探討慢性思覺失調症病人復元歷程中與家人互動經驗

本研究目的在探討慢性思覺失調症病人在疾病復元歷程中與家庭互動的經驗。採用立意取樣法，於中部某精神科專科醫院之社區復健中心進行收案，研究對象為年齡20歲至54歲，經精神專科醫師診斷為慢性思覺失調症，與家人同住一年以上及在社區復健中心待滿6個月以上之病人。透過一對一的深入訪談，收集相關資料，運用錄音筆及隨身筆記紀錄其語言及非語言之行為，以質性研究之內容分析法將訪談內容有系統的方式統整歸納。資料呈現至飽和共訪談10位慢性思覺失調症個案，研究結果呈現四大主題：（一）配合家人所採取之民俗治療與醫學治療、（二）承接家人對待之支持與否定、（三）順應家人的對待所產生之自我肯定與否定、（四）因應家人對待所產生之承擔責任與無所謂。研究結果顯示病人容易承擔家人對疾病態度，而衍生出配合家人所要求的治療模式，也因與家人相處情形，進一步影響到病人對自我肯定與否以及後續發展出角色責任感；另外發現到病人不論在經濟環境良好或是不佳，都可以誘發病人承擔責任及努力邁向復元之動力。依據結果提出建議，可針對與其相關同住家人在面對彼此時，教導有效表達方式與期待，以促病人在復元狀態更為正向，期盼本研究結果可供臨床或相關研究參考。

關鍵字

慢性思覺失調症；復元；家屬互動；經驗

並列摘要

The aim of this study is to explore the interaction experiences with family members during recovery in chronic schizophrenia patients after they have returned home. This study adopted purposive sampling and patients were enrolled from a community rehabilitation center of a mental hospital in central Taiwan. Participants were 20-54years old, diagnosed with chronic schizophrenia by psychiatrists, and had returned to the community and stayed with their family for more than one year. One-to-one in-depth interviews between researcher and participants were conducted to obtain relevant information. A recording pen and notebook were used to record subject’s verbal and non-verbal behavior. Following that, content analysis method in qualitative research was used to analysis the interview content in an objective and systematic manner. Data was collected until saturated. A total of ten chronic schizophreniapatients were interviewed. The results showed four themes: (1) meets the family's decisions in seeking medical treatments and folk therapies; (2) to bear the family's support and denial ; (3) development of self-affirmation or negation due to how the members of family treat them; (4) Dealing with family members of taking responsibility or indifferent ; Results showed that the interaction experiences between chronic schizophrenia patients and their family members affected the patient’s self-responses towards the disease. In addition, the experiences of living with family members further affected patients’ self-affirmation and negation and subsequent development of a responsible attitude for the role. Furthermore, the recovery status of patients after they had returned to their families was also affected by their environmental and financial situation. Recovery is not static and mostly manifested as a status of back-and-forth swinging. Based on the results, this study proposes the teaching of effective expression of self-emotions and expectations when patients face family members who are staying together with them, to promote a more positive recovery status. We hope that the results of this study can provide a reference for clinical practice or relevant studies.