職能平衡與時間管理能力、睡眠品質、生活滿意度的相關性研究

Abstract

職能平衡與健康、安適密切相關。良好的時間管理有助於個人適當安排日常職能，睡眠品質亦影響個體日常參與。部分證據顯示時間管理能力、睡眠品質與生活滿意度皆與職能平衡相關，時間管理能力、睡眠品質亦與生活滿意度相關，但較少研究同時探討上述變項之間的關係以及在精神疾病患者族群中的關係。本研究旨在探討控制自覺健康、自覺壓力、認知功能與症狀嚴重度後，職能平衡與時間管理能力、睡眠品質及生活滿意度的相關性，並檢視職能平衡可能的中介效果。 本研究為橫斷性研究，共納入91位精神疾病相關社區單位之慢性精神疾病患者，採方便取樣，納入標準： (1) 年滿 18 歲； (2) 根據精神疾病診斷與統計手冊（Diagnostic and Statistical Manual of Mental Disorders）第五版（DSM-5）診斷為精神疾病； (3) 具備回答問卷的能力（至少小學五年級程度，且由職能治療師判斷其有能力填答問卷）； (4) 過去一個月內未經變更藥物處方。排除條件：（1）診斷為發展性障礙（如：自閉症譜系障礙、注意力不足／過動症）者。研究工具包含：神經疾患生活品質（Neuro-QoL）應用認知量表、台大症狀量表、職能活動問卷、職能平衡問卷、時間管理能力問卷、個案自陳資訊系統（PROMIS）的睡眠困擾短版問卷和睡眠相關障礙短版問卷，以及生活滿意度問卷。 研究結果發現，時間管理能力是預測職能平衡的獨立關鍵變項，而睡眠品質與職能平衡高度受制於自覺壓力評價。中介機轉方面，職能平衡在時間管理能力與生活滿意度間扮演部分中介角色，而在睡眠品質與生活滿意度間則扮演完全中介角色。此路徑反映了時間管理之「能力」與睡眠之「功能」，皆需先透過職能活動分配的和諧展現，方能轉化為整體生活的滿意感受，體現了職能觀點在精神健康領域的應用價值。 在臨床應用上，建議實務工作者可考慮將職能平衡納入臨床指標，而臨床介入應重視提升個案的時間管理信心與「微觀勝任感」，並系統性地導入壓力管理，以避免壓力破壞職能節奏進而干擾睡眠品質。當個案面臨難以短期排除的睡眠困擾時，治療師可透過其他管道維持職能平衡以保護其生活滿意度。 總結而言，職能平衡提供了一個涵蓋個案感受，並能將個案的功能與能力連結至日常生活的重要觀點。本研究不僅增加了提升生活滿意度的途徑，更為臨床實務提供了具體的轉譯路徑與介入細節。

Background: Occupational balance has been widely linked to health and well-being. Effective time management may facilitate the organization of daily occupations, while sleep quality is thought to influence daily participation. Although evidence suggests that time management ability, sleep quality, and life satisfaction are correlated with occupational balance, few studies have simultaneously explored the interrelationships among these variables, especially within psychiatric populations. Objective: This study aims to examine the associations among occupational balance, time management ability, sleep quality, and life satisfaction, while controlling for perceived health, perceived stress, cognitive function, and symptom severity. Additionally, the potential mediating role of occupational balance is investigated. Methods: This cross-sectional study enrolled 91 participants with chronic mental illness through convenience sampling from community-based mental health settings. Eligibility criteria comprised: (1) age ≧ 18 years old; (2) a diagnosis of a mental disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (3) adequate cognitive capacity for questionnaire completion (defined as a minimum of a fifth-grade education level and verified by an occupational therapist’s clinical judgment); and (4) medication stability for at least one month prior to enrollment. Individuals diagnosed with neurodevelopmental disorders based on the DSM-5 criteria, such as autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD), were excluded. Assessment tools utilized included the Neuro-QoL Cognitive Function 2.0, Taita Symptom Checklist (TSCL), Occupational Questionnaire (OQ), Occupational Balance Questionnaire (OBQ11_C), Time Management Questionnaire, PROMIS Sleep Disturbance (PROMIS-SD) and Sleep-Related Impairment (PROMIS-SRI) Short Forms, and the Satisfaction with Life Scale (SWLS). Results: Time management ability emerged as a robust predictor of occupational balance, while both sleep quality and balance were highly susceptible to perceived stress. Occupational balance partially mediated the relationship between time management and life satisfaction, and fully mediated the path from sleep quality to life satisfaction. These findings underscore that time-management capacity and sleep function must manifest through harmonious occupational engagement to effectively enhance overall life satisfaction. Conclusion: Practitioners are encouraged to integrate occupational balance as a pivotal clinical marker. Interventions should prioritize time-management self-efficacy and systematic stress management to protect occupational rhythms. When sleep disturbances are refractory, therapists can safeguard life satisfaction by fortifying occupational balance through alternative channels. Ultimately, occupational balance serves as a critical bridge between subjective experience and daily functioning, providing a concrete translational pathway for clinical practice.