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  1. NTU Theses and Dissertations Repository
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請用此 Handle URI 來引用此文件: http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/102063
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dc.contributor.advisor潘璦琬zh_TW
dc.contributor.advisorAy-Woan Panen
dc.contributor.author林姿妤zh_TW
dc.contributor.authorZi-Yu Linen
dc.date.accessioned2026-03-12T16:19:19Z-
dc.date.available2026-03-13-
dc.date.copyright2026-03-12-
dc.date.issued2026-
dc.date.submitted2026-02-03-
dc.identifier.citation王文志、張自強、文榮光(2005)。精神科病患於日間病房之預後分析。臺灣職能治療研究與實務雜誌,(1),36-43。https://doi.org/10.6534/jtotrp.2005.1(1).36
王禎邦、歐陽文貞(2020)。臺灣社區精神復健機構發展近況及興革建議。中華心理衛生學刊,33(4),315-340。https://doi.org/10.30074/FJMH.202012_33(4).0001
王曉琳(2016)。自陳式認知功能量表之發展與試驗〔未出版之碩士論文〕。國立臺灣大學職能治療研究所。
邱一珍(2017)。思覺失調症患者穩定就業之歷程探討〔未出版之碩士論文〕。國立師範大學復健諮商研究所。
勞動部(2021)。《110年身心障礙者勞動狀況調查》。取自
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dc.identifier.urihttp://tdr.lib.ntu.edu.tw/jspui/handle/123456789/102063-
dc.description.abstract  後設認知訓練(Metacognitive Training, MCT)透過改善與精神症狀相關的認知偏誤,能有效減輕精神疾病患者之症狀並提升整體功能。然而目前仍缺乏充分的研究討論MCT在台灣的臨床應用,因此本研究旨在探討繁體中文版MCT應用於台灣慢性精神疾病患者之治療成效。
  本研究採單組前後測設計,納入18名參與者(涵蓋思覺失調症、憂鬱症及雙相情緒障礙症患者),進行為期四週、共八次的團體MCT治療。參與者來自台灣北部地區兩處醫療院所(日間病房與社區復健中心)。評估工具包含中文版Davos認知偏誤評估量表(MCL-DACOBS)、中文版精神疾病症狀評量表(C-PSYRATS)、繁體中文版PROMIS憂鬱/焦慮短版量表(PROMIS Depression/ Anxiety 4a v1.0)、圖像化之個人與社會功能自我評估量表(SRG-PSP)、精神科職能治療生活功能量表第3版(sf-ADLS),及Neuro-QoL應用式認知簡短版,並收集參與者滿意度。數據分析使用SPSS 27.0進行,並以無母數統計之威克森符號等級檢定(Wilcoxon Signed-Rank Test)來比較組內前後測差異,以及Cohen’s d 計算組內治療成效之效應值(effect size)。
  研究結果顯示,繁體中文版MCT應用於台灣慢性精神疾病患者具良好的臨床成效與可行性。MCT能有效改善思覺失調症患者的認知偏誤(p ≤ 0.01, dz=1.34)、降低症狀帶來的心理困擾(p=0.01, dz=0.66),並提升整體功能(含社會功能、日常生活功能及認知功能;p=0.01~0.03, dz=0.65~0.90)。針對情緒障礙症患者,認知偏誤呈現趨近顯著的改善趨勢(p=0.07, dz=1.73),且焦慮症狀改善幅度(p=0.07, dz=1.31)大於憂鬱症狀(p=0.18, dz=0.85)。而參與者對MCT課程滿意度高,認為課程內容易懂且實用,治療依從性良好。未來研究建議採用隨機對照試驗設計,擴大樣本規模並納入長期追蹤評估,以進一步確認MCT的療效及其長期維持效果。
zh_TW
dc.description.abstract  Metacognitive Training (MCT) has shown promise in alleviating symptoms and enhance general functioning in patients with mental illness by ameliorating cognitive biases associated with psychiatric symptoms. However, the clinical application of MCT in Taiwan has not been fully explored. Therefore, this study aims to examine the effectiveness of the Traditional Chinese version of MCT in patients with chronic mental illness in Taiwan.
  This study adopted a single-group pretest-posttest design. 18 participants, including patients with schizophrenia, depression, and bipolar disorder, were recruited to undergo an 8-session MCT group intervention over four weeks. Participants were recruited from two psychiatric facilities (a day ward and a community rehabilitation center) located in northern Taiwan. Assessments include the Modified Davos Assessment of Cognitive Biases Scale (MCL-DACOBS), the Chinese versions of the Psychotic Symptom Rating Scales (C-PSYRATS), the Traditional Chinese version of the PROMIS Depression and Anxiety Short Forms (4a v1.0), the Self-reported Graphic Personal and Social Performance Scale (SRG-PSP), Neuro-QoL Item Bank v2.0 – Cognitive Function– Short Form, and Self-Reported Activities of Daily Living Scale, third version (sf-ADLS). Participant satisfaction is also collected. Statistical analyses will utilize non-parametric Wilcoxon Signed-Rank Test and Cohen’s d for effect size calculations.
