進階搜尋


下載電子全文  
系統識別號 U0026-2907202012565700
論文名稱(中文) 慢性思覺失調症患者症狀緩解及衰弱因子與功能性職業表現之關聯性-世代研究
論文名稱(英文) Association of functional employment outcomes with symptomatic remission and frailty factors in chronic patients with schizophrenia - cohort study
校院名稱 成功大學
系所名稱(中) 健康照護科學研究所
系所名稱(英) Institute of Allied Health Sciences
學年度 108
學期 2
出版年 109
研究生(中文) 王三平
研究生(英文) San-Ping Wang
學號 TA8011101
學位類別 博士
語文別 英文
論文頁數 79頁
口試委員 指導教授-張哲豪
口試委員-王榮德
口試委員-郭立杰
召集委員-王作仁
口試委員-陳貞夙
中文關鍵字 職業表現  生理衰弱因子  思覺失調症  症狀緩解 
英文關鍵字 employment outcomes  physical frailty  schizophrenia  symptomatic remission 
學科別分類
中文摘要 前言:
思覺失調症臨床上常從臨床反應( response)、症狀緩解( remission)與復元( recovery)等反應來廣泛驗證治療成效。從職能復健觀點言之,職能治療師關注一個人從自我照顧到工作能力的整體生活型態,個案復元專注於整體功能改善,特別是職業功能更具指標意義。思覺失調症個案藉由生產性職業活動完成職能角色,可以增加生活品質與滿意度,其職業表現為驗證個案功能改善的重要指標。職能治療師提供許多治療性策略,以促進個案回歸社區從事規律性工作為最佳目標。研究顯示影響工作失能個案持續工作的因子非常複雜,且受許多潛在變項干擾,如:年齡、性別、教育背景、訓練計畫之執行、未來工作目標與治療前職業狀態等。另外,探討思覺失調症的職業表現與工作維持時,除了要關注上述干擾因子及精神病理學之症狀緩解外,也還要考慮發病年齡、精神藥物種類與劑量、心理社會功能表現、初始工作樣態及社會支持與技巧等,所以必須控制這些潛在的干擾變項。再者,職業功能與個案生理衰弱能力(如老年族群)有顯著負向影響,而持續工作更需要良好的生理功能,所以思覺失調症個案的生理衰弱因子值得持續監控以長期追蹤其工作表現。
因此,本研究旨在控制各項潛在干擾變項下,探討其功能性職業表現與精神症狀緩解、生理衰弱因子之間的相關性。

研究目的:
本文的研究目的如下:在研究1中,利用二年追蹤研究追蹤以探討個案精神症狀緩解可以影響功能性職業表現;在研究2中,以世代研究探討個案生理衰弱能力影響功能性職業表現。

研究方法:
研究1研究資料為追蹤西元2013年1月~2015年12月台灣東部某精神專科醫院住民,共收集525位治療性社區思覺失調症病患資料。研究者控制潛在干擾變項,如:年齡、性別、教育程度、抗精神病藥物種類及藥物當量、認知功能、基本及工具性日常生活功能( Instrumental activities of daily living, IADL)、個人與社會功能( Personal and Social Performance Scale, PSP)及個案第一年工作型態與收入等。依變項為功能性職業型態收集病患每年有報酬工作累積時間(months/per year)及工作累積總收入(new Taiwan dollars, NT$/per year),每位納入研究個案共收集二年功能性職業表現。針對於依變項所得結果,利用重複測量線性混合模式( linear mixed effect model)去分析個案精神症狀緩解與功能性職業表現相關性。
研究2共收集561位症狀穩定思覺失調症病患資料,除上述潛在干擾變項外,另外研究者也控制個案生理共病狀態,每位納入研究個案每年測量個案生理衰弱因子(Shrink、Weakness、Exhaustion、Slowed walking speed、Low activity)及功能性職業表現共四年,針對所得結果,利用廣義線性模式( Generalized estimating equations, GEE) 去推論個案生理衰弱因子與功能性職業表現相關性。

研究結果:
研究1結果指出個案平均年齡51.8歲,65.3%為男性,其中124位個案符合症狀緩解診斷標準(23.6%, 124/525),第一年平均工作月份為7.21個月,工作平均薪資為11,378元;未符合症狀緩解診斷標準個案,第一年平均工作月份為3.71個月,工作平均薪資為3,048元。經控制相關干擾因子後,以重複測量線性混合模式(linear mixed effect model)得知:具症狀緩解個案相較於未達症狀緩解個案每年可多工作0.8個月 (p = 0.029),且多賺NT$3,250 元 (p = 0.006)。此外,個案個人與社會功能(PSP)與持續工作月份顯著正相關 (ß = 0.03, p = 0.043).。
研究2結果指出57位個案符合生理衰弱因子診斷標準(10.2%),第一年平均工作月份為1.54個月,工作平均薪資為626.4元;未符合生理衰弱因子診斷標準個案,第一年平均工作月份為5.81個月,工作平均薪資為6,055元,經控制相關干擾因子後,以重複測量分析得知:具生理衰弱因子個案每年少工作1.01個月 (p = 0.004),且少賺NT$518 元 (p = 0.029)。此外,個案走路速度快慢明顯與工作持續月份呈現顯著負相關 (ß = -0.82, p = 0.029)。個案工具性日常生活功能(IADL)則明顯與工作月份及薪資顯著正相關 (ß = 0.08; 85.3, p <0.01 )。

研究結論:
思覺失調症個案的職業表現與其精神症狀緩解、生理衰弱因子之間有顯著相關性。為了解個案治療成效,評估個案症狀緩解與生理衰弱因子為一個有效監測指標。個案症狀緩解明顯增加工作持續月份及收入,且生理衰弱因子也明顯減弱工作表現。
依據精神醫療生理心理社會模式,我們主張治療師應隨時監測個案精神症狀緩解,早期檢測個案生理衰弱危險因子,以發展症狀減輕及預防生理衰弱的治療性活動策略,改善個案工具性日常生活能力( IADL)及個人與社會功能( PSP)能力。最終冀望協助精神障礙者回歸社區以從事規律職業表現。
英文摘要 Background:
Clinically, the intervention progresses for the patients with schizophrenia validated through the response to treatment, remission, and recovery. From the perspective of occupational rehabilitation, occupational therapists focus on holistic function of persons’ life from self-care to work. The recovery stage is thus emphasized on their regaining function after symptom control. In addition, the patients with productive life have a very important meaning in their occupational roles. Functional employment contributes substantially to the quality and satisfaction of life is very important to patients with mental disorders. Moreover, employment status is considered a crucial milestone of improved functioning for patients with schizophrenia. The optimal goal for the patients is to return to the community with regular employment. Researchers showed that the factors about sustainable employability were complicated and influenced by many confounding variables. Robust evidences about return to work for the disable people indicated the factors including age, gender, education background, completion of training program, future target job, and occupational status before intervention. In schizophrenia patients, symptomatic remission in psychopathology and other variables such as age at onset, type and dose of antipsychotics, psychosocial function performance, initial employment type, and social support as well as skill were considered in employment outcomes in this study.
