精神障礙者職業訓練之成效分析

Abstract

本研究主要目的是希望了解精神障礙者參與職業訓練過程中，工作自我效能、工作行為、日常生活功能、注意力、及手功能改變情形，提供未來辦理精神障礙者職業訓練成效評量的參考依據。 本研究採立意取樣，以參加北部地區某一精神專科醫院某一年度身心障礙者職業訓練方案並願意參與研究的精神障礙者，分別為參與汽車美容組6位及電腦文書組11位，兩組共17位，另以該院日間型精神復健機構中未曾參與職業訓練並願意參與研究的門診精神障礙者25位為對照組，於職業訓練前、受訓1個月、及受訓4個月三個時間點，三組同時進行工作自我效能、日常生活功能、注意力、及手功能的測量，參與職業訓練者額外進行工作行為衡量。上述資料使用描述性統計及重複量數去了解職業訓練前後各項能力的差異情形、二因子混合設計變異數分析了解各項能力的成效，使用皮爾森積差相關了解工作自我效能及工作行為的相關性。 研究結果發現，電腦文書組的精神障礙者在日常生活功能、注意力、及手功能皆優於汽車美容組與門診對照組；而接受職業訓練兩組的精神障礙者4個月過程中，在工作自我效能方面，其職業準備技巧的信心有顯著的提升；在工作行為有顯著的提升，電腦文書組的精神障礙者有較佳的工作行為；日常生活功能與注意力未達顯著改變；汽車美容組透過耗體力需身體大動作的職業訓練4個月，其手功能有顯著的改變；本研究中所測量的工作自我效能與工作行為兩者間無相關。 根據以上結果，本研究建議在辦理職業訓練過程中，可加入工作自我效能及工作行為評量作為職業訓練成效指標之一；增加職業訓練人員工作自我效能的概念，且能在職業訓練課程或復健訓練過程中可加入工作自我效能相關課程、與運用改變工作自我效能的方法融入訓練課程中，以利後續就業服務；日常生活功能、注意力、及手功能的評量可做為職業訓練過程中輔助參考，以了解受訓學員目前功能狀況。The purpose of this study was to examine the outcome of the vocational training program on the people with mental illness at work-related self-efficacy, work behavior, and functional ability. In this study, researcher invited 42 people with mental illness from one department of mental illness hospital in Taiwan, including 6 people in car washing training program, 11 people in computer-related skills training program, and 25 out-patients as a control group who never ever receive vocational training programs but receive the rehabilitaion training program. All participants were recuited and evaluated in the following tests, including Work-related Self-efficacy Scale, the Activities of Daily Living Rating Scale III, and Chu’s Hand Dexterity Test, and Chu’s Attention Test. Additionally, people who join vocational training program has evaluated the Work Behavior Inventory. All tests are measured before training, afer one month training, and after four months training. These quantitative data were analysed by descriptive statistics, repeated measures, two factor mixed design ANOVA, and Pearson correlation. The results showed receiving four months vocational training program in both groups had significantly improve on the confidence of career preparation skills in the work-related self-efficacy and on the work behavior. The computer-related skill group had better work behavior than the others. All groups in activities of daily living and attention havd no significantly changed. The hand function had significantly improved during four months car washing training. Finally, there had no correlation in work-related self-efficacy and work behavior. The study suggests that in the process of vocational training program, the trainer should evaluate the work-related self-efficacy and work behavior of trainees, and to design the course to increase the concept of work-related self-efficacy. Finally, it is also necessary to understand the current functional status of trainees about the ability of activities of daily living, attention, and hand function.