  The results indicated that the Traditional Chinese version of MCT demonstrates good clinical efficacy and feasibility for patients with chronic mental illness in Taiwan. MCT effectively improved cognitive biases (p ≤ 0.01, dz=1.34) and reduced symptom-related psychological distress (p=0.01, dz=0.66) in patients with schizophrenia, while also enhancing general functioning (including social, daily, and cognitive functions; p=0.01~0.03, dz=0.65~0.90). For patients with mood disorders, the improvement in anxiety symptoms (p=0.07, dz=1.31) was greater than that in depressive symptoms (p=0.18, dz=0.85), and cognitive biases showed a trend of improvement (p=0.07, dz=1.73). Furthermore, participants reported high satisfaction with the MCT program, finding the content easy to understand and practical, and demonstrated good treatment adherence. Future studies are recommended to adopt a randomized controlled trial design with a larger sample size and long-term follow-up assessments to further confirm the efficacy and long-term maintenance effects of MCT.
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dc.description.tableofcontents口試委員審定書 i
致謝 ii
中文摘要 iii
英文摘要 v
第一章、緒論 1
第一節、研究背景與動機 1
第二節、研究目的與假設 4
第三節、名詞解釋 5
第二章、文獻回顧 7
第一節、思覺失調症之相關探討 7
第二節、針對認知偏誤的治療應用於思覺失調症患者之成效 23
第三節、憂鬱症與雙相情緒障礙症中的認知偏誤 28
第三章、研究方法 38
第一節、研究對象 38
第二節、研究設計與流程 38
第三節、研究介入方法 39
第四節、成效評估工具 43
第五節、數據分析 50
第四章、結果 51
第一節、人口學資料分析結果 53
第二節、組內前後測資料分析結果 55
第三節、治療滿意度資料分析結果 63
第四節、介入過程之質性觀察 65
第五章、討論 67
第一節、後設認知訓練改善認知偏誤之成效 67
第二節、後設認知訓練改善精神症狀之成效 68
第三節、後設認知訓練改善情緒症狀之成效 70
第四節、後設認知訓練改善整體功能之成效 71
第五節、後設認知訓練於台灣臨床情境之接受度與可行性 74
第六節、研究優勢與限制 75
第七節、臨床應用 77
第六章、結論 78
參考文獻 79
附錄 108
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dc.language.isozh_TW-
dc.subject思覺失調症-
dc.subject憂鬱症-
dc.subject雙相情緒障礙症-
dc.subject後設認知訓練-
dc.subject認知偏誤-
dc.subject正性症狀-
dc.subject社會功能-
dc.subject日常生活功能-
dc.subject認知功能-
dc.subjectSchizophrenia-
dc.subjectDepression-
dc.subjectBipolar Disorder-
dc.subjectMetacognitive Training (MCT)-
dc.subjectCognitive Biases-
dc.subjectPositive Symptoms-
dc.subjectSocial Functioning-
dc.subjectActivities of Daily Living-
dc.subjectCognitive Functioning-
dc.title後設認知訓練改善台灣精神疾病患者之認知偏誤與症狀之成效:單組前後測研究zh_TW
dc.titleEffectiveness of Metacognitive Training on Cognitive Biases and Symptoms in Taiwanese Individuals with Mental Disorders: A One-Group Pretest–Posttest Studyen
dc.typeThesis-
dc.date.schoolyear114-1-
dc.description.degree碩士-
dc.contributor.oralexamcommittee陳明德;施以諾zh_TW
dc.contributor.oralexamcommitteeMing-De Chen;Yi-Nuo Shihen
dc.subject.keyword思覺失調症,憂鬱症雙相情緒障礙症後設認知訓練認知偏誤正性症狀社會功能日常生活功能認知功能zh_TW
dc.subject.keywordSchizophrenia,DepressionBipolar DisorderMetacognitive Training (MCT)Cognitive BiasesPositive SymptomsSocial FunctioningActivities of Daily LivingCognitive Functioningen
dc.relation.page139-
dc.identifier.doi10.6342/NTU202600380-
dc.rights.note同意授權(全球公開)-
dc.date.accepted2026-02-03-
dc.contributor.author-college醫學院-
dc.contributor.author-dept職能治療學系-
dc.date.embargo-lift2029-03-20-
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