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???org.dspace.app.webui.jsptag.ItemTag.dcfield??? | Value | Language |
---|---|---|
dc.contributor.advisor | 鄭麗珍(Li-Chen Cheng) | |
dc.contributor.author | Ju-Yun Tang | en |
dc.contributor.author | 湯茹雲 | zh_TW |
dc.date.accessioned | 2021-06-17T03:27:55Z | - |
dc.date.available | 2018-04-18 | |
dc.date.copyright | 2018-04-18 | |
dc.date.issued | 2018 | |
dc.date.submitted | 2018-03-28 | |
dc.identifier.citation | 一、英文文獻
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/69787 | - |
dc.description.abstract | 精神病人除了就醫治療外,更重要的是如何有效復健並回歸社會。日間病房是精神病人從醫院銜接社區生活之跳板,亦是我國復健資源大宗,日間病房活動如何更有復健效果而不是繼續機構化,是本研究關注的議題。然根據研究者觀察及文獻蒐集,我國日間病房病人多有因缺權而長期滯留病房的問題,因此本研究以充權為理論基礎,設計日間病房團體活動方案,探討其實施樣貌與成效。
本研究採混和研究方法,以質性研究之參與觀察法呈現病人經歷充權團體工作的歷程及現象等,以量性研究之準實驗設計分別比較參加充權團體與常規活動病人之活動表現,並以充權感受、社會功能、精神症狀嚴重度及生活品質為依變項,比較兩組的變化。實驗組收案25人,對照組35人,分別使用無母數分析、t檢定、相關分析及迴歸分析等方法瞭解病人基本資料、活動表現與依變項之間的影響和關係,研究結果如下: 質性觀察發現病人被充權後能有更多互相參與、自決、問題解決等經驗及反應,但也有資源不足、權力集中特定病友等現象。量性分析發現實驗組在活動表現、精神症狀嚴重度及生活品質的改善都顯著優於對照組,實驗組的背景變項及精神症狀也比較不會影響活動表現和復健成效。另外精神症狀對充權感受及社會功能沒有顯著影響,充權感受、社會功能及生活品質則會互相影響。 因此我們認為日間病房精神病人確實需要被充權,才能有效提升復健表現,改善生活品質,並減少現實條件及精神症狀的影響。建議健保及社會福利能更重視日間病房治療多元化所需資源,評鑑制度也能更顧及精神病人在復健過程中所需的權能感,並鼓勵社區復健機構及康復之家等復健機構也能思考充權帶給精障個案的好處進而運用之。 | zh_TW |
dc.description.abstract | In Taiwan, more psychiatric patients stay in day care units in medical hospitals than in community rehabilitation centers due to unequally allocated reimbursement by the National Health Insurance Scheme. From design, staying in day care units is expected to be transitional so that these patients could reintegrate with the mainstream society. However, it has been reported that patients in day care units tend to prolong their stay without moving from medical hospitals to community programs. Therefore, effective rehabilitation program is called for to empower these patients so that they would successfully re-integrate into the mainstream society. This study aims to develop a empowerment group work program and to evaluate its effectiveness.
