思覺失調症患者穩定就業之歷程探討

Abstract

摘要 本研究旨在探討思覺失調症患者的穩定就業之歷程及影響其穩定就業之相關因素。本研究採用質性研究取向，以深入訪談方式使用半結構式題綱進行資料收集。研究參與者包含四位已持續就業四年以上的思覺失調症患者。所蒐集之研究資料包括訪談逐字稿、訪談札記及研究參與者接受復健之復健記錄並運用NVivo第十版質性軟體進行資料分析。 本研究結果發現：思覺失調症患者的就業歷程可分為六個階段，探索職業性向、發病中斷就業或就學歷程、重返職場，疾病復發而再次中斷、復健訓練且重新探索自我、適應職場新工作、穩定就業後的新挑戰。此外，影響思覺失調症患者穩定就業的因素為疾病的影響、就業的動機、主管的態度、支持的持續性。 根據研究結果，研究者針對四種不同對象提出建議，針對思覺失調症患者，建議他們加強症狀察覺的敏銳度、找出症狀的應對策略、學習如何表達自己的困難之處並尋求協助。針對職場主管，建議他們避免大幅度的改變這些工作者的工作內容。針對康復之家，建議加強思覺失調症患者的體耐力並與職場主管保持密切的連繫。針對政府單位，研究者則建議：政府應發展持續的個別化就業支持模式、增加職場實習的管道、加強關於覺察精神症狀的教育。最後在文末針對未來研究提出建議並說明本研究的限制。

關鍵字：思覺失調症、就業歷程、穩定就業、持續的個別化支持模式、 康復之家

Abstract The purpose of this study was to examine the employment experiences of the people with schizophrenia. The research was conducted through qualitative research approach to interview four participants with schizophrenia who have been working for more than four years using semi-structured interview protocol. Data collected included interview transcripts, researcher’s field notes, and the participants rehabilitation records. The qualitative data were analyzed using software named NVivo10. The major findings of this study consisted of the employment experiences of the participants with schizophrenia, which can be divided into 6 phases: (1) Exploring occupational orientation; (2) Employment or school life being suspended because of the onset of schizophrenia; (3) Employment being suspended again because of the schizophrenia symptoms ;(4) Rehabilitating and re-exploring the self; (5) Adapting to a new workplace ;(6) Facing new challenges after stable employment periods. In addition, the impact factors of the employment experience of the participants with schizophrenia included the impact of the disease, the motivation of employment, the attitude of the job supervisors, the continuous support. According to the results of this study, suggestions were made. First, people with schizophrenia need to strengthen their awareness of the symptoms, identify the coping strategies, and learn how to express their difficulties and seek help. Second, the job supervisors need to avoid changing the job tasks of the participants with schizophrenia. Third, the halfway houses need to teach participants with schizophrenia how to improve their physical endurance, and keep in touch with their job supervisors. Fourth, the local governments need to develop individualized and continuous support models, expand the opportunities for interships, and increase the education about awareness of the mental illness. Finally, the research limitations and recommendations for future research are proposed.

Key word : Schizophrenia, employment experiences, stable employment, individualized and continuous support models, halfway house.