認知訓練團體在思覺失調症患者的應用與評估

目的：本研究設計具體可執行的認知訓練內容，針對失覺思調症患者進行團體治療並評估療效。方法：設計八個單元之認知作業，由專家審查效度後，進行認知訓練團體。本研究之實驗組共招募32位失覺思調症患者進行為期四至六週共八次訓練的認知訓練團體，另外招募14位失覺思調症患者作為對照組。本研究採用前後測設計，比較這兩組患者在認知評估上是否在認知訓練介入前後出現差異。結果：本研究發現認知訓練能有效顯著提升實驗組思覺失調症個案的多項認知表現。即使以共變數分析控制了練習效果後，視覺建構、整體認知功能及注意力，仍可以得到顯著的認知訓練效果。結論：本研究結果顯示多元認知功能訓練能有效提升思覺失調症患者的認知表現。由於慢性化思覺失調患者仍具有認知復健潛能，宜提供復健處遇。

關鍵字

思覺失調症；認知功能；注意力

並列摘要

Objective: The purpose of this study is to examine whether the cognitive training program developed in the present study can improve cognitive functions of schizophrenics. Methods: Eight tasks, including memory flop games, detective games (target searching), Sudoku, matching games, picture solitaire, picture sequencing with stories, puzzle games, and idiom close test, were developed for cognitive training. All tasks were reviewed and validated by an expert in cognitive psychology. Thirty-two participants in the experimental group were pretested with cognitive tests, followed by the six-week cognitive training. After the training, all participants were post-tested with the same cognitive tests as pretest. In addition, 14 participants in the control group were pretested and post-tested with the same cognitive tests and testing schedule as experimental group but did not provide any intervention. Results: The results suggested that our cognitive training program significantly improved cognitive functions of schizophrenics, including abstract thinking, divided attention, thinking flexibility, executive function, attention, and long-term memory. The positive effects of our cognitive training program persisted even after controlling for the effect of practice, visual construction, overall cognitive function, and attention. Conclusion: The presented results suggested that multiple cognitive trainings could potentially enhance cognitive abilities of chronic schizophrenics, so that such program of cognitive rehabilitation should be provided to chronic schizophrenics.