In addition, employment outcomes were reported to be negative associated with physical frailty, which is found to be prevalent in the elder population. The employment sustainability in schizophrenia patients was also related to physical competency, especially if their jobs require considerable physical effort. Therefore, the association about physical frailty and prolonged employment outcome is worthy to be monitored in a longitudinal follow-up study.
Therefore, this dissertation adopted a longitudinal cohort study that aimed to examine the association about employment outcomes with the symptomatic remission and physical frailty in schizophrenia after controlling for potential confounding variables.
Aim
The present dissertation includes two studies with the following aims: Study 1 explores the association between symptomatic remission in schizophrenia and their employment outcomes in a two-year longitudinal study; Study 2 is a longitudinal four-year study that investigates the association between physical frailty and employment outcomes in schizophrenia.

Methods
In Study 1, all of 525 stable patients with schizophrenia in the therapeutic community of a public mental hospital in Taiwan were recruited between 2013 and 2015. Employment outcomes, defined as the cumulative on-the-job duration (months/per year) and income (new Taiwan dollars, NT$/per year), were investigated at the end of 1- and 2-year follow-up periods after enrollment. For repeated measurements, linear mixed models were constructed to examine the association between symptomatic remission and employment outcomes after controlling for potential confounding variables including age, sex, education, type and daily dose of antipsychotics, cognitive function, personal and social performance scale (PSP) and initial employment type.
Study 2 All 561 stable patients with schizophrenia in a therapeutic community in Taiwan were recruited. Employment outcomes, defined as the cumulative annual work duration (months/per year) and income (NT$/per year), were investigated repeatedly at the end of 1-, 2-, 3-, and 4-year follow-ups after enrollment. Generalized estimating equation models were constructed to determine the association between physical frailty (shrink、weakness、exhaustion、slowed walking speed、low activity) and employment outcomes after controlling for variables, including age, sex, education, antipsychotic medication and daily dose, cognitive function, instrumental activities of daily living (IADL), medical comorbidity, and initial employment state at the beginning year.

Results
The findings of Study 1 showed the average age of the patients was 51.8 years, and 65.3% were males. Among them, 124 patients (23.6%, 124/525) met the remission criteria at baseline. The outcomes in remission group at first full year were 7.21 months/per year, and 11,378 NT$/per year; the outcomes in nonremission group at first full year were 3.71 months/per year, and 3,048 NT$/per year. The linear mixed-model analysis showed that patients who had symptomatic remission were employed 0.8 of a month longer (p = 0.029) and earned NT$3,250 more (p = 0.006) within 1 year than those who did not show symptomatic remission. In addition, the cumulative on-the-job duration was associated with personal and social performance scale (PSP) (ß = 0.03, p = 0.043).
