rehabilitation needs of people with schizophrenia and their caregivers

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Principal Investigator Hector W.H. Tsang, PhD, OTR Department of Rehabilitation Sciences, The Hong Kong Polytechnic University 6 Nov 2009

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Rehabilitation Needs of People with Schizophrenia and their Caregivers. Principal Investigator Hector W.H. Tsang, PhD, OTR Department of Rehabilitation Sciences, The Hong Kong Polytechnic University 6 Nov 2009. Background. Hong Kong Government - PowerPoint PPT Presentation

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Page 1: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Principal InvestigatorHector W.H. Tsang, PhD, OTR

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University

6 Nov 2009

Page 2: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Hong Kong Government◦White paper on Rehabilitation (Hong

Kong Government, 1995)◦Hong Kong Rehabilitation Program Plan

1998-99 to 2002-03: Towards a New Rehabilitation Era (Health and Welfare Bureau, 1999)

◦Did not address special needs of people with schizophrenia and their caregivers

Page 3: Rehabilitation Needs of People with Schizophrenia and their Caregivers

No existing validated questionnaire

Research addressing their needs limited (Tsang, Pearson & Yuen, 2002; Yip, 2004)

Page 4: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Identify needs from various perspectives

Make suggestions to the Government for policy development

Page 5: Rehabilitation Needs of People with Schizophrenia and their Caregivers
Page 6: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Phase One To identify issues via focus group

interview

Phase Two To develop and validate questionnaires for

measuring perceived and normative rehabilitation needs for people with schizophrenia and their caregivers

Page 7: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Phase Three To explore and compare perceived and

normative rehabilitation needs via a quantitative survey

Page 8: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Perceived needs ◦“what people think their need are or feel

their needs to be”.

Normative needs ◦“the existence of some standards or

criterion established by custom, authority, or general consensus against which the quantity or quality of a situation or conditions is measured”

Page 9: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Three sample recruited (n=43)

◦People with Schizophrenia (n= 14) Aged >15 and with onset of illness at least 1 year

◦Caregivers of people with schizophrenia (n=13) Acted as main carer and taking care of client at least 1

year

◦ Mental health professionals (n=16) At least 1 year experience working for people with

schizophrenia Six focus groups conducted

Page 10: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Focus groups

Schizophrenia(n=14)

Caregivers(n=13)

Professionals(n=16)

Age 39.6 ± 10.8 49.8 ± 9 .8 N/A

Sex Male Female

7 (50%)7 (50%)

2 (15.4%)11 (84.6%)

8(50%)8(50%)

Educational level Primary Secondary Tertiary

3 (21.4%)11 (78.6%)

0 (0%)

1 (7.7%)6 (46.2%)6 (46.2%)

0(0%)0(0%)

16 (100%)

Duration of illness (Year) 17.9 ± 11.3 N/A N/A

Years of taking care of people with schizophrenia (Year)

N/A 7.9 ± 5.7 N/A

Experience in working in the field of mental health (Year)

N/A N/A 6.5 ± 5

Page 11: Rehabilitation Needs of People with Schizophrenia and their Caregivers

76 items (19 categories) were generated

Categories No of items

Vocational 13

Symptoms 4

Knowledge on mental illness 2

Self care 3

Medical service 9

Social 3

Intimacy 2

Family relationship 6

Parenting 1

Page 12: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Categories No of items

Leisure 3

Participation in Treatment 3

Housing 4

Finance 4

Education 2

Discrimination 5

Social Welfare and Security 3

Budgeting 2

Stress management 4

Harm to self or others 3

Total: 19 Total: 76

Page 13: Rehabilitation Needs of People with Schizophrenia and their Caregivers

50 items (11 categories) were generated

Categories No of items

Workplace/Employment 3

Housing 2

Community support and Welfare system

5

Medical services 4

Financial needs 3

Social life 4

Family 8

Page 14: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Categories No of items

Knowledge on mental illness

3

Discrimination 3

Stress management 8

Self-care 4

Leisure 3

Total 50

Page 15: Rehabilitation Needs of People with Schizophrenia and their Caregivers

To develop and validate questionnaires for measuring perceived and normative rehabilitation needs for ◦people with schizophrenia◦their caregivers

Page 16: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Perceived Needs Perceived Rehabilitation Needs Questionnaire for

people with schizophrenia (PRNQ-S) Perceived Rehabilitation Needs Questionnaire for

caregivers of people with schizophrenia (PRNQ—C) Perceived Rehabilitation Needs Questionnaire for

caregivers towards people with schizophrenia (PRNQ—CS)

