探討思覺失調症患者希望感之相關研究

The Study of Hope among Schizophrenic Patients

吳瑞燕(Jui-Yen Wu)

指導教授 ： 顏 文 娟

中山醫學大學/醫學院/護理研究所/碩士(2015年)

https://doi.org/10.6834/CSMU.2015.00191

摘要

本研究目的為探討影響思覺失調症患者希望感相關因素。本研究以中部某醫學中心精神科門診為研究地點，以立意方式取樣，研究對象須符合:(1)據DSM-Ⅳ或ICD-10診斷為思覺失調症患者(2)年齡介於20－65歲間(3)意識清楚能以國、台語溝通(4)精神症狀穩定，能持續專注約20-30分鐘者共收140位樣本數。本研究採橫斷式及描述性相關因子研究設計，採以Espie, Montgomery & Gilies(1988).所編制疾病症狀量、疾病意義量表(Constructed Meaning Scale )CMS(Fife1995, 2000)、自我控制量表Sense of control Scales(SCS) Lachman1 & Leaver1(1998)及韓、陳(2008)精神疾病自我污名感受量表(簡短版)、鄭伊真(2011)翻譯自尊量表與Snyder et al.(1991)The Hope Scale(THS)量表來測量與希望感分布與相關性及預測。
研究結果顯示思覺失調症患者:(1)疾病症狀越明顯，希望感越低其彼此呈現中度負相關。(2)疾病意義與希望呈現中度正相關。(3)自我控制中受限程度越高，希望感越低其彼此呈現低度負相關。(4)自尊與希望感呈現中度正相關。(5)疾病烙印感受與希望感呈現低度負相關。(6)疾病症狀及自尊可作為預測思覺失調症患者希望狀態。
研究應用與建議:針對研究結果，提升個案的希望感可藉由相關因子中的自我控制受限降低，自尊的提升以及症狀控制程度，臨床護理師可藉由提供疾病知識的正面訊息，以及與個案探討疾病的意義與降低負面疾病烙印感來協助個案提升自尊與希望感，增進照護品質。

關鍵字

思覺失調症 ； 認知適應 ； 希望

並列摘要

The aim of the study was to explore the associated factors of hope in schizophrenia patients. The patients were recruited from psychiatric outpatient department in a medical center in Central Taiwan. In this cross sectional study, Judgmental sampling was used. The eligible inclusion criteria were:(1) DSM-Ⅳ or ICD-10 Diagnosis of schizophrenia (2) age between 20 and 65 years old (3) have clear consciousness and ability to communicate in Chinese and Taiwanese (4) have stable mental condition and maintain 20 to 30 minutes. 140 patients were recruited and descriptive comparative analysis of associated factors. This survey ues cross-sectional and descriptive related factors design. It includes six instruments, Psychological Behavior Scale (PBS), Constructed Meaning Scale(CMS),Sense of control Scales(SCS), Rosenberg Self-esteem Scale (RSES), perceived psychiatric stigma scale(PPSS) and The Hope Scale(THS). By these tests, investigate the sense of hope and related impacts.
The research consequence shows that schizophrenia patients (1) either positive or negative symptoms of disease is more obvious, the sense of hope would be less. It shows moderate negative correlation (2) the significance of disses and hope is moderate positive correlation (3) the higher the degree of self-control is limited, the lower sense of hope would be. It presents low negative correlation with each other (4) self-esteem and a sense of hope showing moderate positive correlation (5) Illness stigma feelings and a sense of hope showing low negative correlation (6) disease symptoms and self-esteem can be used to predict psychosis patients hope state.
Research applications and suggestion: For research results to enhance a sense of hope that the case may be related to factors in reducing self-control is limited, self-esteem enhancement and control the degree of symptoms, clinical nurse can provide a positive message by knowledge of the disease, as well as to investigate the significance of cases of the disease and reduce the negative stigma of the disease to help the case to enhance a sense of self-esteem and a sense of hope, enhance quality of care.

並列關鍵字

schizophrenia ； cognitive adaption ； hope

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