In Study 2: The average age of the patients was 53.78 years, and 64.7% were men. Among them, 57 patients (10.2%) met the physical frailty criteria at the baseline. The outcomes in frailty group at first full year were 1.54 months/per year and 626.4 NT$/per year; the outcomes in nonfrailty group at first full year were 5.81 months/per year and 6,055 NT$/per year. After controlling for confounding variables, we found that patients with physical frailty were employed 1.01 month less (p = 0.004) and earned NT$518 less (p = 0.029) per year than those without physical frailty.
In addition, the patient with slow walking speed was found to be negatively associated with work duration (ß = -0.82, p = 0.029). Instrumental activities of daily living (IADL) was found to be positively associated with both the cumulative work duration and income in the two models (ß = 0.08; 85.3, p <0.01).

Conclusion
In summary, our study revealed that employment outcomes in patients with schizophrenia were associated with symptomatic remission and physical frailty status. Assessing symptomatic remission and physical frailty periodically is useful indicators in monitoring treatment effectiveness for schizophrenia. The patients with symptomatic remission could increase duration of employment and income, and physical frailty could reduce employment outcomes.
Our findings advocate that the strategies based on the bio-psycho-social domains to attain symptomatic remission in schizophrenia and alleviate the level of physical frailty are paramount to improve the IADL and PSP ability for favorable employment outcomes. Therefore, those who suffered severe mental illness still have chances to return to the community with promising outcomes of regular employment.
論文目次 TABLE OF CONTENTS

口試委員會審定書 I
中文摘要 II
ABSTRACT V
致謝 IX
TABLE OF CONTENTS XI
LIST OF TABLES XIII
LIST OF FIGURES XIV
Chapter 1. BACKGROUND and MOTIVATION 1
Chapter 2. LITERATURE REVIEW 4
2.1 Employment outcomes 4
2.2 Symptomatic remission 6
2.3 Physical frailty 6
2.4 Other factors related to employment outcomes 8
Chapter 3. METHODOLGY 10
3.1 Research questions 10
3.2 Hypothesis of each study 11
3.2.1 Hypothesis in study 1: 11
3.2.2 Hypothesis in study 2: 11
3.3 Framework of the research 12
3.4 Target population 13
3.4.1 Rehabilitation model in the therapeutic community 13
3.4.2 Initial type of employment 14
3.5 Primary outcome measure: employment outcomes 15
3.6 Materials and methods between symptomatic remission and employment outcomes (Study 1) 16
3.6.1 Participants and Procedure 16
3.6.2 Measurements of independent variables and outcomes 16
3.6.3 Data analysis 19
3.7 Materials and methods between physical frailty and employment outcomes (Study2) 20
3.7.1 Participants and Procedure 20
3.7.2 Measurements of independent variables and outcomes 20
3.7.3 Data analysis 22
Chapter 4. RESULTS 25
4.1 Results in symptomatic remission and employment outcomes (Study 1) 25
4.1.1 Demographic data 25
4.1.2 Factors related to employment outcomes 25
4.2 Results in physical frailty and employment outcomes (Study 2) 26
4.2.1 Demographic data 26
4.2.2 The association between physical frailty status (frail vs. non-frail) and employment outcomes 27
4.2.3 The association between five domains and employment outcomes 28
4.2.4 Other factors related to employment outcomes 28
Chapter 5. DISCUSSIONS 30
5.1 Symptomatic remission and employment outcomes 30
5.2 MMSE and employment outcomes 31
5.3 Physical frailty and employment outcomes 33
5.4 IADL and PSP for job acquisition for patients with schizophrenia 35
5.5 Clinical implication 36
5.6 Strength and limitations 37
Chapter 6. CONCLUSIONS 39
Abbreviations 40
Declarations 41
Ethics approval and consent to participate 41
Availability of data and materials 41
Funding 41
REFERENCES 42
APPENDICES
Appendix A: Ethics Committee of the Institutional Review Board at Yuli Hospital 62
Appendix B: Background questionnaires 63
Appendix C: Mini-mental state examination (MMSE) 65
Appendix D: Personal and social performance (PSP) 67
Appendix E: Description of Holm-Bonferroni method 75
Appendix F: Physical frailty status 77
Appendix G: Basic and instrumental activities daily living ( BADL/ IADL) 78
參考文獻 Abdi, H. (2003). Partial least squares (PLS) regression. In Lewis-Beck, M. et al. (eds), Encyclopedia of social sciences research methods. Oaks, CA: Sage:792-5.
Akechi, T., Kugaya, A., Okamura, H., Yamawaki, S., & Uchitomi, Y. (1999). Fatigue and its associated factors in ambulatory cancer patients: a preliminary study. Journal of Pain and Symptom Management, 17(1), 42-48.