Normative Needs Normative Rehabilitation Needs Questionnaire for

people with schizophrenia (NRNQ—S) Normative Rehabilitation Needs Questionnaire for

caregivers of people with schizophrenia (NRNQ—C)

Page 17: Rehabilitation Needs of People with Schizophrenia and their Caregivers

PRNQ—S (n=49) PRNQ—CS (n=32) NRNQ—S (n=48)

M SD ICC α M SD ICC α M SD α 

Needs Vocational 3.71 0.81 0.73 0.90 3.61 1.13 0.74 0.96 4.03 0.48 0.89 

Symptoms 3.46 1.25 0.69 0.91 4.35 0.73 0.90 0.84 4.27 0.66 0.89 

Knowledge on illness 3.86 1.03 0.45 0.68 4.17 0.83 0.73 0.61 4.09 0.76 0.92 

Self care 3.53 1.02 0.87 0.82 3.92 1.02 0.91 0.88 3.91 0.75 0.90 

Medical service 3.79 1.11 0.65 0.89 4.39 0.55 0.69 0.85 4.29 0.39 0.80 

Social 3.53 1.12 0.83 0.90 4.08 0.87 0.78 0.91 3.86 0.69 0.90 

Intimacy 3.72 1.30 0.81 0.95 3.77 1.17 0.89 0.88 3.7 0.74 0.85 

Family relationship 3.64 0.81 0.72 0.85 3.87 0.77 0.72 0.80 3.87 0.52 0.78 

Parenting 2.2 1.35 0.74 / 1.84 1.30 0.55 / 3.83 0.83 / 

Leisure 3.53 1.12 0.77 0.843.82 1.11

0.63 0.94 3.68 0.63 0.86 

Participation in treatment 3.72 1.30 0.68 0.75 4.17 0.84 0.78 0.78 4.4 0.61 0.84 

Housing 2.86 1.32 0.75 0.89 3.34 1.32 0.86 0.90 3.88 0.57 0.80 

Finance 3.54 1.12 0.75 0.80 3.52 1.21 0.86 0.89 3.71 0.76 0.86 

Education 3.73 1.31 0.71 0.95 3.58 1.20 0.60 0.78 3.57 0.81 0.88 

Discrimination 3.24 1.33 0.77 0.9 3.71 0.99 0.82 0.82 4.35 0.61 0.91 

Social welfare and security 3.57 1.20 0.81 0.75 4.28 0.88 0.76 0.81 4.02 0.64 0.81 

Budgeting 3.55 1.46 0.82 0.84 3.55 1.25 0.87 0.84 4.04 0.87 0.76 

Stress management 3.61 1.27 0.87 0.93 4.36 0.68 0.80 0.83 4.19 0.57 0.87 

Harmful to self or public 2.24 1.24 0.77 0.76 2.93 1.09 0.84 0.71 4.4 0.67 0.85 

Psychometrical Properties of PRNQ—S, PRNQ—CS, and NRNQ—S

Page 18: Rehabilitation Needs of People with Schizophrenia and their Caregivers

PRNQ—S (n=49) PRNQ—CS (n=32) NRNQ—S (n=48)

M SD ICC α M SD ICC α M SD α

Services Vocational rehabilitation 2.96 1.09 0.79 0.81 3.60 1.09 0.69 0.86 3.9 0.64 0.9

Community rehabilitation 3.55 1.47 0.92 / 3.88 1.21 0.90 / 4.38 0.57 /

Family intervention 2.94 1.53 0.79 0.82 3.39 1.20 0.80 0.85 3.89 0.7 0.81

Residential placement 1.72 1.10 0.62 0.94 2.61 1.13 0.72 0.84 4.06 0.66 0.86

Psychotherapy 2.69 1.31 0.72 / 4.38 0.87 0.61 / 4.06 0.63 /

Psychiatric medication 3.53 1.16 0.81 0.75 3.53 0.71 0.74 0.15 4.43 0.6 0.89

Self management program 2.57 1.42 0.86 / 4.13 0.91 0.84 / 4.17 0.69 /

Social activity 2.93 1.10 0.79 0.82 3.42 0.83 0.79 0.75 3.76 0.63 0.90

Social welfare 3.57 1.20 0.81 0.75 3.55 1.09 0.91 0.65 4.09 0.64 0.88

Emergency service 2.50 1.38 0.75 0.64 3.31 1.37 0.73 0.86 4.02 0.71 0.71

Others 3.17 1.12 0.72 0.84 2.70 0.78 0.82 0.72 3.07 0.55 0.69

Psychometrical Properties of PRNQ—S, PRNQ—CS, and NRNQ—S

Page 19: Rehabilitation Needs of People with Schizophrenia and their Caregivers

PRNQ—C (n=32) NRNQ—C (n=48)

