參與庇護工作坊之精神分裂症患者，自我效能、疾病管理對工作行為之探討
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2011
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工作對精神分裂症患者不僅帶來社會心理的滿足，也能增加自信與尊嚴，職業復健的核心目標為協助精神分裂症患者重返職場。而衛政機關提供庇護性工作坊的工作訓練，目的為增強精神分裂症患者的工作準備度，以協助日後轉至支持性或一般性就業。
本研究針對精神分裂症患者參與庇護性工作坊的工作行為進行預測變項的探討，變項包含：病前工作經驗史、教育程度、自我效能以及疾病管理等。收案機構包含衛政體系五家復健中心與五家康復之家，共招募 131 位目前接受庇護性工作訓練的精神分裂症患者。
首先，向研究對象說明研究目的與流程，取得受試者同意書，再以「簡易智能狀態測驗」作為篩選工具，確定研究對象能理解研究目的與問卷內容；隨後，請研究對象自行填寫「自我效能量表」、「精神分裂症疾病知識量表」、「藥物態度量表」等問卷。最後，研究者依「工作行為評量表」評估研究對象參與庇護性工作坊的工作行為。
上述資料採用描述性統計、 t 檢定、單因子變異數分析、皮爾森績差相關和逐步複迴歸等進行資料分析，探究工作行為的預測性。
研究結果顯示：自我效能方面，不同教育程度的精神分裂症患者，自我效能沒有差異性 (F值=.098，p >.05)；但病前工作經驗達一年以上者，比病前工作經驗未達一年者自我效能的平均分數高 17.42 ( t＝2.741*，p<.05)。
疾病管理方面，教育程度在大專及大專以上的精神分裂症患者，比國中及國中以下者「精神疾病症狀知識量表」平均分數高 4.46 ( F=3.527*，p <.05)，而不同教育程度組在「藥物態度量表」則無差異 ( F=1.897，p>.05)；不同病前工作經驗史的精神分裂症患者，疾病管理的兩個軸向皆無差異。
工作行為方面，不同教育程度的精神分裂症患者在工作行為上無差異( F=.946，p>.05)；但病前工作經驗達一年以上的精神分裂症患者，比病前工作經驗未達一年者，工作行為的評估高 9.18 ( t＝3.345*, p<.05)。
此外，參與庇護性工作坊的精神分裂症患者，其自我效能與工作行為達顯著相關，( r=.405**，p<0.01)；疾病管理的「藥物態度量表」與工作行為也達顯著相關 (r=.309**，p<0.01)，但在「精神疾病症狀知識量表」與工作行為則未達顯著相關 (r=.151，p>0.01)。
精神分裂症患者參與庇護性工作坊工作行為之預測力方面，依序為自我效能、病前工作經驗史，以及藥物態度，以自我效能的預測力最高。
結論：職業重健人員提供精神分裂症患者就業服務時，能適度的增強案主職前社交與技能訓練的自我效能，且持續提供疾病管理與復原的概念，使職業輔導的服務更具全面性。
Background and Purpose: In Taiwan, most clients with chronic schizophrenia receive work training in hospital-based sheltered workshop in order to improve work bebaviors for preparing employment. As service providers, we need to understand the factors that affect work behaviors of clients with schizophrenia in sheltered workshop. Through literature review, poor illness management and negative self-efficacy have been found for clients with schizophrenia. Some demographic factors, such as education and previous employment history, were discussed as predictors for employment outcomes of schizophrenia. Therefore, the purposes of this study were to explore the predictive value of self-efficacy, illness management, education and previous employment history for work behaviors of clients with schizophrenia in sheltered workshop. Method: In this study, 131 people with schizophrenia from 5 Community Rehabilitation center and 5 Recovery Home participated in this study. Clients scored more than 24 in the Mini-Mental Status Examination (MMSE), were recruited and evaluated by the following three self-report questionnaires, which are the Self-Efficacy Scale (SES), Knowledge for Illness Scale (KIS), and Drug Attitude Inventory (DAI). In addition, Work Behavior Inventory (WBI) was used to evaluate participants’ work behaviors in sheltered workshop. Data was analyzed via descriptive statistics, t test, ANOVA, Pearson correlation and stepwise multiple regression analysis. Result：The results have indicated the followings; Firstly, participants with previous employment history reported higher self-efficacy and work behavior. Secondly, participants with tertiary education were found to have higher score in Knowledge for Illness Scale (KIS) than those with junior education. Thirdly, Self-Efficacy Scale (SES) and Drug Attitude Inventory (DAI) were correlated with work behaviors. In addition to these findings, self-efficacy, previous employment history and drug attitude emerged as significant predictors of work behaviors for clients with schizophrenia in sheltered workshop. Conclusion: According to these findings, we suggest that the vocational rehabilitation practitioners utilize the concept of self-efficacy in prevocational program to improve confidence about social skill and work behaviors, and design illness management groups to promote drug compliance and recovery concept for the clients with schizophrenia in sheltered workshop.
Background and Purpose: In Taiwan, most clients with chronic schizophrenia receive work training in hospital-based sheltered workshop in order to improve work bebaviors for preparing employment. As service providers, we need to understand the factors that affect work behaviors of clients with schizophrenia in sheltered workshop. Through literature review, poor illness management and negative self-efficacy have been found for clients with schizophrenia. Some demographic factors, such as education and previous employment history, were discussed as predictors for employment outcomes of schizophrenia. Therefore, the purposes of this study were to explore the predictive value of self-efficacy, illness management, education and previous employment history for work behaviors of clients with schizophrenia in sheltered workshop. Method: In this study, 131 people with schizophrenia from 5 Community Rehabilitation center and 5 Recovery Home participated in this study. Clients scored more than 24 in the Mini-Mental Status Examination (MMSE), were recruited and evaluated by the following three self-report questionnaires, which are the Self-Efficacy Scale (SES), Knowledge for Illness Scale (KIS), and Drug Attitude Inventory (DAI). In addition, Work Behavior Inventory (WBI) was used to evaluate participants’ work behaviors in sheltered workshop. Data was analyzed via descriptive statistics, t test, ANOVA, Pearson correlation and stepwise multiple regression analysis. Result：The results have indicated the followings; Firstly, participants with previous employment history reported higher self-efficacy and work behavior. Secondly, participants with tertiary education were found to have higher score in Knowledge for Illness Scale (KIS) than those with junior education. Thirdly, Self-Efficacy Scale (SES) and Drug Attitude Inventory (DAI) were correlated with work behaviors. In addition to these findings, self-efficacy, previous employment history and drug attitude emerged as significant predictors of work behaviors for clients with schizophrenia in sheltered workshop. Conclusion: According to these findings, we suggest that the vocational rehabilitation practitioners utilize the concept of self-efficacy in prevocational program to improve confidence about social skill and work behaviors, and design illness management groups to promote drug compliance and recovery concept for the clients with schizophrenia in sheltered workshop.
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庇護性工作坊, 自我效能, 疾病管理, 工作行為, sheltered workshop, self-efficacy, illness management, work behavior