Andreasen, N. C., William T. Carpenter, J., Kane, J. M., Lasser, R. A., Marder, S. R., & Weinberger, D. R. (2005). Remission in Schizophrenia: Proposed Criteria and Rationale for Consensus. American Journal of Psychiatry, 162(3), 441-449. doi:doi:10.1176/appi.ajp.162.3.441
Ariëns, G., Bongers, P., Douwes, M., Miedema, M., Hoogendoorn, W., van der Wal, G., van Mechelen, W. (2001). Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study. Occupational and environmental medicine, 58(3), 200-207.
Aström, M., Adolfsson, R., & Asplund, K. (1993). Major depression in stroke patients. A 3-year longitudinal study. Stroke, 24(7), 976-982.
Berger, A. M., & Farr, L. (1999). The influence of daytime inactivity and nighttime restlessness on cancer-related fatigue. Paper presented at the Oncology nursing forum.
Bejerholm, U. (2010). Relationships between occupational engagement and status of and satisfaction with sociodemographic factors in a group of people with schizophrenia. Scandi J Occupa T , 17, 244-254.
Bowie, C. R., Leung, W. W., Reichenberg, A., McClure, M. M., Patterson, T. L., Heaton, R. K., & Harvey, P. D. (2008). Predicting schizophrenia patients' real-world behavior with specific neuropsychological and functional capacity measures. Biol Psychiatry, 63(5), 505-511.
Brown, H., & Prescott, R. (2006). Applied mixed models in medicine. 2nd ed. Hoboken, NJ: Wiley.
Carmona, V. R., GÓMez-Benito, J., Huedo-Medina, T. B., Rojo, J. E., & Gómez-Benito, J. (2017). Employment outcomes for people with schizophrenia spectrum disorder: A meta-analysis of randomized controlled trials. International Journal of Occupational Medicine & Environmental Health, 30(3), 345-366. doi:10.13075/ijomeh.1896.01074
Chakraborty, R., Chatterjee, A., & Chaudhury, S. (2012). Internal predictors of burnout in psychiatric nurses: An Indian study. Industrial psychiatry journal, 21(2), 119.
Chang, Y.-J., Yeh, W.-Y., Chen, C.-W., Chen, C.-J., Shih, T.-S., & Cheng, Y. (2008). Factors associated with workers’ burnout and “over-commitment to work”: a survey among employees of 36 companies in Taipei city. Taiwan Journal of Public Health, 27(6), 463-477.
Chiu, E.C., Lai, K.Y., Lin, S.K., Tang, S.F., Lee, S.C., & Hsieh, C.L. (2019). Construct Validity and Reliability of the Comprehensive Occupational Therapy Evaluation Scale (COTES) in People with Schizophrenia. American Journal of Occupational therapy, 73(6), 73062050601-73062050608. doi: 10.5014/ajot.2019.026807.
Chung, W.S., Lan, Y.L., & Yang, M.C. (2012). Psychometric testing of the short version of the world health organization quality of life (WHOQOL-BREF) questionnaire among pulmonary tuberculosis patients in Taiwan. BMC public health, 12(1), 630.
Coelho, F. G., Stella, F., de Andrade, L. P., Barbieri, F. A., Santos-Galduroz, R. F., Gobbi, S., & Gobbi, L. T. (2012). Gait and risk of falls associated with frontal cognitive functions at different stages of Alzheimer's disease, Neuropsychol Dev Cogn B Aging Neuropsychol Cogn, 19(5), 644-656. doi:10.1080/13825585.2012.661398
Cohen, G. L., & Sherman, D. K. (2014). The psychology of change: Self-affirmation and social psychological intervention. Annual review of psychology, 65, 333-371.
Costa, G. (1996). The impact of shift and night work on health. Applied ergonomics, 27(1), 9-16.
Cooper C, Dere W, Evans W (2012). Frailty and sarcopenia: definitions and outcome parameters. Osteoporosis International, 23(7), 1839-1848. doi:10.1007/s00198-012-1913-1
Crowther, R., Marshall, M., Bond, G., & Huxley, P. (2001). Vocational rehabilitation for people with severe mental illness. Cochrane Database Syst Rev (2), CD003080. doi:10.1002/14651858.CD003080
Delbert G. Robinson, Margaret G. Woerner, Marjorie McMeniman, Alan Mendelowitz, & Robert M. Bilder. (2004). Symptomatic and Functional Recovery From a First Episode of Schizophrenia or Schizoaffective Disorder. American Journal of Psychiatry, 161(3), 473-479. doi:10.1176/appi.ajp.161.3.473
Diehl, M., Coyle, N., & Labouvie-Vief, G. (1996). Age and sex differences in strategies of coping and defense across the life span. Psychology and aging, 11(1), 127.
Dodd, M. J., Miaskowski, C., & Paul, S. M. (2001). Symptom clusters and their effect on the functional status of patients with cancer. Paper presented at the Oncology nursing forum.
Duvdevany, I., & Arar, E. (2004). Leisure activities, friendships, and quality of life of persons with intellectual disability: Foster homes vs community residential settings. International Journal of Rehabilitation Research, 27(4), 289-296.