M SD ICC α M SD α 

Needs Workplace/Employment 3.11 1.13 0.64 0.62 3.99 0.54 0.75 

Housing 3.2 1.3 0.71 0.69 3.88 0.71 0.77 

Community support and welfare system 4.07 0.71 0.58 0.83 3.89 0.49 0.77 

Medical services 4.10 0.85 0.75 0.80 4.01 0.62 0.86 

Financial needs 3.66 1.18 0.78 0.80 3.66 0.60 0.75 

Social life 3.20 1.10 0.86 0.91 3.60 0.59 0.86 

Family 3.73 0.88 0.87 0.88 4.01 0.59 0.88 

Knowledge on illness 4.26 0.71 0.89 0.83 4.09 0.58 0.79 

Discrimination 3.16 0.86 0.80 0.61 3.97 0.61 0.87 

Stress management 4.08 0.77 0.85 0.89 4.08 0.51 0.94 

Self care 3.85 0.91 0.83 0.78 3.84 0.58 0.80 

Leisure 2.91 1.05 0.86 0.94 3.44 0.58 0.83 

Psychometrical Properties of PRNQ—C and NRNQ—C

Page 20: Rehabilitation Needs of People with Schizophrenia and their Caregivers

PRNQ—C (n=32) NRNQ—C (n=48)

M SD ICC α M SD α

 

Services Family intervention 3.66 1.23 0.71 / 3.92 0.74 /

 

Psychotherapy 3.63 1.29 0.76 / 3.92 0.77 /

 

Self management program 3.66 1.21 0.80 / 3.83 0.75 /

 

Social activity 3.56 1.03 0.72 0.79 3.81 0.58 0.66

 

Social welfare 3.02 1.45 0.98 0.72 3.93 0.69 0.89

 

Emergency services 3.25 1.21 0.76 0.81 3.99 0.67 0.90

 

Others 2.62 0.81 0.82 0.57 3.30 0.65 0.71

 

Psychometrical Properties of PRNQ—C and NRNQ—C

Page 21: Rehabilitation Needs of People with Schizophrenia and their Caregivers

To identify perceived and normative rehabilitation needs for people with schizophrenia and their caregivers via a quantitative survey

To compare the needs and the supplies of the present mental health service delivery

To propose directions for future mental health policy and rehabilitation services development

Page 22: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Participants

Schizophrenia(n=194)

Caregivers(n=83)

Professionals(n=112)

Age

18-25

26-35

36-45

46-55

56 or above

10 (5.15%)47 (24.23%)58(51.79%)56 (28.87%)23 (20.54%)

3(3.6%)9(10.8%)13(15.7%)21(25.3%)37(44.6%)

12 (10.71%)63 (56.25%)28 (25.00%)8 (7.14%)1 (0.89%)

Sex Male Female Missing

104 (53.61%)90 (46.39%)

32(38.6%)51(61.4%)

32 (28.57%)72 (64.29%)

8 (7.14%)

Educational level Illiterate Primary Secondary Tertiary or above

3 (1.55%)48 (24.74%)

130 (67.01%)13 (6.70)

6(7.2%)30(36.1%)41(49.4%)

6(7.2%)

N/A

Page 23: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Participants

Schizophrenia(n=194)

Caregivers(n=83)

Professionals(n=112)

Duration of receiving mental health services

2 years or below

2-5 years

5-10 years

10 years or above

14 (7.25%)

35 (18.13%)48 (24.87%)96 (49.74%)

N/A N/A

Year of taking care of people with schizophrenia

2 years or below

2-5 years

5-10 years

10 years or above

N/A 13(15.7%)19(22.9%)14(16.9%)37(44.6%)

N/A

Experience in working in the field of mental health

2 years or below

2-5 years

5-10 years

10-15 years

16 years or above

Missing

N/A N/A 19 (16.96%)35 (31.25%)33 (29.46%)19 (16.96%)

5 (4.46%)1 (0.89%)

Page 24: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Most important needs

PRNQ-S(Schizophrenia)

Medical Services(M=4.02,SD=0.76)

Knowledge on Mental Illness(M=3.95,SD=1.05)

Stress Management(M=3.87,SD=1.02)

PRNQ-CS(Carers)

Medical Services(M=4.48,SD=0.53)

Symptoms(M=4.39,SD=0.65)

Stress Management (M=4.39,SD=0.81)

NRNQ-S(Professionals)

Discrimination(M=4.5,SD=0.57)

Participation in Treatment(M=4.49,SD=0.54)

