Developing Practical Guidelines on Natural Experience Activities for Individuals with Chronic Schizophrenia

[[abstract]]本研究旨在研發慢性精神分裂症病患自然體驗活動指引，並探討病患參與活動後對其認知功能的成效，及病患參與自然體驗活動之經驗反應。藉由四種策略：應用生態療癒環境、體驗與探索、反思及團體活動，研發慢性精神分裂症病患自然體驗活動指引之後，先試行前驅研究後，再進行類實驗研究。方便取樣，以北部某精神科專科教學醫院日間留院慢性精神分裂症病患為對象，對照組23名，進行常規性精神復健活動，實驗組25名，除接受日間留院常規性精神復健治療外，另接受連續8週的自然體驗活動，每週一次，每次約90分鐘。8週活動結束後，實驗組病患在專注度、學習能力、決斷能力、遵行指示及解決問題能力等五項認知能力比對照組病患顯著改善（p＜0.05），且病患回饋參與自然體驗活動能提升其認知功能與正面情緒。結論：自然體驗活動指引可作為實務指引，提供臨床護理人員帶領活動之依據。 The purposes of this study were to develop practical guidelines on natural experience activities forindividuals with chronic schizophrenia, to examine changes in cognitive functions after participation in such activities, and to examine participants’ reactions to such activities. The guidelines were developed by using the restorative environment, experience and adventure, reflection and group activities. After a pilot study, a quasi-experiment design was used. Convenience samples of 48 patients diagnosed with chronic schizophrenia were recruited from the day care center of a specialized psychiatric hospital innorthern Taiwan. The control group comprised 23 patients, and the experimental group 25. Patients in the experimental group received the natural experience activities for 90 minutes each week for eight weeks. The results found that patients in the experimental group showed significant improvement on cognitivefunctions (p＜0.05), especially on focus, ability to learn, decision making, following orders, and problem solving, but there was no improvement in the control group. The patients in the experimental group showed improvements in cognitive function and positive emotions. In conclusion, the practical guidelines on natural experience activities may provide valid references for nursing staff leading natural experienceactivities in clinical practice