精神分裂症患者疾病適應歷程之敘說研究
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Date
2003
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Abstract
本研究目的在於透過精神分裂症患者的自我敘說，來了解精神分裂症患者在罹病後對於其
在就醫、就業、人際關係及疾病污名的適應歷程。希望藉由研究結果了解精神分裂症患者
的處境及其所面臨的問題，以提供給醫療人員及病患與其家屬之參考。
本研究採質化取向的敘說研究進行資料的收集與分析，以半結構式的訪談大綱對兩位受訪
者進行訪談，收集其罹病後的整個疾病歷程。訪談後將訪談資料整理成逐字稿，再以敘說
分析方法進行受訪者的資料分析。最後，寫出兩位受訪者在疾病適應歷程中的生命故事。
本研究所得到的結果如下：
一、 精神分裂症患者的疾病適應歷程呈現多層次的樣貌，除了疾病症狀問題外，如何以帶
病之身重建生活、解決人生發展任務的要求、尋找個人的價值是患者關注的焦點。
二、 在社區化的趨勢下，精神分裂症患者重返社區的生活中，醫療體系所提供的服務已不
足以應付患者日常生活的需要，除了醫療外，同時還要結合社政、勞工及教育等各方面資
源來協助患者在社區中的復健。
三、 精神分裂症的疾病污名影響患者在生活上的適應，傾向隱匿自己的病情，擔心身分曝
光，而媒體的報導強化患者對自身因疾病污名而不被接受的恐懼。
四、 目前社區精神復健資源仍是有不足的現象，而且仍多以醫療模式為主要內容，其他生
活上的需要常無法得到滿足。
五、 家庭為精神分裂症患者主要的社會支持力量，幫助患者得以安心接受治療，相對地，
若家庭的支持力量不夠，則會增加患者對未來生活的焦慮感。
六、 為因應社區化的精神醫療趨勢，應建構一個整合性的社區精神復健模式，利用個案管
理來統整不同體系的資源。
最後，根據研究結果提供給病患及其家屬、與醫療單位或社福機構、甚至媒體對精神分裂
症有較為建設性之觀點。
The study intends to understand how schizophrenic patients to cope with their illness through a narrative study. The process of the study is by the in-depth interviews and narrative analysis. Two interviewees are invited to share their experience through the semi-structure interview. The results are as follows: 1. It is complicated for the schizophrenic patients to adapt their situation. For example, they need to rebuild their livelihood, and also hard to meet the developmental tasks, and to identify their existential values. 2. Apparently, the medical resources are not good enough for these patients. For example, they need the much help from welfare, labor, and education etc. in addition to the medical treatment. 3. The patients are reluctant to talk about their illness because of people’s stigma to schizophrenia. 4. And, it is lack of rehabilitation resources in the community to help the patients with their situation. 5. They can get the help from their family. The family help them to survive the medical treatment and rehabilitation process. 6. At present, it is urgent to set up a community-based medical care for schizophrenic patients in the rehabilitation system. In brief, this study contributes some suggestions to the patients and their family, mental health providers, and the news media deal with the issues about schizophrenia as well .
The study intends to understand how schizophrenic patients to cope with their illness through a narrative study. The process of the study is by the in-depth interviews and narrative analysis. Two interviewees are invited to share their experience through the semi-structure interview. The results are as follows: 1. It is complicated for the schizophrenic patients to adapt their situation. For example, they need to rebuild their livelihood, and also hard to meet the developmental tasks, and to identify their existential values. 2. Apparently, the medical resources are not good enough for these patients. For example, they need the much help from welfare, labor, and education etc. in addition to the medical treatment. 3. The patients are reluctant to talk about their illness because of people’s stigma to schizophrenia. 4. And, it is lack of rehabilitation resources in the community to help the patients with their situation. 5. They can get the help from their family. The family help them to survive the medical treatment and rehabilitation process. 6. At present, it is urgent to set up a community-based medical care for schizophrenic patients in the rehabilitation system. In brief, this study contributes some suggestions to the patients and their family, mental health providers, and the news media deal with the issues about schizophrenia as well .
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Keywords
精神分裂症患者, 疾病適應歷程, 疾病污名, 專業人員, 正性症狀, 負性症狀