Harmful to Self or Public(M=4.39,SD=0.69)

Page 25: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Most important services

PRNQ-S Social Welfare and security (M=3.61,SD=1.17)

Psychiatric Medication (M=3.58,SD=0.99)

Community Outreaching Services(M=3.48,SD=1.40)

PRNQ-CS Psychotherapy (M=4.20,SD=1.10)

Self Management Program(M=4.19,SD=0.98)

Community Outreaching Services(M=4.04,SD=1.17

NRNQ-S Community Outreaching Services(M=4.51,SD=0.59)

Psychiatric Medication (M=4.35,SD=0.64)

Self Management Program (M=4.23,SD=0.69)

Page 26: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Most important needs

PRNQ-C Knowledge on Mental Illness (M=4.30,SD=0.77)

Stress Management(M=4.25,SD=0.76)

Community Support and Welfare system(M=4.14,SD=0.75)

NRNQ-C Stress Management (M=4.22,S=0.57)

Discrimination(M=4.19,SD=0.64)

Knowledge on Mental Illness (M=4.19,SD=0.54)

Page 27: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Most important services

PRNQ-C Family Intervention (M=3.70,SD=1.23)

Self Management Program(M=3.71,SD=1.19)

Emergency Services(M=3.60,SD=1.27)

NRNQ-C Emergency Services(M=4.11,SD=0.7)

Psychotherapy(M=4.09,SD=0.75)

Social Welfare(M=4.07,SD=0.70)

Page 28: Rehabilitation Needs of People with Schizophrenia and their Caregivers
Page 29: Rehabilitation Needs of People with Schizophrenia and their Caregivers
Page 30: Rehabilitation Needs of People with Schizophrenia and their Caregivers
Page 31: Rehabilitation Needs of People with Schizophrenia and their Caregivers
Page 32: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Mean

Page 33: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Mean

Page 34: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Mean

*P ≦ 0.05

Page 35: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Mean

*P ≦ 0.05

Page 36: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Mean

*P ≦ 0.05

Page 37: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Allocate more resources in terms of funding and manpower on the provision of rehabilitation services (e.g., family intervention, psychotherapy, etc).

Strengthen social, welfare, and financial support to people with schizophrenia and their caregivers (e.g. Comprehensive Social Security Assistance, advocacy groups, etc).

Page 38: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Empower people with schizophrenia and their caregivers and set up channels to solicit their opinions in developing mental health care policy and rehabilitation services given the fact that their opinions are significantly different from normative needs as expressed by mental health professionals in some aspects

Formulate policies and strategies to reduce social stigma on mental illness.

Page 39: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Enhance public education on mental illness by establishing community-based resource centres, setting up hotlines, etc.

Conduct similar needs assessment in a regular way to include other conditions (e.g., bipolar disorders, substance abuse, etc.) and different age groups.

Page 40: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Increase manpower for psychiatric rehabilitation particularly occupational therapists, psychologists, and social workers

Adopt second generation psychotropic drugs to reduce side effects and improve recovery.

Page 41: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Adopt an ‘Integrated Community-based Care Approach’ which allows utilization of available community resources and provides early intervention, crisis support, protected housing, sheltered employment and integrated supported employment.

Develop complementary and alternative approaches to the treatment of mental illness such as cognitive remediation training and mindfulness-based interventions.

Page 42: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Formulate specific policies on provision of psychiatric services for caregivers to reduce their burden, increase their quality of care, and improve their quality of life.

Allocate more resources and manpower on the provision of services for caregivers

Provide more support and practical advice for caregivers on psychiatric symptoms, use of medications, and management of disturbing behaviour and disabilities.

Page 43: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Provide adequate interventions and support to alleviate caregivers’ emotional crisis in taking care of their relatives with schizophrenia.

Publish caregiver booklet or launch formal care-support programmes, as guidelines or promotions for home-based care.

Set up more resource centres to allow easier access to caregiver supports and information services.

Page 44: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Public Policy Research Grant, RGC Richmond Fellowship of Hong Kong United Christian Hospital Department of Rehabilitation Sciences,

The Hong Kong Polytechnic University

Page 45: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Thank You!

