The Mediating Effect of Community Living Skills on Stigma Perception and Quality of Life for the Patients with Schizophrenia

[[abstract]]本研究旨在探討社區思覺失調症病患之疾病烙印、社區生活功能對生活品質的影響。以北部某精神專科教學醫院之日間留院、職能工作坊、門診之思覺失調症病患為對象，以結構式問卷進行訪談，共收集100位病患。所有病患皆完成疾病烙印（精神疾病自我污名化量表The InternalizedStigma of Mental Illness Scale）、社區生活功能（Community Living Skills Scale）、生活品質（The Taiwanese version of Lancashire Quality ofLife Profile）等資料收集，並進行描述性、差異性、相關性及階層複迴歸分析。結果顯示：1.疾病烙印與社區生活功能及生活品質有顯著負相關（r= -.45, p＜0.001; r= -.39, p＜0.001），而社區生活功能與生活品質為顯著正相關（r=.58,p＜0.001）。2.分兩階段探討疾病烙印與社區生活功能對於社區生活品質之影響力，在疾病烙印與社區生活功能變項，共可有效解釋生活品質34.4%的變異量（F(2,97)=16.64, p＜0.001）；但是疾病烙印變項在經由社區生活功能中介變項後，對生活品質變項之解釋力未達統計之顯著性，顯示社區生活功能可完全中和病患之疾病烙印對生活品質之負向影響。總結來說，思覺失調症病患的社區生活功能在疾病烙印與生活品質間為完全中介的角色，亦即提升思覺失調症患者之社區生活功能，能減少病人受到疾病污名化之負面影響，是增進病人回歸社會與生活適應的重要措施，值得精神衛生照護專業人員重視。 The aims of the study were to explore the relations of stigma, community living skills and quality of life among community-dwelling patients with schizophrenia. A total of 100 patients recruited from day care hospitals, occupational workshops, and outpatient service of the psychiatric teaching hospitals of Taipei City. The organized questionnaires were used to collected data, which included the internalized stigma of mental illness scale, the community living skills scale, and the Taiwanese Lancashire quality of life profile. In addition, descriptive, differentiation, correlation statistics and hierarchical regression analysis were used to analyze data. The major results were as follows. Firstly, stigma perception of mental illness is negatively related with community living skills and quality of life (r= -.45, p＜0.001; r= -.39, p＜0.001). Secondly, community living skills showed positively related to quality of life (r=.58, p＜0.001). The major findings of this study has shown that: the variables of stigma perception with mental illness and the community living skills can explain 34% variance of quality of life (F(2,97)=16.64, p＜0.001); moreover, community living skills can be a mediate factor linking to the adverse effect of stigma perception of mental illness for a better quality of life. Based on the findings, the study suggested that community living skills can substantially mediate the stigma perception of mental illness which impacts on patient’s life quality. Therefore, psychiatric professionals can refer to aforementioned data and further develop interventions for patients to improve community living skills and quality of life