成年就業精神分裂症患者康復經驗之研究

A Study of the Vocational Recovery among Employed Adults with Schizophrenia

李雅敏(Ya-Min Li) ； 林宏熾(Hung-Chih Lin)

《復健諮商》 第2期 (2008/12) Pp. 49-75

https://doi.org/10.30123/RC.200812.0003

摘要

本研究旨在探討成年就業精神分裂症患者康復之經驗，並分析就業與康復之關係、促進康復之要素與康復之挑戰。本研究主要參與者有七位，年齡介於27-45歲之間，爲領有身心障礙手冊之就業精神分裂症患者，並訪談其關係人十位。研究採取質性研究方法，透過個別深度訪談進行資料蒐集，將所得資料進行三角交叉檢核，以紮根理論方法分析資料。
研究結果以幾個面向歸納之：就業於康復歷程之角色、促進康復的要素與康復的挑戰等，並以成年就業精神分裂症患者康復經驗之概念圖來表示。研究歸納就業於康復歷程之角色爲：就業是病情穩定的指標、具有復健功效；就業代表突破自我、提供自信、快樂、安全感、希望與生活充實、有目的等正向心理資源；就業表示社會融入、回歸正常生活與對社會有貢獻等。研究亦發現促進康復的要素分爲內在動力與外在資源，促進康復的內在動力有六個面向：包括康復驅力、自我覺察、自我肯定、正向性格特質、正向信念與康復的因應策略等；促進參與者康復的外在資源有：專業的協助、家庭支持、朋友支持、社會福利與醫療資源、有利的環境與宗教信仰等。康復的挑戰有：疾病的影響、藥物副作用、環境壓力、社會的污名與個人的劣勢等。
本研究依據研究發現、參與者之意見和研究者的反省，針對相關服務人員與成年精神分裂症患者及家屬提出一些具體的建議。

關鍵字

精神分裂症 ； 精神障礙 ； 就業 ； 康復 ； 職業康復

並列摘要

The purpose of this study was to understand the recovery experience of employed adults with schizophrenia. The following aspects were addressed: the vocational profile, the relationship between employment and recovery, the elements promoting recovery and the challenge encountered. Seven employed adults with schizophrenia who were between 27 and 34 years old with the disability identifications issued by the Taiwan Government were interviewed in this study, and 10 people who closely related to the interviewees were also interviewed. Qualitative research methods were conducted through in-depth interviews to collect data, followed with the triangulation and the grounded theory analyses.
The findings were concluded as the following aspects: the relationship between employment and recovery, the role of employment in recovery process, the benefits of employment on recovery, related factors contributing to the recovery, and the challenges toward recovery. The study worked out of a concept-map of the recovery experience among employed adults with schizophrenia. With the relationship between employment and recovery, the role of employment served an index for predicting the stabilization of the rehabilitative effects; employment meant ”self-renewal”, which provided self-confidence, happiness, security, hope, richness, and the goal of life; employment meant returning to the society, back to life-line and being able to contribute to the community.
The results of this study also showed the factors contributing to the recovery included selfmotivation and the resources available outside. The former contained six domains: recovery motivation, self awareness, self affirmation, positive personality traits, positive thinking, and coping strategies for recovery. The latter contained also six areas: support of professionals, support of family, support of friends, social welfare and medical resources, positive environment, as well as the religion. The challenges toward recovery involved five domains: the influence of the disease, side effects of the medicine, the environment with pressure, social stigma, and the personal deficits.
Recommendations are offered regarding the implications of these findings for rehabilitation professionals, families, and social welfare personels.

並列關鍵字

schizophrenia ； psychiatric disability ； employment ； recovery ； vocational recovery