Page 46: Rehabilitation Needs of People with Schizophrenia and their Caregivers

Perceived Rehabilitation Needs Questionnaire (Schizophrenia) – [PRNQ – S] 香港精神分裂症患者康復需要問卷調查

簡介 此問卷旨在辨認香港精神分裂症患者的康復需要。調查所得的結果將協助制定香港公共政策及日後提供精神健康服務,並協助政府及志願機構根據服務使用者的需要更妥善地安排資源及提高服務質素。 本問卷分為三部份。第一部份將以各康復需要對您的重要性及您對各康復需要的滿足程度進行評分。第二部份將以您對現有各項康復服務的重要性及滿意程度進行評分。第三部份將問及您的背景資料,以便進行資料分析。

Page 47: Rehabilitation Needs of People with Schizophrenia and their Caregivers

第一部份: 康復需要

我們將列舉一共 19類 76項精神病患者的康復需要。請就以下各康復需要對您的重要性進行評分,以 1至 5

分為標準,請您圈出各需要對您的重要性,1分代表非常不重要,5分代表非常重要。然後就該項需要,再以1至 5分為標準,評定現有服務能否滿足您的需要。以 1至 5分為標準,請圈出您對各需要的滿足程度,1分代表未能滿足,5分代表十分滿足。 A. 工作 重要性 曾否接受有關服

務?(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

1. 增加工作動機 1 2 3 4 5 是 否 1 2 3 4 5 2. 提升就業機會 1 2 3 4 5 是 否 1 2 3 4 5 3. 改善與同事關係 1 2 3 4 5 是 否 1 2 3 4 5 4. 改善與上司關係 1 2 3 4 5 是 否 1 2 3 4 5 5. 提升工作技巧/能力 1 2 3 4 5 是 否 1 2 3 4 5 6. 延長工作的穩定性 1 2 3 4 5 是 否 1 2 3 4 5 7. 增加在職支援/輔導 1 2 3 4 5 是 否 1 2 3 4 5 8. 增加工作訓練的機會 1 2 3 4 5 是 否 1 2 3 4 5 9. 加強面試技巧 1 2 3 4 5 是 否 1 2 3 4 5 10. 公司樂意讓員工請假 覆診

1 2 3 4 5 不 適 用

11. 增加晉升機會 1 2 3 4 5 不 適 用 12. 能夠得到合理工資 1 2 3 4 5 不 適 用 13. 增加工種選擇 1 2 3 4 5 不 適 用

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Page 48: Rehabilitation Needs of People with Schizophrenia and their Caregivers

B. 病徵 重要性 曾否接受有關服務?(如回答是)

滿意程度 非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

14. 改善陽性及陰性病徵 1 2 3 4 5 是 否 1 2 3 4 5 15. 維持情緒穩定 1 2 3 4 5 是 否 1 2 3 4 5 16. 減少行為問題 1 2 3 4 5 是 否 1 2 3 4 5 17. 增加對病徵的處理方 法

1 2 3 4 5 是 否 1 2 3 4 5

C. 精神病的資料及認識 重要性 曾否接受有關服

務?(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

18. 增加對精神病及其藥 物的認識

1 2 3 4 5 是 否 1 2 3 4 5

19. 有足夠渠道獲得有關 資訊

1 2 3 4 5 是 否 1 2 3 4 5

D. 自我照顧能力 重要性 曾否接受有關服

務?(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

20. 改善自理技巧及個人 衞生問題

1 2 3 4 5 是 否 1 2 3 4 5

21. 改善家居管理能力 1 2 3 4 5 是 否 1 2 3 4 5 22. 改善財物管理能力 1 2 3 4 5 是 否 1 2 3 4 5

E. 醫療 重要性 曾否接受有關服

務?(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

23. 提供足夠精神科專業 人仕跟進

1 2 3 4 5 是 否 1 2 3 4 5

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Page 49: Rehabilitation Needs of People with Schizophrenia and their Caregivers

24. 增加社區康復資源 1 2 3 4 5 是 否 1 2 3 4 5 25.加強了解病人心靈需要 1 2 3 4 5 是 否 1 2 3 4 5 26. 避免經常轉換醫療人 員保持關係穩定

1 2 3 4 5 不 適 用

27. 能獲配合適的藥物 1 2 3 4 5 不 適 用 28. 減少藥物的副作用 1 2 3 4 5 不 適 用 29. 增長診症時間 1 2 3 4 5 不 適 用 30. 縮短首次排診時間 1 2 3 4 5 不 適 用 31. 改善病人權益及選擇 權

1 2 3 4 5 不 適 用

F. 社交 重要性 曾否接受有關服

務?(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

32. 改善社交技巧 1 2 3 4 5 是 否 1 2 3 4 5 33. 擴闊社交網絡, 結交朋 友

1 2 3 4 5 是 否 1 2 3 4 5

34. 增強社交動機 1 2 3 4 5 是 否 1 2 3 4 5

G. 親密關係 重要性 曾否接受有關服務?(如回答是)

滿意程度 非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

35. 增強信心及改善與異 性相處技巧

1 2 3 4 5 是 否 1 2 3 4 5

36. 學習正確的性知識 1 2 3 4 5 是 否 1 2 3 4 5

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Page 50: Rehabilitation Needs of People with Schizophrenia and their Caregivers

