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  • 學位論文

臺北市住宿型精神復健機構精神分裂症住民生活品質探討

Investigation of the Quality of Life of the Residents with Schizophrenia in Residential Institutions for Psychiatric Rehabilitation in Taipei City

指導教授 : 陳銘祥
共同指導教授 : 孫本初 韓 釗

摘要


本研究之目的在探討臺北市政府衛生局於2012年做的住宿型精神復健機構督導考核成績,與被服務之「精神分裂症」住民「生活品質」整體安適之滿意程度是否有差異,若有,則進一步針對二者差異較大的住宿型精神復健機構,進行個案分析,以瞭解差異的情形、原因。 以居住在臺北市合法立案且接受衛生局2012年督導考核之住宿型精神復健機構,經精神科專科醫師,診斷為精神分裂症病人,年齡在18-65歲間,適合積極復健,精神症狀穩定,意識清楚,能與訪談者溝通,經機構照護者協助講解願意接受訪談的住民為研究對象,採用「臺灣版精神分裂症患者生活品質評量表」問卷進行資料蒐集。共回收521份問卷,獲得有效問卷477份,有效問卷率63.5%,所得資料以描述性統計進行分析,並針對差異情形較大之4家機構,進行深入的個案分析,探討其差異為何並究明影響住民「生活品質」的相關因素。 由整體評量項目資料分析結果,在「整體安適」、「休閒/社區參與」、「宗教」、「居住狀況、居住安全」、「疾病的認」及「整體性的生活狀況」是「大部分滿意」,而在「對於自己經濟狀況」、「可能再住院」、「對於自己家庭、家人互動狀況」、「交友的狀況」及「自己的整體健康狀況」,則介於「滿意與不滿意各半」、「大部分滿意」間。整體而言,精神分裂症住民對於目前居住於「住宿型精神復健機構」的生活品質是「大部分滿意」。對於整體性的生活狀況滿意程度:其平均數為5.07、標準差為1.26,此等結果和住宿型精神復健機構督導考核成績,進行相關個案分析,二者相關係數為 .171,未達顯著意義,亦即住宿型精神復健機構的精神分裂症住民生活品質問卷調查整體安適滿意度與督導考核結果之成績優劣,未有顯著相關性。 依據研究結果,建議督導考核的指標訂定,應參酌執行服務工作的實務經驗,及服務使用者的實際感受,提出適當的修正,以落實督導考核目的提昇病友精神復健照護品質。

並列摘要


This study aims to investigate into the differences between the assessment results compiled by the Department of Health of Taipei City Government in 2012, and the overall well-being of the “Quality of Life” of those "schizophrenic" residents served. Individual institutes of those psychiatric residential rehabilitations displaying larger differences are further analyzed in order to understand the underlying situations and reasons to these differences. The study subjects of this study are schizophrenic patients between the age of 18-65, who have been diagnosed by psychiatric specialists and who reside in legally incoporated psychiatric residential rehabilitations in Taipei City, which are under the supervision of the Health Bureau for assessments in 2012. These patients are conscious and mentally stable, fit for active rehabilitation and are able to communicate with the interviewer. With the assistance by caretakers in the institutions these patients are able to be interacted with the interviewer. The study adopts the “the Taiwanese version of the Lancashire Quality of Life Profile (T-LQOLP)" questionnaire for data collection. A total of 521 questionnaires were collected where 477 valid questionnaires were obtained, generating a survey validity of 63.5%. The data collected were analyzed in terms of descriptive statistics, correlation analysis and other statistical methods. An indepth case study is further conducted focusing on 4 institutions displaying larger differences, in order to explore these differences and the factors related to how the residents’ “quality of life” is affected. Data analysis results from the overall assessment shows that the patients/residents are "generally satisified" with their "overall well-being"; "leisure/community participation"; "religion"; "dwelling conditions, housing security"; "disease recognition" and "holistic living conditions". Meanwhile, their “own financial conditions”; “probability to be re-hospitalized”; “interaction with their own families”; “friend making” and “overall health conditions” are in between “half satisfied” and"generally satisified". Overall, schizophrenic residents are “generally satisied” with their current quality of life living in the "Psychiatric Residential Rehabilitations”. Their level of satisfation on the overall living conditions shows a mean of 5.07 and a standard deviation of 1.26. Taking these numbers and the assssement results from the psychiatric residential rehabilitations for further case analysis, produces a correlation coefficient of .171, it indicates no strong significance. In other words there is no significant coorelation between the overall well-being satifaction gathered from the quality of life survey, and the assessments results conducted by the Department of Health. According to the research findings, it is recommended that the setting of supervision and evaluation indicators should be take into account the practical experiences from delivering service works, as well as the actual experiences of those served. Appropriate amendments should be proposed in order to achieve the purpose of supervision and assessment and improve the quality of rehabilitation and care for psychiatric patients。

參考文獻


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