新冠肺炎威脅下的精神病院：嚴重精神疾病患者的心理經驗初探

Living in a Psychiatric Hospital under Threat of COVID-19: The Psychological Experience of Patients with Severe Mental Illness

10.30074/FJMH.202112_34(4).0003

李弘毅(Hung-I Lee)；林耀盛(Yaw-Sheng Lin)

新冠肺炎 ； 嚴重精神疾病 ； 精神病房 ； 隔離 ； 感染控制 ； COVID-19 ； infection control ； psychiatric ward ； quarantine ； severe mental illness

中華心理衛生學刊

34卷4期（2021 / 12 / 01）

373 - 393

繁體中文

研究目的：本研究主要透過深入訪談，探討在新冠肺炎威脅期間裡，精神病院裡長期安置之嚴重精神疾病患者，面對包含隔離在內等各種感染預防控制措施下的心理經驗現象和意義。研究方法：本研究以東部某精神專科醫院病房患者為研究對象，資料蒐集時程為2020年7月至8月。透過訪談5位患者。研究參與者接受1次以上的訪談。每次訪談約60～90分鐘。訪談資料轉錄為逐字稿後，以主題分析方法進行資料分析與再書寫。研究結果：提出5個心理經驗主題：流動的凝滯和閉絕，日常不再的時間經驗時刻，靜默等待被取消的過往回復，再日常化運動，聯結他者的關係顯現和行動。研究結論：本研究呈現新冠病毒作為他者，在預防性隔離和感控中塑造著嚴重精神疾病患者在精神病院的生活和世界，感受和意義，關係和情感。

Purpose: We explored the phenomenon and significance of the psychological experience of patients with severe mental illness living in psychiatric hospitals under the threat of COVID-19. Through in-depth interviews, we explored how patients experienced COVID-19 infection controls, including quarantine. Methods: Between July and August 2020, we interviewed 5 patients living in a psychiatric hospital in eastern Taiwan. Each interview lasted 60 to 90 minutes. We applied a thematic analysis method to analyze the data. Results: We identified 5 psychological experience themes: reduction of mobility and sense of in-place loss, change of time perception with the loss of daily rhythms, waiting to regain past routines, re-ordered daily life activities, and relational acts with others. Conclusions: In clinical practice, we recommend treating the threat of COVID-19 as an opportunity to reconnect with one another, recognize the challenges that can be faced together, contemplate the meaning of existence, and embrace the potential for renewed ethics.

