研究目的：本研究之目的為探討思覺失調症精神障礙者參與職業訓練的成效，並進一步 找出參與職業訓練的思覺失調症精神障礙者其就業能力之影響因子。研究方法：本研究 為追蹤研究，個案須完成18個月的職業訓練，共收集四次的問卷資料。本研究採立意取 樣，於台灣南部某精神專科醫院附設社區復健中心進行收案。參與者從初次進到職業訓 練，到接受18個月的職業訓練期間，共接受四次問卷施測(每6個月一次)。問卷分為五個 部分，包含參與者基本資料、獨立生活功能評估、社會支持評估、工作表現評估(包含工 作行為、態度與能力)與精神狀況評估(包括情緒、思考、知覺、認知障礙，與行為問題等 面向)。研究結果：研究參與者包括54位男性與50位女性，平均年齡為46.75歲。在參與18 個月後的職業訓練，參與者在工作態度與工作能力都有顯著提升，且認知障礙是就業能 力的顯著影響因子。此外，對中重度精神障礙者而言，社會支持與認知障礙為其就業能 力的顯著影響因子。研究結論：透過18個月的職業訓練，參與者在工作態度、工作能力 面皆有顯著提升，且高「社會支持」與低「認知障礙」為對中重度精神障礙者就業能力 的正向顯著影響因子。

Purpose: The purpose of this study is to explore the effectiveness of vocational training participation among patients with schizophrenia (PwS) and to further identify the factors affecting the employability of those who participate in vocational training. Method: This study was the final of 4 waves of surveys over an 18 month period of PwS who participated in and completed vocational training during that period. We applied purposive sampling and recruited participants at a community rehabilitation center affiliated with a psychiatric hospital in southern Taiwan. Participants completed 4 questionnaires, including a baseline survey upon entering the training program, and 3 follow-up surveys, once every 6 months over the following 18 months. The questionnaire included 5 parts: basic information, assessment of independent living function, assessment of social support, assessment of work performance (including work behavior, attitude, and ability), and assessment of mental status (including 5 domains: emotional, thought, perception, cognitive impairment, and behavioral problems). Results: A total of 54 male and 50 female participants (average age 46.75 years) completed the survey. After participating in vocational training for 18 months, participants showed significant improvement in both work attitude and work capabilities. Moreover, cognitive impairment was identified as a significant factor affecting employability. Additionally, for individuals with moderate to severe mental disorders, social support and cognitive impairment were significant factors influencing their employability. Conclusions: Through 18 months of vocational training, participants demonstrated significant improvements in both work attitude and job skills. Additionally, high “social support” and low “cognitive impairment” were identified as positive and significant factors influencing the employability of individuals with moderate to severe mental disorders.

職業訓練；思覺失調；就業能力