Fasseeh, A., Nemeth, B., Molnar, A., Fricke, F. U., Horvath, M., Koczian, K., . . . Kalo, Z. (2018). A systematic review of the indirect costs of schizophrenia in Europe. Eur J Public Health, 28(6), 1043-1049. doi:10.1093/eurpub/cky231
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198. doi:https://doi.org/10.1016/0022-3956(75)90026-6
Geethu Mathew, N. R., Shanbhag, D., Goud, R., Subramanian, S., Lobo, C., Xavier, A., & Dasari, P. (2016). Quality of life and probable psychological distress among male workers at a construction site, Kolar district, Karnataka, India. Indian journal of occupational and environmental medicine, 20(1), 54.
Green, M. F., Kern, R. S., Braff, D. L., & Mintz, J. (2000). Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the "right stuff"? Schizophr Bull, 26(1), 119-136. doi:10.1093/oxfordjournals.schbul.a033430
Greenwood, K. E., Landau, S., & Wykes, T. (2005). Negative symptoms and specific cognitive impairments as combined targets for improved functional outcome within cognitive remediation therapy. Schizophr Bull, 31(4), 910-921.
Guo, N.-W., Liu, H.-C., Wong, P.-F., Liao, K.-K., Yan, S.-H., Lin, K.-P., . . . Hsu, T.-C. (1988). Chinese Version and Norms of the Mini-Mental State Examination. [Chinese Version and Norms of the Mini-Mental State Examination]. Journal of Rehabilitation Medicine Association (16), 52-59.
Guo, X., Zhang, Z., Zhai, J., Fang, M., Hu, M., Wu, R., . . . Zhao, J. (2012). Effects of antipsychotic medications on quality of life and psychosocial functioning in patients with early-stage schizophrenia: 1-year follow-up naturalistic study. Compr Psychiatry, 53(7), 1006-1012. doi:10.1016/j.comppsych.2012.03.003
Haynes, V. S., Zhu, B., Stauffer, V. L., Kinon, B. J., Stensland, M. D., Xu, L., & Ascher-Svanum, H. (2012). Long-term healthcare costs and functional outcomes associated with lack of remission in schizophrenia: a post-hoc analysis of a prospective observational study. BMC Psychiatry, 12, 222. doi:10.1186/1471-244X-12-222
Helldin, L., Kane, J. M., Karilampi, U., Norlander, T., & Archer, T. (2007). Remission in prognosis of functional outcome: a new dimension in the treatment of patients with psychotic disorders. Schizophr Res, 93(1-3), 160-168. doi:10.1016/j.schres.2007.01.014
Horacek, J., Bubenikova-Valesova, V., Kopecek, M., Palenicek, T., Dockery, C., Mohr, P., & Höschl, C. (2006). Mechanism of Action of Atypical Antipsychotic Drugs and the Neurobiology of Schizophrenia. CNS Drugs, 20(5), 389-409. doi:10.2165/00023210-200620050-00004
Hu, W.-Y., Chiu, T.-Y., Bhikkhu, H.-M., Chen, C.-Y., & Chen, Y.-C. (1999). Spiritual Needs of Terminal Cancer Patients from the Viewpoint of Medical Professionals. Formosan Journal of Medicine, 3(1), 8-19.
Jeste, D. V. (2013). A fulfilling year of APA presidency: From DSM-5 to positive psychiatry. Am J Psychiatry, 170(10), 1102-1105. doi:10.1176/appi.ajp.2013.1701001
Jeste, D. V., Lieberman, E. J. A., Fassler, D., & Peele, R. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®), Fifth Edition. Washington, DC: American psychiatric association.
Jha, A., Sadhukhan, S. K., Velusamy, S., Banerjee, G., Banerjee, A., Saha, A., & Talukdar, S. (2012). Exploring the quality of life (QOL) in the Indian software industry: a public health viewpoint. International journal of public health, 57(2), 371-381.
Kau L.-J., Yeh E.-K., Lin M.-Y., Chu T.-F., Chou M.-H., & Li S.-I. (1981). A study with the revised Chinese version of Brayman's Comprehensive Occupational Therapy Evaluation Scale. Chinese Journal of Psychology, 23, 1-7.
Karow, A., Moritz, S., Lambert, M., Schottle, D., Naber, D., & Initiative, E. (2012). Remitted but still impaired? Symptomatic versus functional remission in patients with schizophrenia. Eur Psychiatry, 27(6), 401-405. doi:10.1016/j.eurpsy.2011.01.012
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull, 13. doi:10.1093/schbul/13.2.261
Keefe, R. S. E. (2007). Cognitive deficits in patients with schizophrenia: effects and treatment. J Clin Psychiatry, 68 Suppl 14, 8-13.
Koster, M., & Bergsma, J. (1990). Problems and coping behaviour of facial cancer patients. Social science & medicine, 30(5), 569-578.
