思覺失調症患者症狀嚴重度、失能程度與生活品質之相關研究

Abstract

生活品質是思覺失調症者復健成效的重要指標，本研究將以思覺失調症者的生活品質為關注之焦點，並探討其與「精神症狀嚴重度」和「失能程度」之相關。 本研究之對象來自北部地區某醫學中心的日間病房以及身心科門診，共35位思覺失調症者參與。在研究工具部分，以DSM-5「精神病症狀嚴重度臨床評分表」測量思覺失調症者的精神症狀嚴重度；失能程度則採用「身心障礙功能鑑定量表成人版」的表現及生活情境下的能力；並以「台灣簡明世界衛生組織生活品質問卷」評量生活品質。所有資料皆以電腦統計軟體SPSS22.0進行統計分析。其研究結果如下： 1.思覺失調症者之症狀嚴重度中以「認知減損」最嚴重，以「躁症」影響最不嚴重。 2.思覺失調症者之失能程度中，「表現」以及「生活情境下的能力」並無明顯差異，以「工作與學習」領域失能程度最高，以「生活自理」領域失能程度為最低。 3.思覺失調症者整體的生活品質滿意度為中等程度滿意，其中生理範疇的滿意度為最高，心理範疇的滿意度為最低。 4.思覺失調症者症狀嚴重度與整體生活品質達顯著負相關(r=-0.54, p<0.01)，並與生理、心理、社會關係以及環境範疇達到負相關。 5.「表現」以及「生活情境下的能力」的整體失能程度與整體生活品質達到顯著的負相關(r=-0.36, p<0.05)，並與生理及環境範疇達顯著負相關。 建議未來臨床專業人員在協助思覺失調症者的過程中，應該全面性評估精神症狀以及其失能程度，提供個別化的復健計劃，以增進思覺失調症者個人對於生活品質之滿意度。Quality of life (QOL) has been recognized as an indicator of the outcome of rehabilitation in patients with schizophrenia. The objective of the study was to explore the relationship between symptoms severity, disability severity and QOL of schizophrenic patients. 35 clients who had been diagnosed with schizophrenia were recruited from 2 of the hospitals in Metropolitan Taipei area. All the participants were assessed using the Clinician-Related Dimensions of Psychosis Symptom Severity, Functioning scale of Disability Evaluation System-Adult Version and World Health Organization’s Quality of Life (WHOQOL-BREF). Data was analyzed by SPSS 22.0. The results indicated the flowerings: 1.According to severity of symptoms of the patients with schizophrenia, the most severe symptom was impaired cognition, and the less one was mania symptom. 2.The domains of functional disability of the patients with schizophrenia, there was no difference between performance and capability. The most impaired domain was the domain of work (74.90%), and the less impaired one was self-care (6.79%). 3.The satisfaction level toward QOL was moderate (mean=3.09, SD=0.95). Among the domains of QOL, patients were more satisfied with physical domains and less satisfied with psychological domain. 4.The results indicated the severer the symptom, the poor QOL he has(r=-0.54, p<0.01). In addition, the severity of symptoms was negatively correlated with physical, physiological, social relationship and environment domains. 5.The functional disability was negatively correlated with QOL (r=-0.36, p<0.05), especially in the physical and environment domains. According to these findings, we suggest that assessing the severity of symptoms and functional disability of patients with schizophrenia can contribute to developing rehabilitation intervention for improving QOL.