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題名 | 日間留院及居家治療之精神分裂症患者生活品質之比較=Quality of Life for Schizophrenic Patients: A Comparison of Day-hospital and Home-care Patients |
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作者 | 林進嘉; 殷建智; 李添誠; 謝秀幸; | 書刊名 | 臺灣精神醫學 |
卷期 | 15:3 2001.09[民90.09] |
頁次 | 頁226-236 |
分類號 | 419.72 |
關鍵詞 | 精神分裂症; 生活品質; 日間留院; 居家治療; Schizophrenia; Quality of life; Day-care; Home-care; |
語文 | 中文(Chinese) |
中文摘要 | 目的:本研究從主觀與客觀兩方面,探討日間留院及居家治療之精神分裂症患者的生活品質是否有差異?及其影響因素。方法:南部某醫學中心精神科一年中,接受日間留院或居家治療,符合DSM-IV精神分裂症診斷,年齡在18歲至65歲之男女病患。在個案及家屬同意下,由研究人員使用精神科生活品質量表,以會談病人、家屬及家訪進行評分。結果:日間留院組有49名;居家治療組有168名。客觀的生活品質,兩組皆以角色功能最差;社會文化次之、家庭生活再次之;主觀七個層面生活品質的排序,兩組不一致。又客觀生活品質,除了家庭生活外,日間留院組在生活環境、精神健康、身體健康、角色功能、社會文化、與心理特質等六個層面均顯著優於居家治療組。主觀生活品質,兩組在七層面均未達顯著差異。逐步複迴歸顯示,精神症狀穩定、家人關心度高、個案的病識感與認知功能好,其整體客觀生活品質愈好;個案病程是10到15年,相對於病程5年以內者,其主觀生活品質愈不好;而藥物副作用少、家人支持人數多,其主觀生活品質愈好。結論:精神分裂症患者之生活品質的本土性資料尚待建立,我們建議用主觀與客觀的量表來評量。不同病期與不同治療模式的個案,其長期追蹤下的生活品質為何,則需將來進一步的研究,以作為預後的重要指標。 |
英文摘要 | Objective: The purpose of this study was to investigate quality of life differences for schizophrenic patients comparing day and home care, and to analyze the contributing factors for this important indicator of patient health and comfort. Methods: Schizophrenic patients, aged between 18 to 65 years, were recruited by sequential sampling from day and home-care patients under the supervision of the psychiatric department of a medical center in Tainan during a one-year period. Data were collected from interview and home visit after informed consents were obtained. Results: Forty-nine day-care and 168 home-care patients were recruited for the study. The three quality of life dimensions with the lowest objective-assessment scores were role function, and social and family life. Patients in day-care scored better for six of the seven objective dimensions for quality of life compared to the home-care group, with family life the exception. There were no significant differences, however, comparing these two groups for the seven subjective dimensions. By stepwise multi-regression analysis, the significant predictors for objective quality of life were stable mental status, family support, good insight and cognitive function. The predictors for subjective quality of life were duration of illness, side-effects of medication, and family support. Conclusion: The quality of life for schizophrenic patients is measurable, however, further study is needed to investigate the quality of life for patients at different stages of the disorder, and in different treatment settings. Further, long-term follow-up data for defined groups may provide important information to predict outcome for schizophrenic patients. |
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