H. 家庭 重要性 曾否接受有關服務?(如回答是)

滿意程度 非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

37. 改善與家人關係 1 2 3 4 5 不 適 用 38. 避免家人期望過高 1 2 3 4 5 不 適 用 39. 得到家人精神上支持 1 2 3 4 5 不 適 用 40. 得到家人物質上支持 1 2 3 4 5 不 適 用 41. 有足夠的生育及家庭 計劃的認識

1 2 3 4 5 是 否 1 2 3 4 5

42. 增加家人對精神病的 認識及接納病人

1 2 3 4 5 是 否 1 2 3 4 5

I. 子女照顧 重要性 曾否接受有關服

務?(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

43. 改善照顧兒童技巧 1 2 3 4 5 是 否 1 2 3 4 5

J. 娛閒 重要性 曾否接受有關服務?(如回答是)

滿意程度 非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

44. 提供足夠娛閒機會 1 2 3 4 5 是 否 1 2 3 4 5 45. 提供合適的娛閒安排 1 2 3 4 5 是 否 1 2 3 4 5 46. 增加對娛閒的興趣 1 2 3 4 5 是 否 1 2 3 4 5 K. 參與治療問題 重要性 曾否接受有關服

務?(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

47. 能夠定時覆診 1 2 3 4 5 是 否 1 2 3 4 5 48. 改善服食藥物習慣 1 2 3 4 5 是 否 1 2 3 4 5 49. 積極參加治療 1 2 3 4 5 是 否 1 2 3 4 5

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L. 住屋 重要性 曾否接受有關服務?(如回答是)

滿意程度 非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

50. 提供足夠的居住過渡 安排

1 2 3 4 5 是 否 1 2 3 4 5

51. 改善居住空間 1 2 3 4 5 是 否 1 2 3 4 5 52. 避免居住地點距離服 務網絡過遠

1 2 3 4 5 是 否 1 2 3 4 5

53. 提供足夠的住屋選擇 1 2 3 4 5 是 否 1 2 3 4 5 M. 經濟 重要性 曾否接受有關服

務?(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

54. 提供足夠食物 1 2 3 4 5 是 否 1 2 3 4 5 55. 提供足夠交通費用 1 2 3 4 5 是 否 1 2 3 4 5 56. 提供足夠娛樂費用 1 2 3 4 5 是 否 1 2 3 4 5 57. 提供足夠藥物費用 1 2 3 4 5 是 否 1 2 3 4 5 N. 教育 重要性 曾否接受有關服

務?(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

58. 提供足夠基本教育機 會

1 2 3 4 5 是 否 1 2 3 4 5

59. 提供足夠的教育或進 修機會

1 2 3 4 5 是 否 1 2 3 4 5

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O. 歧視 重要性 曾否接受有關服務?(如回答是)

滿意程度 非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

60. 減少被排斥的機會 1 2 3 4 5 是 否 1 2 3 4 5 61. 減少被家人歧視 1 2 3 4 5 是 否 1 2 3 4 5 62. 減少被公眾歧視 1 2 3 4 5 是 否 1 2 3 4 5 63. 減少自我歧視及自卑 感

1 2 3 4 5 是 否 1 2 3 4 5

64. 減少因精神病而缺乏 機會(工作,教育)

1 2 3 4 5 是 否 1 2 3 4 5

P. 社區福利及支援 重要性 曾否接受有關服

務?(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

65. 提供足夠綜援金額 1 2 3 4 5 是 否 1 2 3 4 5 66. 提供足夠社區援助 1 2 3 4 5 是 否 1 2 3 4 5 67. 增加求助渠道 1 2 3 4 5 是 否 1 2 3 4 5

Q. 金錢管理 重要性 曾否接受有關服務?(如回答是)

滿意程度 非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

68. 減少過度揮霍 1 2 3 4 5 是 否 1 2 3 4 5 69. 增強理財能力 1 2 3 4 5 是 否 1 2 3 4 5

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R. 壓力管理 重要性 曾否接受有關服務?(如回答是)

滿意程度 非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

70. 減少焦慮 1 2 3 4 5 是 否 1 2 3 4 5 71. 減少日常生活/工作壓 力

1 2 3 4 5 是 否 1 2 3 4 5

72. 改善壓力管理技巧 1 2 3 4 5 是 否 1 2 3 4 5 73. 建立有規律的生活模式 1 2 3 4 5 是 否 1 2 3 4 5

S. 對公眾或自身構成危害 重要性 曾否接受有關服

務?(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

74. 減少自殺行為 1 2 3 4 5 是 否 1 2 3 4 5 75. 減少暴力行為 1 2 3 4 5 是 否 1 2 3 4 5 76. 減少酗酒行為 1 2 3 4 5 是 否 1 2 3 4 5 除上述以外,請問您對康復需求有沒有其他意見 ?