Kwekkeboom, K. L., Abbott-Anderson, K., & Wanta, B. (2010). Feasibility of a patient-controlled cognitive behavioral intervention for pain, fatigue, and sleep disturbance in cancer. Paper presented at the Oncology nursing forum.
Lallart, E., Jouvent, R., Herrmann, F. R., Perez-Diaz, F., Lallart, X., Beauchet, O., & Allali, G (2014). Gait control and executive dysfunction in early schizophrenia, J Neural Transm (Vienna), 121(4), 443-450. doi:10.1007/s00702-013-1111-0
Lancon, C., Bayle, F. J., Llorca, P. M., Rouillon, F., Caci, H., Lancrenon, S., & Gorwood, P. (2012). Time-stability of the "Functional Remission of General Schizophrenia" (FROGS) scale. Eur Psychiatry, 27(6), 437-441. doi:10.1016/j.eurpsy.2011.02.014
Leclerc, A., Pietri, F., Boitel, L., Chastang, J.-F., Carval, P., & Blondet, M. (1992). Level of education, lifestyle, and morbidity in two groups of white collar workers. Journal of epidemiology and community health, 46(4), 403-408.
Lee, P.-C., Kuo, M.-J., & Li, C.-Y. (2005). Quality of Life among Manual Workers in the Steel Manufacturing Industry. Fu-Jen Journal of Medicine, 3(2), 81-90.
Lin, C.-Y., Chen, H., & Pakpour, A. H. (2016). Correlation between adherence to antiepileptic drugs and quality of life in patients with epilepsy: a longitudinal study. Epilepsy & Behavior, 63, 103-108.
Lin, C.-Y., Li, Y.-P., Lin, S.-I., & Chen, C.-H. (2016). Measurement equivalence across gender and education in the WHOQOL-BREF for community-dwelling elderly Taiwanese. International psychogeriatrics, 28(8), 1375-1382.
Lin, Y.-C. (2002). A Study of the Relationships Between Female Manager Quality-Work life and Work Adjustment. (Master), Zhongyuan University, Taoyuan.
Llorca, P. M., Lancon, C., Lancrenon, S., Bayle, F. J., Caci, H., Rouillon, F., & Gorwood, P. (2009). The "Functional Remission of General Schizophrenia" (FROGS) scale: development and validation of a new questionnaire. Schizophr Res, 113(2-3), 218-225. doi:10.1016/j.schres.2009.04.029
Lundy, J. J., Coons, S. J., Wendel, C., Hornbrook, M. C., Herrinton, L., Grant, M., & Krouse, R. S. (2009). Exploring household income as a predictor of psychological well-being among long-term colorectal cancer survivors. Quality of Life Research, 18(2), 157-161.
Macfarlane, G. J., Thomas, E., Papageorgiou, A. C., Croft, P. R., Jayson, M. I., & Silman, A. J. (1997). Employment and physical work activities as predictors of future low back pain. Spine, 22(10), 1143-1149.
Marchesi, C., Affaticati, A., Monici, A., De Panfilis, C., Ossola, P., & Tonna, M. (2014). Predictors of symptomatic remission in patients with first-episode schizophrenia: a 16years follow-up study. Compr Psychiatry, 55(4), 778-784. doi:10.1016/j.comppsych.2013.12.011
Martini, L. C., Barbosa, J. B. N., Petreche, B., Fonseca, A. O., Santos, F. V. D., Magalhaes, L., Marques, A.G., Soares, C., Cordeiro, Q., Attux, C., Bressan, R.A., (2018). Schizophrenia and work: aspects related to job acquisition in a follow-up study. Braz. J. Psychiatry. 40 (1), 35-40. doi:10.1590/1516-4446-2016-2128
Mock, V., Pickett, M., Ropka, M. E., Lin, E. M., Stewart, K. J., Rhodes, V. A., . . . McCorkle, R. (2001). Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer practice, 9(3), 119-127.
Mohr, P., Rodriguez, M., Bravermanova, A., Melicher, T., Ceplova, Z., Cermak, J., & Pecenak, J. (2014). Social and functional capacity of schizophrenia patients: A cross-sectional study. Int J Soc Psychiatry, 60(4), 352-358. doi:10.1177/0020764013489673
Morosini, P. L., Magliano, L., Brambilla, L., Ugolini, S., & Pioli, R. (2000). Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatr Scand, 101(4), 323-329.
Naz, S., Hashmi, A. M., & Asif, A. (2016). Burnout and quality of life in nurses of a tertiary care hospital in Pakistan. JPMA. The Journal of the Pakistan Medical Association, 66(5), 532-536.
Neill, C. M., & Kahn, A. S. (1999). The role of personal spirituality and religious social activity on the life satisfaction of older widowed women. Sex Roles, 40(3), 319-329.
Noh, J.-W., Kim, J., Park, J., Kim, H.-j., & Kwon, Y. D. (2015). Gender difference in relationship between health-related quality of life and work status. PLoS One, 10(12), e0143579.
