精神疾病患者復元經驗與歷程的探究
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2014
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精神疾病患者的生病經歷，相較於其他疾病來說，有其復元歷程的個別性與特殊性。每一個人受到精神疾病的影響不同，而邁向復元牽涉到的家庭互動、專業服務，及病患內在自我改變歷程，直接影響復元的結果，也在患者的復元歷程中扮演著關鍵性意義，因此值得我們對此現象進行深入探討。
本研究藉文獻的回顧整理出復元歷程中關鍵的四個面向：發病初始、求醫之路、回歸社區、家人支持，並透過訪談蒐集12位精神疾病患者的復元主觀經驗。研究發現，精神疾病患者在發病初始階段對精神疾病患者的復元具有指標性的意義，但是在社會工作相關的文獻中很少討論，，值得精神醫療社工實務的後續研究持續探討與了解。除此之外，研究者也發現，患者住院次數的多寡不僅呈現在病患復元歷程的個別差異中，且住院次數不同的病患，也表現出不同的復元歷程和不同的復元結果。最後，研究者也發現，社區資源能否即早介入與患者內在自我的建立，是患者能否復元的關鍵面向，而其中患者內在自我的成長似乎是患者能否邁向復元的最重要因素。
研究者在探討完12位精神疾病患者主觀的復元經驗後，進一步依據精神疾病患者走出醫院的路、回歸社區的路、內在自我的改變，以及精神疾病對患者及社會大眾的意義等四個面向，對精神醫療社工實務與制度面提出對精神醫療三級預防、對社工、對醫療單位、對復健服務、對患者、對家屬的相關建議，以及對後續相關研究的展望。
Compared to other physical diseases, the recovery experience of each psychiatric patient has their own nature and recovery journey. Everyone’s recovery journey can further differentiated by their family relationships and interactions, professional services they have got, and the patient’s self strengths. These dimensions are not only affecting the outcome of recovery journey but also play critical parts of going through recovery process for patients. Therefore, it’s a phenomenon worthies studying through in depth. By reviewing related literatures, this research has sorting out four key dimensions play important roles in the recovery process of psychiatric patients. They are getting sick, the treatment process, the road of returning community, and family supports. After reading through 12 mentally ill patients’ recovery experience carefully collected by individual interviews, the study firstly finds that the initial stage of the incidence of mental illness is significant indicators for moving toward recovery, but it is rarely discussed in the literatures and worth to explore further. Secondly, the researchers also finds that the effects of times of hospitalized showed not only in the courses of patient's recovery, but also showed in the results of rehabilitation. Finally, the researcher finds the early interventions; proper community resources; and patients’ self strength are key issues for the patients’ recovery, in which the growth of the inner self strength seems to be the most critical element during the patient moving towards recovery. After studying12 patients’ experiences, I have discussed key issues of backing toward recovery for psychiatric patients in four dimensions in the final chapter of this thesis. They are the way of leaving hospital, the way of returning community, patients’ internal strength and the meaning of being a psychiatric patient for the patient per se and the whole society. The researcher also has proposed recommendations regarding psychiatric social work practice and institutions, including issues related to the system of three-level-prevention, psychiatric social worker, medical units, rehabilitative services, the families and also for the following researches.
Compared to other physical diseases, the recovery experience of each psychiatric patient has their own nature and recovery journey. Everyone’s recovery journey can further differentiated by their family relationships and interactions, professional services they have got, and the patient’s self strengths. These dimensions are not only affecting the outcome of recovery journey but also play critical parts of going through recovery process for patients. Therefore, it’s a phenomenon worthies studying through in depth. By reviewing related literatures, this research has sorting out four key dimensions play important roles in the recovery process of psychiatric patients. They are getting sick, the treatment process, the road of returning community, and family supports. After reading through 12 mentally ill patients’ recovery experience carefully collected by individual interviews, the study firstly finds that the initial stage of the incidence of mental illness is significant indicators for moving toward recovery, but it is rarely discussed in the literatures and worth to explore further. Secondly, the researchers also finds that the effects of times of hospitalized showed not only in the courses of patient's recovery, but also showed in the results of rehabilitation. Finally, the researcher finds the early interventions; proper community resources; and patients’ self strength are key issues for the patients’ recovery, in which the growth of the inner self strength seems to be the most critical element during the patient moving towards recovery. After studying12 patients’ experiences, I have discussed key issues of backing toward recovery for psychiatric patients in four dimensions in the final chapter of this thesis. They are the way of leaving hospital, the way of returning community, patients’ internal strength and the meaning of being a psychiatric patient for the patient per se and the whole society. The researcher also has proposed recommendations regarding psychiatric social work practice and institutions, including issues related to the system of three-level-prevention, psychiatric social worker, medical units, rehabilitative services, the families and also for the following researches.
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復元經驗, 精神疾病患者, 精神醫療社會工作, Recovery Experiences, Psychiatric Patient, Psychiatric Social Work