--- 第一部份完 ---

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Page 54: Rehabilitation Needs of People with Schizophrenia and their Caregivers

第二部份: 康復服務

我們將列舉一共 11類 31項精神病患者的康復服務。請就以下各項康復服務對您的重要性進行評分,以 1至 5分為標準,請圈出各需要對您的重要性,1分代表非常不重要,5分代表非常重要。然後請填寫您曾否接受該項服務,如曾接受該項服務,請再以 1至 5分為標準,評定您是否滿意該服務。以 1至 5分為標準,請圈出您對各服務的滿意程度,1分代表未能滿意,5分代表十分滿意。如未曾接受該項服務,則無需填寫對該項服務的滿意程度。 A. 工作康復 重要性 曾否接受此服務?

(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

1. 輔助就業* 1 2 3 4 5 是 否 1 2 3 4 5 2. 社會企業* 1 2 3 4 5 是 否 1 2 3 4 5 3. 庇護工場 1 2 3 4 5 是 否 1 2 3 4 5 4. 勞工處展能就業科 1 2 3 4 5 是 否 1 2 3 4 5 5. 日間醫院 (精神科) 1 2 3 4 5 是 否 1 2 3 4 5 6. 日間訓練及活動中心 1 2 3 4 5 是 否 1 2 3 4 5 B. 社區康復 重要性 曾否接受此服務?

(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

7. 社區外展精神康復服 務* (社康)

1 2 3 4 5 是 否 1 2 3 4 5

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C. 家庭康復 重要性 曾否接受此服務?(如回答是)

滿意程度 非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

8. 家庭自助組織 1 2 3 4 5 是 否 1 2 3 4 5 9. 家庭治療(Family Therapy)*

1 2 3 4 5 是 否 1 2 3 4 5

D. 住宿服務 重要性 曾否接受此服務?

(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

10. 中途宿舍 1 2 3 4 5 是 否 1 2 3 4 5 11. 長期護理院 1 2 3 4 5 是 否 1 2 3 4 5 12. 單身人仕宿舍 1 2 3 4 5 是 否 1 2 3 4 5 13. 私營院舍 1 2 3 4 5 是 否 1 2 3 4 5 E. 心理治療 重要性 曾否接受此服務?

(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

14. 心理治療* 1 2 3 4 5 是 否 1 2 3 4 5 F. 藥物治療 重要性 曾否接受此服務?

(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

15. 精神科口服藥物 1 2 3 4 5 是 否 1 2 3 4 5 16. 精神科注射藥物 1 2 3 4 5 是 否 1 2 3 4 5 G. 自我管理 重要性 曾否接受此服務?

(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

17. 自我管理教育及訓練* 1 2 3 4 5 是 否 1 2 3 4 5

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H. 社交生活 重要性 曾否接受此服務?(如回答是)

滿意程度 非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

18. 社交訓練小組 1 2 3 4 5 是 否 1 2 3 4 5 19. 娛閒活動/小組 1 2 3 4 5 是 否 1 2 3 4 5 20. 會社(Club house) 1 2 3 4 5 是 否 1 2 3 4 5 21. 自助組織 1 2 3 4 5 是 否 1 2 3 4 5 I. 社區福利保障 重要性 曾否接受此服務?

(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

22. 綜援 1 2 3 4 5 是 否 1 2 3 4 5 23. 傷殘津貼 1 2 3 4 5 是 否 1 2 3 4 5 24. 恩恤住屋 1 2 3 4 5 是 否 1 2 3 4 5 J. 緊急服務 重要性 曾否接受此服務?

(如回答是) 滿意程度

非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

25. 電話熱線 (如自殺或 家庭暴力

1 2 3 4 5 是 否 1 2 3 4 5

26. 緊急住所服務 1 2 3 4 5 是 否 1 2 3 4 5

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K. 其他 重要性 曾否接受此服務?(如回答是)

滿意程度 非常不重要 ------------ 非常重要 未能滿意 ------------ 十分滿意

27. 氣功 1 2 3 4 5 是 否 1 2 3 4 5 28. 宗教活動 1 2 3 4 5 是 否 1 2 3 4 5 29. 特殊教育 1 2 3 4 5 是 否 1 2 3 4 5 30. 瑜伽 1 2 3 4 5 是 否 1 2 3 4 5 31. 認知治療訓練* 1 2 3 4 5 是 否 1 2 3 4 5 除上述以外,請問您對現有各康復服務有沒有其他意見?