A mixed method approach was used for data collecting in this study. Qualitatively, participant observation was used to record how participants would react to a given opportunity to make decisions and take actions on their own will in groups. And quantitatively, a quasi-experimental design was used to compare the outcomes performance of participants between the experimental group and the control group. Twenty-five patients from one hospital were recruited as the experimental group, and thirty-five from another hospital as control group. Four outcome measures were included as dependent variables which were empowerment perception, social functions, severity of psychiatric symptoms, and quality of life. The results indicated that participants had better performance in mutual participation, self-determination, and problem solving during e group process. However, insufficient resources for activities and uneven distributions of power within group were also observed. Quantitative analysis found that participants in the experimental group had significantly improved on their activity participation, psychiatric symptoms, and quality of life than participants in the control group. In addition, participants’ psychiatric symptoms have no significant impact on their empowerment perception and social functions. And, participants’ empowerment perception, social functions, and quality of life had interactional effect. In conclusion, this study indicates that empowering patients in day care unit could improve their psychiatric symptoms and quality of life. Policy and practice implications are included. | en |
dc.description.provenance | Made available in DSpace on 2021-06-17T03:27:55Z (GMT). No. of bitstreams: 1 ntu-107-R01330004-1.pdf: 4846774 bytes, checksum: d45a7b595da18e0c9f1a70ce8e499dae (MD5) Previous issue date: 2018 | en |
dc.description.tableofcontents | 口試委員審定書……………………………………………………………………… i
謝誌…………………………………………………………………………………... ii 中文摘要…………………………………………………………………………...... iv Abstract………………………………………………………………………………... v 目錄…………………………………………………………………………………… vii 圖目錄……………………………………………………………………………….. x 表目錄………………………………………………………………………………... x 第一章 緒論 第一節 研究背景…………………………………………………… 1 第二節 研究動機…………………………………………………… 4 第三節 研究目的…………………………………………………… 6 第二章 文獻探討 第一節 我國日間病房的充權障礙因素分……………… 7 第二節 充權理論及其於精神疾病族群之應用………… 11 一、 充權理論介紹………………………………………………… 11 二、 充權在精神病人的適用性與有效因素探討…………………………… 13 第三節 日間病房充權相關之介入方法及成效…………………………… 18 第三章 研究方法 第一節 研究典範…………………………………………………………… 23 第二節 研究架構…………………………………………………………… 27 第三節 研究設計及對象…………………………………………………… 28 第四節 研究工具…………………………………………………………… 31 第五節 統計方法…………………………………………………………… 36 第六節 介入方案設計……………………………………………………… 38 第七節 研究倫理…………………………………………………………… 42 第四章 研究結果 第一節 充權團體的實際規劃與實施…………………………………… 43 一、 第1週準備期-充權過程中之適應不良行為的覺醒與問題界定…… 43 二、 第2週宣導期-促進個案覺察及解決問題之動機…………………… 44 三、 第3週催化期-引導自發性的選擇並承擔角色…………………… 48 四、 第4週規劃期-透過互相參與、角色承擔,形成個案主導的復健處遇 51 五、 第5~11週執行期-更豐富的處遇策略與病友建立個別化知識…… 54 六、 第12週檢討期-確認病友需求,共同思考如何有更多收穫……..….. 