探討思覺失調症病人希望感之相關因素研究

The Study of Hope among Patients with Schizophrenic

吳瑞燕(Jui-Yen Wu)；王素鴻(Su-Hung Wang)；黃麗華(Li-Hua Huang)；顏文娟(Wen-Jiuan Yen)

思覺失調症 ； 認知適應 ； 希望感度 ； schizophrenia ； cognitive adaption ； hope

若瑟醫護雜誌

12卷1期（2018 / 10 / 01）

19 - 28

繁體中文

背景：思覺失調症病人對自我疾病負向認知影響情緒適應，將影響疾病治療，因此了解其因應及適應狀況，強化希望感有助於增強病人內在力量及疾病穩定。目的：探討思覺失調症病人希望感影響因子，作為改善精神病人身心健康與疾病復原計畫之參考。方法：研究對象為中部某醫學中心精神科門診140位思覺失調症病人，採橫斷式描述性相關研究設計，以疾病症狀量表、疾病意義量表、自我控制量表、自尊量表及希望感量表五種研究工具進行測量。統計以SPSS17.0套裝軟體次數分配百分比、平均值、標準差、t檢定、ANOVA、Pearson correlation、Multiple regression進行統計分析。結果：(1)疾病症狀、自我控制的受限程度與希望感呈現中、低度負相關(r=-0.46，p＜0.001；r=-0.19，p＜0.05)；(2)疾病意義、自尊與希望感呈現中度正相關(r=0.45，p＜0.001；r=0.67，p＜0.001)；(3)疾病症狀p=0.021*及自尊p=＜0.001**可作為預測思覺失調症病人希望感狀態。結論與建議：能正向接納自己的疾病且增進自我控制感與自尊以及疾病症狀改善，對希望感提升具有正面的意義。因此，建議精神科醫護人員能重視病患疾病感受、自尊、自我控制感等相關問題評估及護理應用，期待病人因希望感存在，能過著有目標具意義的生活。

Background: Negative cognition of one's own schizophrenia affects the patient's emotional adaptation and future treatment. Therefore, enhancing their adaptive ability and building the hope to increase their inner strength may stabilize the disorder. Purpose: The purpose of this study was to explore the hope impact factor of patient with Schizophrenia, as a reference for improving the health of physical and mental, and illness recovery for the patients with mental illness. Methods: The study was a cross sectional, descriptive study. We recruited 140 patients of schizophrenia from the psychiatric clinics in a medical center of central Taiwan. We used 5 instruments including Psychological Behavior Scale (PBS), Constructed Meaning Scale (CMS), Sense of Control Scales(SCS), Rosenberg Self-Esteem Scale (RSES), and The Hope Scale (THS). The data was analyzed by SPSS percentage, mean, standard deviation, t-test, ANOVA, Pearson correlation, and multiple regressions. Results:(1) The psychological symptoms and behaviors were moderately negative correlation (r=-0.46, p＜0.001) to the hope, and the perceived constraints of the sense of control were weakly negative correlation (r=-0.19, p＜0.05) to the hope.(2) The meaning of the disorder (r=0.45, p＜0.001) and the self-esteem (r=0.67, p＜0.001) both showed moderately positive correlation with the hope.(3) The psychological symptoms and behaviors (p=0.021*) and the self-esteem (p=＜0.001**) could be used to predict the level of hope in the patients of schizophrenia. Conclusions and Suggestions: In summary, improving the psychological symptoms and raising the self-esteem could increase the hope among the patients of schizophrenia. We suggested that the psychiatric staffs can implement the assessment of the hope among the patients. It may improve the psychological symptoms and increase their self-esteem. We expect that thereby the patients could have a purposeful and meaningful life.

1. 張作貞(2008)。精神疾病烙印及抗烙印行動之對話。東吳社會工作學報，18，135-156。
   連結：
2. (2000).A Handbook of Psychological Tests.
3. Ellis-Stoll, CC,Popkess-Vawter, S(1998).A concept analysis on process empowerment.Advanced Nursing Science,21(2),62-68.
4. Espie, CA,Montgomery, JM,Gilies, JB(1988).The development of a psychosocial behavior scale for the assessment of mentally handicapped people.Journal of Mental Deficiency Research,32,395-403.
5. Herth, KA(1989).The relationship between level of hope and level of coping response and othervariables in patients with cancer.Oncology Nursing Forum,16(1),67-72.
6. Karidi, MV,Stefanis, CN,Theleritis, C,Tzedaki, M,Rabavilas, AD,Stefanis, NC(2010).Perceived social stigma, self-concept, and self-stigmatization of patient with schizophrenia.Comprehensive Psychiatry,51(1),19-30.
7. Lachman, ME,Weaver, SL(1998).Socio demographic variations in the sense of control by domain: Findings from the Mac Arthur studies midlife.Psychology and Aging,13(4),553-562.
8. Lachman, ME,Weaver, SL(1998).The sense of control as a moderator of social class differences in health and well-being.Journary of Personality and Social Psychology,74(3),763.
9. Pen, DL,Kohlmaier, JR,Corrigan, PW(2000).Interpersonal Factors Contributing Stigma of Schizophrenia: Social Skills, Perceived Attractiveness, and Symptoms.Schizophrenia Research,45(1-2),37-45.
10. Seligman, MEP(2002).Authentic happiness: Using the new positive psychology to realize your potential for lasting fulfillment.New York:Free Press.
11. Snyder, CR,Harris, C,Anderson, JR,Holleran, SA,Irving, LM,Sigmon, ST(1991).The will and the ways: Development and validation of an individual differences measure of hope.Journal of Personality and Social Psychology,60(4),570-585.
12. Taylor, SE(1983).Adjustment to threatening events: A theory of cognitive adaptation.American Psychologist,38(11),1161-1173.
13. Vrbova, k,Prasko, J,Ociskova, M,Kamaradova, D,Marackova, M,Holubova, M(2017).Quality of life, self-stigma, and hope in schizophrenia spectrum disorders: A cross sectional study.Neuropsychiatr Disease and Treatment,13,567-576.
14. Waghorn, G,Chant, D,Whiteford, H(2003).The strength of self-reported course of illness in predicting vocational recovery for persons with schizophrenia.Journal of Vocational Rehabilitation,18(1),33-41.
15. 王淑清,潘璦琬,鍾麗英,熊秉荃(2011)。影響思覺失調症病人生活品質之因素─一年之追蹤研究。護理暨健康照護研究，7(1)，55-64。
16. 黃錫美(2007)。希望感之概念分析。慈濟護理雜誌，6(2)，57-63。
17. 衛生福利部﹕101 年度全民健康保險醫療統計年報。2014 年 8 月 10日取自 http://www.-mohw.-gov.tw/cht/DOS/StatisticP.aspx?f_list_no=312&fod_list_no=2657&doc_no=13275
18. 鄭伊真(2011)。台南市，國立成功大學教育研究所。
19. 蘇清菁,陳玉敏(2009)。無望感之概念分析。長庚護理，20(4)，456-462。

1. (2024)。罕見疾病患者主要照顧者社會支持、希望感與復原力之相關研究。台灣健康照顧研究學刊，30，82-100。