Park, H. K., Chun, S. Y., Choi, Y., Lee, S. Y., Kim, S. J., & Park, E.-C. (2015). Effects of social activity on health-related quality of life according to age and gender: an observational study. Health and quality of life outcomes, 13(1), 140.
Poulsen, M. G., Poulsen, A. A., Khan, A., Poulsen, E. E., & Khan, S. R. (2012). Factors associated with subjective well‐being in cancer workers in Queensland. Journal of medical imaging and radiation oncology, 56(3), 347-353.
Powell, P. A., Azlan, H. A., Simpson, J., & Overton, P. G. (2016). The effect of disgust-related side-effects on symptoms of depression and anxiety in people treated for cancer: a moderated mediation model. Journal of behavioral medicine, 39(4), 560-573.
Ramsey, S. D., Andersen, M. R., Etzioni, R., Moinpour, C., Peacock, S., Potosky, A., & Urban, N. (2000). Quality of life in survivors of colorectal carcinoma. Cancer, 88(6), 1294-1303.
Ratjen, I., Schafmayer, C., di Giuseppe, R., Waniek, S., Plachta-Danielzik, S., Koch, M., . . . Schlesinger, S. (2017). Postdiagnostic physical activity, sleep duration, and TV watching and all-cause mortality among long-term colorectal cancer survivors: a prospective cohort study. BMC cancer, 17(1), 701.
Reddy, L. F., Llerena, K., & Kern, R. S. (2016). Predictors of employment in schizophrenia: The importance of intrinsic and extrinsic motivation. Schizophr Res, 176(2-3), 462-466. doi:10.1016/j.schres.2016.08.006
Reis, P. F., Peres, L. S., Tirloni, A. S., Reis, D. C. d., Estrázulas, J. A., Rossato, M., & Moro, A. R. P. (2012). Influence of anthropometry on meat-packing plant workers: an approach to the shoulder joint. Work, 41(Supplement 1), 4612-4617.
Ribeiro, S. M. d. F., Braga, C. B. M., Peria, F. M., Martinez, E. Z., Rocha, J. J. R. d., & Cunha, S. F. C. (2017). Effects of zinc supplementation on fatigue and quality of life in patients with colorectal cancer. Einstein (São Paulo), 15(1), 24-28.
Rios, K. A., Barbosa, D. A., & Belasco, A. G. S. (2010). Evaluation of quality of life and depression in nursing technicians and nursing assistants. Revista latino-americana de enfermagem, 18(3), 413-420.
Rubenstein, and Laurence Z. (2006). Falls in older people: epidemiology, risk factors and strategies for preventio. Age Ageing, 35, 37-41. doi: 10.1093/ageing/afl084
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2009). Kaplan & Sadock`s Comprehensive Textbook of Psychiatry. Ninth Edition Philadelphia: Lippincott Williams & wilkins.
Saha, S., Chant, D., Welham, J., & McGrath, J. (2005). A systematic review of the prevalence of schizophrenia. PLoS Med, 2(5), e141. doi:10.1371/journal.pmed.0020141
Schennach-Wolff, R., Jager, M., Seemuller, F., Obermeier, M., Messer, T., Laux, G., . . . Riedel, M. (2009). Defining and predicting functional outcome in schizophrenia and schizophrenia spectrum disorders. Schizophr Res, 113(2-3), 210-217. doi:10.1016/j.schres.2009.05.032
Schmidt, M. E., Wiskemann, J., Armbrust, P., Schneeweiss, A., Ulrich, C. M., & Steindorf, K. (2015). Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: a randomized controlled trial. International journal of cancer, 137(2), 471-480.
Sharpley, C. F., Bitsika, V., & Christie, D. R. (2010). ‘Why I feel bad’: refinement of the Effects of Prostate Cancer Upon Lifestyle Questionnaire and an initial exploration of its links with anxiety and depression among prostate cancer patients. Psycho‐Oncology, 19(8), 839-846.
Short, P. F., & Mallonee, E. L. (2006). Income disparities in the quality of life of cancer survivors. Medical care, 16-23.
Slesina, W., Rennert, D., & Patzelt, C. (2010). Prediction models on return to work of rehabilitants following vocational training programme participation. Rehabilitation (Stuttg), 49(4), 237‐247. doi:10.1055/s-0030-1261903
Strasser, B., Steindorf, K., Wiskemann, J., & Ulrich, C. M. (2013). Impact of resistance training in cancer survivors: a meta-analysis. Medicine & Science in Sports & Exercise, 45(11), 2080-2090.
Streibelt, M., & Egner, U. (2013). A systematic review of the predictors of return to work following vocational retraining. Rehabilitation (Stuttg), 52(2), 111‐118. doi:10.1055/s-0032-1323670
Su, C.C., Bai, Y.M., Chou, M.H., Wang, J.D., Yang, Y.K., (2018). Estimate dynamic changes of dysfunction and lifelong spent for psychiatric care needs in patients with schizophrenia. Eur. Psychiatry. 54, 65-70.
