社區門診思覺失調症病人復元之影響因素

Factors Influencing Recovery in Community Outpatients with Schizophrenia

10.6142/VGHN.202012_37(4).0002

鄭惠美(Huei-Mei Cheng)；謝佳容(Chia-Jung Hsieh)；劉玟宜(Wen-I Liu)

社區門診思覺失調症 ； 復元 ； 賦能 ； community outpatients with schizophrenia ； recovery ； empowerment

榮總護理

37卷4期（2020 / 12 / 01）

342 - 351

繁體中文

瞭解社區門診思覺失調症病人復元之因素有助於發展復元導向之精神衛生照護服務，國內缺乏具實證基礎之相關研究，故本研究目的在探討社區門診思覺失調症病人復元之影響因素。本研究採橫斷式研究設計，於北部某醫學中心精神科門診收案，以思覺失調症病人為研究對象，由研究對象自填問卷及護理師評估進行資料收集，探討個人因素、疾病現況及疾病管理三構面共12個變項與復元之相關性，並以複迴歸統計方法檢定各變項對復元程度之影響力。研究結果發現社區門診思覺失調症病人疾病現況因素之整體功能（p= .13）與復元程度未達顯著相關，精神症狀（p＜ .001） 與復元程度則為負相關，且達統計上顯著差異；在疾病管理因素中，信守服藥（p＜ .001）及賦能（p＜ .001）兩個變項與復元有顯著正相關。整體迴歸模式（R^2=0.600）解釋力達60.0%，賦能（β=0.59）為最顯著的影響因素，其次為信守服藥（β=0.19），而精神症狀則呈負向影響（β=-0.17）。依研究結果建議護理人員可加強社區門診思覺失調症病人賦能發展的方案，催化復元為導向之社區精神衛生照護服務。

Understanding recovery and related factors in community-based schizophrenia can help in prescribing individualized recovery targets and evaluating factors influencing recovery, thereby developing mental health care services based on recovery results. The aim of this study was to discuss factors influencing recovery among community outpatients with schizophrenia. The study had a cross-sectional research design and was conducted in a psychiatric outpatient department of a medical center in Northern Taiwan. Data from community outpatients with schizophrenia were collected through self-filled structural questionnaires and interviews, which included questions on case factors, current status of the disease, disease management factors, and degree of recovery. Multiple regression analysis was used to test the predictors. Based on correlation results, the variables that significantly correlated with the ＂degree of recovery＂ were selected as influential factors for an overall F test achieving a significant level of (p＜ .001), with all independent variables affecting dependent variables significantly. The explanatory power was 60.0%. Among disease management factors, a significantly positive correlation among ＂medication adherence＂ (p＜ .001), ＂empowerment＂ (p＜ .001), and ＂degree of recovery＂ was observed. The results of the t-test revealed that the regression coefficients of ＂medication adherence＂ (β=0.19), ＂empowerment＂ (β=0.59), and ＂overall function＂ (p＜ .05) were significantly positively correlated. The higher the degree of medication adherence, the better the performance of empowerment. The better the overall function, the higher the degree of recovery. The regression coefficient of the ＂psychotic symptom assessment＂ was significantly negative (β =-0.17), indicating that the higher the case scores in mental symptoms (indicating more symptoms), the worse the degree of recovery. Thus, empowerment can help in recovering from schizophrenia and improve quality of life.

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