62 第二節 充權團體介入成效評估…………………………………………… 63 一、 研究對象基本資料……………………………………………………… 63 二、 個案基本資料(背景變項)之影響…………………………………… 66 三、 實驗組與對照組活動表現的之比較與影響…………………………… 72 四、 充權介入方案之成效分析……………………………………………… 77 五、 研究結果摘要…………………………………………………………… 86 第五章 結論與建議 第一節 研究發現與討論…………………………………………………… 91 一、 充權團體應用於精神科日間病房之樣貌……………………………… 91 二、 充權團體工作應用於精神科日間病房的具體效果…………………… 93 三、 充權在精神科日間病房實施之可能限制……………………………… 97 第二節 研究建議…………………………………………………………… 100 一、 對實務工作者的回應:精神科日間病房病人充權的需要和策略…… 100 二、 對機構的回應:使精神醫療及復健機構成為充權助力……………… 102 三、 對政策的回應:改善社會結構造成的精神病人缺權處境…………… 103 第三節 研究限制與貢獻…………………………………………………… 106 第四節 未來研究展望…………………………………………………… 107 參考文獻 一、英文部分……………………………………………………………………… 108 二、中文部分……………………………………………………………………… 113 附錄一 精神科團體治療紀錄…………………………………………………… 117 附錄二 充權感受量表………………………………………………………… 118 附錄三 社會功能量表(病患自填版本)……………………………………… 120 附錄四 簡短精神症狀評量表BPRS…………………………………………… 123 附錄五 世界衛生組織生活品質問卷(臺灣簡明版)………………………… 125 附錄六 人體研究倫理委員會通過證明函……………………………………… 127 附錄七 受試者同意書…………………………………………………………… 128 附錄八 充權感受量表使用授權書……………………………………………… 134 附錄九 社會功能量表使用授權書……………………………………………… 135 附錄十 世界衛生組織生活品質問卷(台灣簡明版)使用授權書……………136 圖目錄 圖1-1-1 近年復健資源成長變化表……………………………………………… 2 圖2-2-1 充權過程模式…………………………………………………………… 12 圖2-2-2 充權實務要素與處遇策略……………………………………………… 13 圖3-1-1 精神科日間病房充權臨床模式………………………………………… 26 圖3-2-1 充權團體介入方案研究架構…………………………………………… 27 圖4-1-1 社團招募公告…………………………………………………………… 47 圖4-1-2 日間病房活動表………………………………………………………… 49 表目錄 表1-1-1 我國精神醫療暨復健網絡表…………………………………… 2 表2-2-1 充權運用於精神衛生領域之介入研究………………………………… 15 表2-3-1 日間病房介入研究文獻整理…………………………………………… 21 表3-5-1 本研究使用統計方法說明表…………………………………………… 36 表3-6-1 日間病房充權團體活動內容…………………………………………… 38 表4-1-1 各社團執行規劃內容表………………………………………………… 52 表4-1-2 社團執行期病友充權內涵及處遇策略………………………………… 59 表4-2-1 實驗組與對照組基本資料描述性統計………………………………… 65 表4-2-2 背景變項對活動表現的影響………………………………………… 67 表4-2-3 實驗組活動需協助程度相關因素之多變項線性迴歸分析………… 68 表4-2-4 兩組背景變項對「充權感受」、「社會功能」、「精神症狀嚴重度」與「生活品質」前、後測之影響……………………………………………… 70 表4-2-5 實驗組生活品質後測相關因素多變項線性迴歸分析……………71 表4-2-6 實驗組與對照組活動表現t檢定…………………………………… 72 表4-2-7 活動表現與精神症狀嚴重度前測之單因子共變數分析……… 73 表4-2-8 兩組活動表現與「充權感受」、「社會功能」、「精神症狀嚴重度」與「生活品質」前、後測之關係分析…………………………………… 75 表4-2-9 精神症狀嚴重度後測相關因素多變項線性迴歸分析………… 76 表4-2-10 實驗組依變項前、後測之Wilcoxon rank-sum test…… 77 表4-2-11 對照組依變項前測、後測之t檢定…………………………… 77 表4-2-12 實驗組與對照組依變項前測、後測之t檢定…………………… 78 表4-2-13 精神症狀嚴重度後測之單因子共變數分析……………………… 79 表4-2-14 實驗組「充權感受」、「社會功能」、「精神症狀嚴重度」、「生活品質」之相關分析………………………………………………………… 81 表4-2-15 對照組「充權感受」、「社會功能」、「精神症狀嚴重度」、「生活品質」之相關分析………………………………………………………… 82 表4-2-16 實驗組與對照組「充權感受」、「社會功能」、「精神症狀嚴重度」、「生活品質」之相關分析….……………………………………………… 83 表4-2-17 生活品質相關因素之多元迴歸分析…………………………… 84 表4-2-18 充權感受相關因素之多元迴歸分析………………………… 85 表4-2-19 社會功能相關因素之多元迴歸分析………………………… 85 表4-2-20 充權團體工作應用於精神科日間病房之研究假設與結果…… 89 表5-2-1 區域醫院評鑑日間病房條文…………………………………… 104 | |
dc.language.iso | zh-TW | |
dc.title | 充權團體工作應用於精神科日間病房之成效評估 | zh_TW |
dc.title | Evaluating Effectiveness of Empowerment Group Work for Day Care Patients in Psychiatric Hospital | en |
dc.type | Thesis | |
dc.date.schoolyear | 106-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 蔡尚穎,吳慧菁 | |
dc.subject.keyword | 充權,日間病房,精神病人,團體工作,復健成效,介入研究, | zh_TW |
dc.subject.keyword | empowerment,day care,psychiatric patient,group work,rehabilitation effectiveness,intervention research, | en |
dc.relation.page | 136 | |
dc.identifier.doi | 10.6342/NTU201800704 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2018-03-28 | |
dc.contributor.author-college | 社會科學院 | zh_TW |
dc.contributor.author-dept | 社會工作學研究所 | zh_TW |
Appears in Collections: | 社會工作學系 |
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