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研究生: 徐珮芳
Hsu, Pei-Fang
論文名稱: 思覺失調個案穩定就業之歷程探究
An Inquiry on the Stable Employment of People with Schizophrenia
指導教授: 張千惠
Chang, Chien-Huey
口試委員: 何英奇 韓福榮 張千惠
口試日期: 2021/07/29
學位類別: 碩士
Master
系所名稱: 復健諮商研究所
Graduate Institute of Rehabilitation Counseling
論文出版年: 2021
畢業學年度: 109
語文別: 中文
論文頁數: 133
中文關鍵詞: 思覺失調症職業訓練穩定就業
英文關鍵詞: schizophrenia, vocational training, stable employment
研究方法: 半結構式訪談法
DOI URL: http://doi.org/10.6345/NTNU202101802
論文種類: 學術論文
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  • 本研究主要在於探討思覺失調症患者完成職業訓練後可以穩定就業的歷程與因素,並且了解從進入職場到穩定就業時所面臨到的挑戰為何。本研究採用質性研究,透過半結構題綱與深入訪談方式收集資料,共訪談五位個案與三位職訓老師。並運用NVivo 11進行資料分析。
      研究結果發現,思覺失調症患者參加完職業訓練至穩定就業之歷程包含:1. 於青春期與成年期發病,因狀況不穩定而接受數個月的治療。2. 症狀穩定後重返職場,但因壓力與症狀影響導致工作中斷,無法穩定就業。3. 受到污名化影響求職困難,另尋找就業方向與資源。4. 參加職業訓練學習專業技能,透過職訓班輔導員協助順利找到工作。5. 個案面對到工作挑戰時,願意積極面對並尋求家人、同儕與職訓班輔導員協助,解決就業時的挑戰,並穩定就業。
      思覺失調症患者參加完職業訓練後可穩定就業之因素包含:
    一、職訓中心提供的協助:1. 具備良好的工作態度,學習改善問題,避免問題行為的發生。2. 每日固定的訓練時間,有助於個案回歸到規律的生活。3. 人際互動技巧的提升。4. 透過面試模擬增加面試技巧與信心。5. 提供就業獎勵,有助於個案持續就業的動力。6. 職訓中心持續提供支持與輔導。
    二、個人明確的就業動機:1. 學習專業技能與做出成品提高自信心與成就感。2. 明確的就業動機,以及珍惜目前的工作機會。3. 課程所學的技能與知識,應用於工作中。
    三、社會支持:1. 家人提供就業支持。2. 同儕提供就業支持。
      思覺失調症患者參加職業訓練至穩定就業期間所面臨到的工作困境,包含:1. 個案病識感的不足,未能穩定服藥與回診,導致精神狀況不穩定。2. 工作時間長,體力無法負荷全職的工作。3. 無法得到主管與同事的支援,與職場態度不友善。4. 受媒體汙名化影響,雇主對個案症狀不熟悉或有所誤解
      最後,本研究根據研究結果,研究者依序給思覺失調症患者、職業訓練單位、職場主管與未來研究提出相關建議,並且說明研究限制,以供未來研究之參考。

    This research is mainly to explore the process and factors of stable employment for persons with schizophrenia after completing vocational training, and to understand the challenges they face from start to stable employment. This research uses qualitative approach, collects data through semi-structured in-depth interviews. The participants contains five cases and three vocational training teachers. And NVivo 11 software was used for data analysis.
    The results of the study found that the process of persons with schizophrenia from completing vocational training to stable employment includes: 1. Onset in adolescence and adulthood, the participants received treatment for several months due to unstable conditions; 2. The participants returned to the workplace after the symptoms have been stabilized, but the work was interrupted due to stress and symptoms, and the employment status cannot be stabilized; 3. Affected by stigma, it was difficult to find jobs, and transition to different fields of work and resources; 4. Participating in vocational training to learn professional skills, and finding a job smoothly through the vocational training class counselors; 5. When an individual faced work challenges, he/she was willing to face and seek assistance from family members, peers and vocational training class counselors and actively solved the employment challenges and stabilized employment.
    The factors that can stabilize the employment of persons with schizophrenia after participating in vocational training include:
    (1). Assistance provided by the Vocational Training Center: 1. Having a good work attitude, learning to improve problem solving, and avoiding behavioral problems; 2. A daily routine schedule helps the participants return to a regular life; 3. The improvement of interpersonal interaction skills; 4. Increasing interview skills and confidence through interview simulations; 5. Providing employment incentives to help the individual's motivation for on-going employment; 6. The support and counseling from the Vocational Training Center.
    (2). A clear personal motivation for employment: 1. Learning professional skills and finishing assignments to improve self-confidence and sense of accomplishment; 2. Clear motivation for employment, and cherishing current job opportunities; 3. Applying the skills and knowledge learned from the vocational training courses.
    (3). Social support: 1. The family provided employment support; 2. Peers provided employment support.
    The challenges faced by persons with schizophrenia from participating in vocational training to stable employment include: 1. The individual had insufficient awareness of sympoms, and was unable to stabilize medication and return visits, resulting in mental instability; 2. The working hours were long, and the physical strength was unable to support the full-time work; 3. Unable to get support from supervisors and colleagues, and unfriendly attitude of people at workplace; 4. Affected by stigma from the media, employers are unfamiliar or misunderstood about the symptoms of the participants.
    Finally, based on the results of this study, the researcher provided relevant suggestions for persons with schizophrenia, vocational training centers, and workplace supervisors. Finally, the researcher offered suggestions for future research.

    第一章 緒論 1 第一節 研究動機 1 第二節 研究目的與問題 3 第三節 名詞釋義 3 第二章 文獻探討 5 第一節 思覺失調症特質及就業困難因素之探討 5 第二節 職業訓練概況與效益 12 第三章 研究方法 19 第一節 研究設計 19 第二節 研究參與者 19 第三節 研究流程 21 第四節 研究工具 23 第五節 資料整理與分析 25 第六節 研究信實度 27 第七節 研究倫理 28 第四章 思覺失調症患者職業訓練至穩定就業歷程故事 31 第一節 小進的故事 31 第二節 小敏的故事 50 第三節 小燕的故事 62 第四節 小睿的故事 80 第五節 小喬的故事 95 第五章 綜合討論 110 第六章 結論與建議 120 第一節 結論 120 第二節 建議與限制 124 參考文獻 127 附錄一 132 附錄二 133

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