應用認知功能訓練模組提升思覺失調症個案就業準備度之案例報告

研究目的：本研究主要運用強化認知功能之訓練介入模組，以探討是否能增加個案的就業準備度與就業穩定度。研究方法：結合注意力訓練與目標管理之神經心理功能訓練，對就業不穩定之思覺失調症個案進行為期10週、每週1小時之神經認知功能訓練，並由神經心理衡鑑結果、日常生活行為及職業適應功能三個層次分析訓練介入對提升個案就業準備度之成效。研究結果：神經心理衡鑑結果發現個案注意力容量增加與活動轉換時的自我監控能力提升。日常行為結果顯示個案自覺整體憤怒及不耐煩情緒的頻率下降、情緒監控的能力進步及日常生活執行功能困難降低。職業適應功能結果顯示個案於訓後2週內自行就業，已穩定就業超過12個月，並持續就業中。訓練後3個月追蹤，神經心理衡鑑結果發現個案的注意力與自我監控能力仍維持在中上水準，日常行為之情緒調控與監控能力維持於無異常表現，職業適應功能除持續穩定就業外，薪資亦顯著提升，顯示訓練成效可於訓練後持續維持。研究討論：對思覺失調症個案進行注意力與目標管理訓練介入，初步證實對其就業準備度與後續之就業穩定度具相當助益。未來研究可增加樣本數，用以討論個別差異對介入之影響。

關鍵字

注意力訓練；目標管理訓練；就業前準備

並列摘要

Objectives: A training intervention module was developed for strengthening cognitive functions and to investigate whether the intervention can enhance his employment readiness and stability. Methods: A schizophrenia patient with unstable employment was asked to undergo a weekly, 1-hour long cognitive function training session for 10 weeks, which combined attention and goal management training. The effectiveness of the training intervention on improving the patient employment readiness was analyzed from three aspects, namely the neuropsychological test results, daily-life behavior, and occupational adaptation. Results: The neuropsychological test results showed that the patient's attention capacity and self-monitoring ability when switching activities increased after receiving the training. Examining the daily-life behavior showed that the patient's perceived frequency of anger and impatience decreased, the emotion monitoring ability was improved, and difficulty in executing daily life activities was reduced. Regarding occupational adaptation, the patient found a job without others' assistance 2 weeks after the training, and had been stably employed for more than 12 months and continued to be employed thereafter. A follow-up was conducted 3 months after the training. The neuropsychological test results showed that the patient's attention capacity and self-monitoring ability were still maintained at a medium-high level. From the aspect of daily-life behavior, no abnormalities were observed regarding emotion regulation and monitoring abilities. In terms of occupational adaptation, the patient enjoyed a stable employment with a substantial increase in salary, implicating that the effectiveness of the intervention can be sustained after the training. Discussion: The proposed intervention with attention and goal management training for the schizophrenia patient was preliminarily verified to be effective in enhancing patients' employment readiness and subsequent employment stability.

並列關鍵字

attention training ； goal management training ； employment readiness

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應用認知功能訓練模組提升思覺失調症個案就業準備度之案例報告

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