探討慢性精神病人之復原力及其相關因素

Exploring Resilience and Its Related Factors in Patients with Chronic Mental Illness

黃智玉(Chin‐Yu Huang) ； 陳如容(Ru‐Rong Chen) ； 鄭淦元(Kan‐Yuan Cheng) ； 宋素卿(Su‐Ching Sung)

《護理暨健康照護研究》 10卷2期 (2014/06) Pp. 154-163

https://doi.org/10.6225/JNHR.10.2.154

摘要

背景：復原力為個體成功因應困境的能力，對精神病人重返社會具有重要影響。目前復原力研究雖多在探討高危險群對象，但缺乏精神病人的復原力及其相關因素之探討研究。目的：本研究旨在探討精神病人之人口學特性、精神症狀、壓力知覺感受、醫病互動、社會支持、社會適應能力與復原力的關係，及了解復原力的預測因子。方法：招募東部某精神專科醫院共180位慢性精神病人為研究對象。運用簡式精神症狀量表、壓力知覺量表、醫病互動量表、社會支持量表、復原力量表、社會適應能力量表收集資料。結果：本研究對象屬中度復原力。精神病人的復原力與醫病互動、社會支持呈顯著正相關，與壓力知覺感受、社會適應能力、精神症狀呈顯著負相關。逐步多變項迴歸分析顯示壓力知覺感受、社會支持、教育程度與社會適應能力對復原力之解釋力約45.3%。結論／實務應用：提升社會支持與社會適應能力、降低壓力知覺感受，可提升精神病人的復原力與降低復發機會，進而協助病人重返社會。

關鍵字

醫病互動 ； 壓力知覺感受 ； 復原力 ； 社會適應能力 ； 社會支持

並列摘要

Background: Resilience embodies the personal qualities that enable one to thrive in the face of adversity and is a significant factor affecting the health of patients with mental illness. Most research on resilience has focused on patients in high‐risk groups. Thus, there is lack of research exploring the resilience of psychiatric patients and related factors. Purpose: The aims of the present study were to (1) explore the relationships among demographic characteristics, psychiatric symptoms, perceived stress, medical professional‐patient interaction, social support, social adaptive function, and resilience and (2) identify indicators of resilience in psychiatric patients. Methods: A total of 180 psychiatric patients were recruited from a mental hospital in eastern Taiwan. The brief psychiatric rating scale, perceived stress scale, questionnaire of medical professional‐patient interaction and social support, Connor‐Davidson Resilience Scale (CD‐RISC), and social adaptive function scale were used to collect data. Results: Participants in the present study showed an intermediate level of resilience. Resilience scores correlated positively with medical professional‐patient interaction and social support and negatively with perceived stress, social adaptive function, and psychiatric symptoms. Stepwise multiple regression analysis indicated that perceived stress, social support, education, and social adaptive function collectively accounted for 45.3% of the total variance. Conclusion / Implications for Practice: For psychiatric patients, enhancing social support and social adaptive function and decreasing perceived stress improves their resilience and decreases the frequency of their psychiatric episodes, thus increasing their chances of returning to society.

並列關鍵字

medical professional‐patient interaction ； perceived stress ； resilience ； social adaptive function ； social support

參考文獻

劉萱、邱啟潤（2012）•長照機構之老年住民復原力及 其相關因素探討•護理暨健康照護研究，8(3)，179− 190。[Liu, X., & Chiou, C. J. (2012). The resilience of elderly residents in long-term care facilities and related factors. Journal of Nursing and Healthcare Research, 8(3), 179−190.] doi:10.6225/JNHR.08.3.179

Andersen, J., Larsen, J. K., Krner, A., Nielsen, B. M., Schultz, V., Behnke, K., & Bjrum, N. (1986). The Brief Psychiatric Rating Scale: Schizophrenia, reliability and validity studies. Nordic Journal of Psychiatry, 40(2), 135−138. doi:10. 3109/08039488609096456

Campbell-Sills, L., & Stein, M. B. (2007). Psychometric analysis and refinement of the Connor-Davidson Resilience Scale (CD-RISC): Validation of a 10-item measure of resilience. Journal of Traumatic Stress, 20, 1019−1028. doi:10.1002/ jts.20271

Chiba, R., Miyamoto, Y., & Kawakami, N. (2010). Reliability and validity of the Japanese version of the recovery assessment scale (RAS) for people with chronic mental illness: Scale development. International Journal of Nursing Studies, 47(3), 314−322. doi:10.1016/j.ijnurstu.2009.07.006

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(2), 385−396. doi:10.2307/2136404