--- 第二部份完 ---

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Page 58: Rehabilitation Needs of People with Schizophrenia and their Caregivers

第三部份:背景資料 以下問題是關於您的背景資料,方便我們在分析研究結果時,將您的資料和其他與您背景相似的人士歸類: 性別: 男 女 年齡: 18 – 25歲 26 – 35歲 36 – 45歲 46 – 55歲 56 歲或以上 教育程度: 未曾接受正式教育 小學 中學 大學或以上 其他,請註明: 婚姻狀況: 單身 已婚 離婚 喪偶 與何人同住: 家庭成員,請註明: 獨居 朋友 中途宿舍 其他,請註明: 就業狀況: 公開就業,請註明: 保安員 派傳單 侍應 清潔 售貨員 文員 速遞 其他,請註明: 輔助就業 日間訓練及活動中心 庇護工場 暫無職業 其他,請註明: 如正在就業,月入: $3,000 或以下 $3,001 – $5,000 $5,001 - $10,000 $10,001 或以上 如暫無職業,主要收入來源: 自行賺取 儲蓄 家庭 傷殘津貼 綜援 其他,

請註明:

接受精神病服務年期: 2年或以下 2 – 5年 5 – 10年 10年以上

--全問卷完,謝謝!--

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輔助就業 輔助就業服務主要為在就業上有困難的殘疾人士安排公開就業機會及提供支援服務,並給予在職跟進及輔導。服務會提供就業選配、與僱主安排面試及陪同服務使用者前往面試。在成功介紹工作後會透過定期探訪及與僱主、服務使用者、其家人及轉介機構聯絡提供在職跟進服務。 社會企業 大多數是由非營利組織/非政府組織實施,社會企業透過商業手法運作,賺取利潤用以貢獻社會。它們所得盈餘用於扶助弱勢社群、促進社區發展及社會企業本身的投資。它們重視社會價值,多於追求最大的企業盈利。 社區外展精神康復服務 由專業人仕(如:精神科醫生, 護士, 職業治療師, 社工等)所提供的外展精神康復服務, 服務或訓練地點一般於服務使用者的家居或在社區進行。 家庭治療 家庭治療是以家人為單位及對象的一種團體治療,經由語言、互動等治療模式,其目的在消除個人因家庭所產生的生理或心理症狀,解決之間的衝突,重新建構

Glossary for the Services provided in Hong Kong regarding Public Policy Research (PPR)

by(Principal Investigator: Dr. Hector W.H. Tsang, Department of RS, The Hong Kong Polytechnic University)

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心理治療 由臨床心理學家所提供的心理治療, 臨床心理學家利用心理學的原理去幫助當事人解決各種情緒、思想、行為上的困擾,例如:過份憂慮、恐懼、抑鬱及與人相處困難等等。治療的最終目的是為促進身心健康,增加適應 生活的能力。 自我管理教育及訓練 泛指所有促進自我精神健康的教育及訓練, 從而提高獨立生活能力, 避免病發及改善生活質數. (如: 健康生活, 藥物管理, 壓力管理, 病悉感建立等) 。 會所 (Clubhouse ) 會所的運作模式,讓精神病康復者能夠自願地以終身會員的身份參與會所工作,與會所職員並肩管理會所日常運作。會員可自由選擇自己喜歡的工作,會所亦尊重他們的選擇。會員在會所工作,不但可發展其工作技能,並可有機會從實際工作中發揮會員的優點。會員的才華被肯定、被尊重,是令會員每天都期待身處會所的重要元素。 認知矯正治療 Cognitive remediation Therapy (CRT) CRT是運用語音及動畫等的多媒體電腦程式, 循序漸進地訓練精神病患者的腦部認知功能, 內容包括專注力,記憶力,計算,問題處理能力等基本腦部認知的訓練. 透過這些訓練, 精神病患者能改善認知缺陷, 從而提升日常生活的功能。 積極性社區治療 (Assertive Community treatment, ACT) 積極性社區治療是一種供應服務的模型,目的是為那些同時有多種複雜需要的病人,提供靈活與全面的服務。積極社療有幾個獨特的主要成分,故此與其他個案管理模式不同,這些特點,包括:較低的職員對消費者比率、團隊護理方式、以消費者為本的服務方式、積極性的外展與延續服務等。

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