Świtaj, P., Anczewska, M., Chrostek, A., Sabariego, C., Cieza, A., Bickenbach, J., & Chatterji, S. (2012). Disability and schizophrenia: a systematic review of experienced psychosocial difficulties. BMC Psychiatry, 12(1), 193. doi:10.1186/1471-244x-12-193
Taghavi, S. M., Mokarami, H., Nazifi, M., Choobineh, A., Marioryad, H., & Kujerdi, M. F. (2014). The Influence of Socio-Demographic, Health and Work-Related Factors on Health-Related Quality of Life among Iranian Industrial Workers. Health, 6(16), 2250.
Tsang, H. W. H., Leung, A. Y., Chung, R. C. K., Bell, M., & Cheung, W. (2010). Review on vocational predictors: a systematic review of predictors of vocational outcomes among individuals with schizophrenia: an update since 1998. Australian & New Zealand Journal of Psychiatry, 44(6), 495-504. doi:10.3109/00048671003785716
Ucok, A., Serbest, S., & Kandemir, P. E. (2011). Remission after first-episode schizophrenia: results of a long-term follow-up. Psychiatry Res, 189(1), 33-37. doi:10.1016/j.psychres.2010.11.013
Vadiraja, H., Rao, R. M., Nagarathna, R., Nagendra, H., Patil, S., Diwakar, R. B., . . . Ajaikumar, B. (2017). Effects of yoga in managing fatigue in breast cancer patients: A randomized controlled trial. Indian journal of palliative care, 23(3), 247.
Valencia, M., Fresan, A., Barak, Y., Juarez, F., Escamilla, R., & Saracco, R. (2015). Predicting functional remission in patients with schizophrenia: a cross-sectional study of symptomatic remission, psychosocial remission, functioning, and clinical outcome. Neuropsychiatr Dis Treat, 11, 2339-2348. doi:10.2147/NDT.S87335
Vanaki, Z., & Vagharseyyedin, S. A. (2009). Organizational commitment, work environment conditions, and life satisfaction among Iranian nurses. Nursing & health sciences, 11(4), 404-409.
Wang, S., Wang, J., Chang, J., Wu, B., Wang, T., & Sun, H. (2020). Symptomatic remission affects employment outcomes in schizophrenia patients. BMC Psychiatry 20, 219. https://doi.org/10.1186/s12888-020-02630-z
Wang, S., Wang, J., Chang, J., Wu, B., Chern, J., & Wang, T. (2020). Frailty affects employment outcomes in patients with schizophrenia in noncompetitive employment: A 4-year longitudinal study. Schizophrenia Research. https://doi.org/10.1016/j.schres.2020.04.026
Wehman P, Sherron P, Kregel J, Kreutzer J, Tran S, & Cifu D. (1993). Return to work for persons following severe traumatic brain injury: Supported employment outcomes after five years. Am J Phys Med Rehabil., 72(6):355-363.
Winters-Stone, K. M., Dobek, J., Bennett, J. A., Nail, L. M., Leo, M. C., & Schwartz, A. (2012). The effect of resistance training on muscle strength and physical function in older, postmenopausal breast cancer survivors: a randomized controlled trial. Journal of Cancer Survivorship, 6(2), 189-199.
World health organization (2001). International classification of functioning, disability and health: ICF. Switzerland: World health organization.
Wu, B. J., Lan, T. H., Hu, T. M., Lee, S. M., & Liou, J. Y. (2015). Validation of a five-factor model of a Chinese Mandarin version of the Positive and Negative Syndrome Scale (CMV-PANSS) in a sample of 813 schizophrenia patients. Schizophr Res, 169(1-3), 489-490. doi:10.1016/j.schres.2015.09.011
Wu, B. J., Lin, C. H., Tseng, H. F., Liu, W. M., Chen, W. C., Huang, L. S., . . . Lee, S. M. (2013). Validation of the Taiwanese Mandarin version of the Personal and Social Performance scale in a sample of 655 stable schizophrenic patients. Schizophr Res, 146(1-3), 34-39.
Yanos, P. T., Rosenfield, S., & Horwitz, A. V. (2001). Negative and supportive social interactions and quality of life among persons diagnosed with severe mental illness. Community mental health journal, 37(5), 405-419.
Yeh, W.-Y., Cheng, Y., Chen, C.-J., Hu, P.-Y., & Kristensen, T. S. (2007). Psychometric properties of the Chinese version of Copenhagen burnout inventory among employees in two companies in Taiwan. International journal of behavioral medicine, 14(3), 126-133.
論文全文使用權限
  • 同意授權校內瀏覽/列印電子全文服務,於2020-08-11起公開。
  • 同意授權校外瀏覽/列印電子全文服務,於2020-08-11起公開。


  • 如您有疑問,請聯絡圖書館
    聯絡電話:(06)2757575#65773
    聯絡E-mail:etds@email.ncku.edu.tw