探討思覺失調症患者出院前不確定感的主觀經驗

思覺失調症患者常因疾病慢性化必須長期治療，但漫長的病程衍生各方面的不確定感困擾，在國內較欠缺這方面的質性研究，故本研究以質性研究的深度訪談法，探討思覺失調症患者在出院前的不確定感主觀經驗。於中部某醫學中心精神科急性病房進行立意取樣，收案條件方面，病患必須需具以下條件: 1.有經精神科專科醫師所確立診斷之思覺失調症且尚未出院；2.年齡介於二十歲以上至六十五歲之間；3.具有口語表達能力且能清楚的描述；4. 病情穩定；5. 有意願接受訪談錄音者。資料收集採半結構式一對一深入訪談，以Colaizzi''s(1978)進行資料分析，共訪談10位個案。研究結果呈現三個主題及七個次主題，分別為疾病的不確定感(對病因的認知、疾病控制)；未來規劃的不確定感(人際關係、未來自我決定)；安穩生活的不確定感(經濟、求職、親密關係)。研究結果發現思覺失調症病患在描述對自己疾病、出院後的未來生活存在著多方面的不確定感，雖經過多年的治療與衛教，但對本身疾病存在著模糊不明的經驗及感受，對於症狀控制及治療雖然採配合就醫，訪談瞭解發現多呈現被動消極的態度，對於未來亦存在許多無法決定不可預測的疑惑感，也因此無法感到可以擁有安穩的生活。透過本研究盼能增加專業人員認識思覺失調症患者在出院前的不確定感主觀經驗，協助釐清及減少患者不確定感的困擾，以提供更符合患者出院需求的介入措施及對疾病與藥物的管理能力。

Patients with Schizophrenia often have long-term treatment due to chronic diseases, but the long-term disease process always makes them feel uncertainty in various aspects. In Taiwan, there is a lack of qualitative research in this area. Therefore, this study explores the subjective experience of uncertainty in patients with Schizophrenia before discharge using qualitative study methods of descriptive phenomena. This study takes patients as samples with purposive sampling from a medical center in Central Taiwan. Considering the sample condition, the patients are: 1. who had been diagnosed Schizophrenia by Psychiatric specialists and not been discharged; 2. between 20 and 65 years old; 3. able to express orally and clearly describe; 4. stable mood; 5. willing to be recording interviewees. The data collection method in this study is one-on-one in-depth interview with semi-structured, 10 patients with Schizophrenia as the interviewees are sampled, and then Colaizzi''s method is applied to analyze the data. This study presented three themes and seven sub-themes, namely, the uncertainty of the disease (cognition of the cause, disease control); the uncertainty of future planning (interpersonal relationship, future self-determination); the uncertainty of a stable life (economic, job search, intimate relationship). The study found that patients with Schizophrenia have many uncertainties about their own diseases and future life after discharge. Although practicing several years of treatment and education, patients have vague and unclear experience of their diseases. In the symptom control and treatment, although the patients cooperated with the doctor, the study found that they all showed a passive and negative attitude, and there are many doubts that cannot be determined and unpredictable in the future. So, they cannot feel safe life. Finally, this study can provide professionals to understand the subjective experience of uncertainty in patients with Schizophrenia before discharge, to help these professionals clarify and reduce the confusion of patients, and to provide interventions that better meet the patient''s discharge requirements and ability to manage diseases and drugs.