1. Abad, C., Fearday, A., & Safdar, N. (2010). Adverse effects of isolation in hospitalised patients: A systematic review. Journal of Hospital Infection, 76(2), 97-102. doi: 10.1016/j.jhin.2010.04.027
   連結：
2. Bland, A. M. (2020). Existential givens in the COVID-19 crisis. Journal of Humanistic Psychology, 60(5), 710-724. doi: 10.1177/0022167820940186
   連結：
3. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. doi: 10.1191/1478088706qp063oa
   連結：
4. Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet, 395(10227), 912-920. doi: 10.1016/S0140-6736(20)30460-8
   連結：
5. Calder, A. J., Novak, L. F., & Lane, A. (2020). We’re all going crazy now: How the COVID-19 pandemic can promote more compassionate clinical perspectives. Journal of Humanistic Psychology, 60(5), 639-646. doi: 10.1177/0022167820938615
   連結：
6. DuBose, T. (2020). When COVID-19 meets pandemic hope: Existential care of, and in, the impossible. Journal of Humanistic Psychology, 60(5), 564-570. doi: 10.1177/0022167820944645
   連結：
7. Hasson-Ohayon, I., & Lysaker, P. H. (2020). Special challenges in psychotherapy continuation and adaption for persons with schizophrenia in the age of coronavirus (COVID-19). Counselling Psychology Quarterly, 34(2), 1-9. doi: 10.1080/09515070.2020.1781595
   連結：
8. Iaboni, A., Cockburn, A., Marcil, M., Rodrigues, K., Marshall, C., Garcia, M. A., … Flint, A. J. (2020). Achieving safe, effective, and compassionate quarantine or isolation of older adults with dementia in nursing homes. The American Journal of Geriatric Psychiatry. doi: 10.1016/j.jagp.2020.04.025
   連結：
9. Iasevoli, F., Fornaro, M., D’Urso, G., Galletta, D., Casella, C., Paternoster, M., … Group, C.-i. P. S. (2020). Psychological distress in serious mental illness patients during the COVID-19 outbreak and one-month mass quarantine in Italy. Psychological Medicine, 51, 1054-1056. doi: 10.1017/S0033291720001841
   連結：
10. Kavoor, A. R. (2020). COVID-19 in people with mental illness: Challenges and vulnerabilities. Asian Journal of Psychiatry, 51, 102051. doi: 10.1016/ j.ajp.2020.102051
    連結：
11. Luiggi-Hernandez, J. G., & Rivera-Amador, A. I. (2020). Reconceptualizing social distancing: Teletherapy and social inequality during the COVID-19 and loneliness pandemics. Journal of Humanistic Psychology, 60(5), 626-638. doi: 10.1177/0022167820937503
    連結：
12. Muruganandam, P., Neelamegam, S., Menon, V., Alexander, J., & Chaturvedi, S. K. (2020). COVID-19 and severe mental illness: Impact on patients and its relation with their awareness about COVID-19. Psychiatry Research, 291, 113265. doi: 10.1016/ j.psychres.2020.113265
    連結：
13. Rohr, S., Muller, F., Jung, F., Apfelbacher, C., Seidler, A., & Riedel-Heller, S. G. (2020). Psychosocial impact of quarantine measures during serious coronavirus outbreaks: A rapid review. Psychiatrische Praxis, 47(4), 179-189. doi: 10.1055/a-1159-5562
    連結：
14. Trabucchi, M., & De Leo, D. (2020). Nursing homes or besieged castles: COVID-19 in northern Italy. Lancet Psychiatry, 7(5), 387-388. doi: 10.1016/S2215-0366(20)30149-8
    連結：
15. Van Manen, M. (2002). Care-as-worry, or “don’t worry, be happy”. Qualitative Health Research, 12(2), 262-278. doi: 10.1177/104973202129119784
    連結：
16. 林耀盛 ( 2015 )。誰的精神疾病？反思「精神分裂症」更名之後。人社東華， 5 ， 2 。 取自 http://journal.ndhu.edu.tw/category/2015/2015-q1/page/2/
17. 林耀盛 ( 2020 年 7 月 )。防疫新生活，就是回到日常健康行為的實踐。臺大心理學系 季報。取自 http://www.psy.ntu.edu.tw/circulations/202007/alumni.html
18. 林耀盛 ( 2021 年 1 月 25 日 )。後疫情狀態下防疫共同體。思想坦克。取自 http:// www.voicettank.org/single-post/2021012502/
19. 衛生福利部疾病管制署 ( 2020 年 4 月 20 日 )。因應 COVID-19 ( 武漢肺炎 ) 疫情，中 央流行疫情指揮中心訂有醫院及照護機構探視管理作業原則，籲請醫界朋友配合 辦理 ( 疾病管制署致醫界通函第 430 號 )。衛生福利部疾病管制署。取自 https:// www.cdc.gov.tw/Category/ListContent/wUSsVJVXn1I1VVTOv7_3bA?uaid=l6_ DcFifhJ6bIt5vd5TAGQ
20. 靳希平、水輒 ( 譯 )( 2007 )。現象學入門：反思性分析 ( 原作者： Embree, L. )。北京： 北京大學出版社。

1. 蕭伃伶(Yu-Ling HSIAO);黃素容(Su-Jung HUANG);闕可欣(Ke-Hsin CHUEH)(2024)。康復之家慢性精神病人復原力之探討。護理雜誌。71(6)。47-58。