric clients will be the stage army at day care ward and psychiatric clients with mental retardation have the problem about the admission of the day care ward. In addition, the high rate of be hospitalized repeated and suicide problem at day care ward will be discussed in this study. Conclusions: The future plan of psychiatric day care ward can integrate the local psychiatric rehabilitation association and set the case manager in order that clients with psychiatric disabilities can receive the whole services from the day care ward in community and vocational rehabilitation.

並列關鍵字

Clients with Psychiatric Disabilities ； Day Care ； Outcome