Journal of Taiwan Occupational Therapy Research and Practice
目的：影響精神障礙者就業因素多元，臨床工作者使用各種不同與就業相關之評估工具協助個案釐清就業相關問題，以提升就業成功率。本研究探討精神障礙者工作相關評量工具，以人類職能模式做為工具分類基準，檢視工具評量面向，並探討量表之評分方式與計分形式。方法：本文使用文獻回顧的方式，在Medline, CINAHL及PsycInfo等資料庫中以下列三組關鍵字搜尋英文實證型文獻，包括：(1)精神醫學，(2)職業、工作，(3)心理計量特性、信度、效度。並以人類職能模式為理論根據，將被研究之工具歸類為單面向評估工具或多面向評估工具。另統計各評估工具之量表評估方式與計分形式。結果：經篩選後共21個工具納入本次分析。依據人類職能模式，共有12項(57.1%)工具被歸類為多面向評量工具，9項(42.9%)工具歸類為單面向評估工具。單面向評估工具中，評量個案環境支持度之工具最多(n=5, 23.8%)，其次為評量個案表現能力(n=4, 19.0%)。量表評估方式以個案自填式問卷為主(n=9, 42.9%)，會談式評量次之(n=5, 23.8%)；量表計分形式以李克氏量尺(n=18, 85.7%)為主，其中又以五點量尺最多(n=9, 50%)。結論：人類職能模式可協助臨床治療者檢視影響精神障礙者工作復健相關因素，於臨床應用時，合併多項單面向評估結果，或使用多面向評估工具，較能多元化地協助釐清精障者就業相關問題。
Background: There are many factors associated with the outcomes of vocational rehabilitation for individuals with mental illness. Thus, a well developed assessment providing comprehensive data for intervention is important. The purpose of the study is to use the Model of Human Occupation (MOHO) to probe the evaluation dimensions of the assessments. Methods: We conducted a literature review using databases of Medline, Psyclnfo, and CINAHL, and a combination of three groups of key-words was used to perform the search. We categorized these assessments into two different types based on the Model of Human Occupation. In addition, we counted the frequency of different formats of the assessments. Results: Twenty one assessments were identified. Based on the MOHO, twelve assessments (57.1%) were categorized as multiple subsystems assessments; night assessments (42.9%) were categorized as single subsystem assessments. Environmental domain (n=5, 23.8%) and performance skills domain (n=4, 19.0 %) were evaluated the most frequently. Most of the scales were designed as self-report format (n=9, 42.9%); Likert-type scales were used the most frequently. Five-point rating scale was the most common type (n=9, 50%). Conclusions: The Model of Human Occupation provides the therapists a comprehensive framework to analyze clients' needs and plan further vocational rehabilitation. When choosing assessments, clinicians need to consider using several single domain tests, or multidimensional assessments to understand the strengths and limits of individuals with mental illness.