Journal of Taiwan Occupational Therapy Research and Practice
目的：社區復健中心（即精神復健機構-日間型）之設置為臺灣社區精神復健服務類型之一。本研究主旨為探討社區復健中心慢性精神疾患（通稱精神病人）之手部靈巧度表現，包括性別、年齡、學歷、工作性質等因素在手部靈巧度表現的差異。方法：本研究對象為北部某精神科專科教學醫院附設四家社區復健中心之精神病人，研究者透過病歷記載收集精神病人基本資料，並由四家社區復健中心內各一名資深職能治療師，藉普渡插板測驗，以團體方式施測精神病人。普渡插板測驗是評估雙手靈巧度的標準化測驗，測量兩種手部活動的靈巧度。結果：本研究對象共205名，男性為91位，佔44.4%，81.5%診斷為精神分裂病，學歷為高中職者佔58.0%，平均年齡為39.01歲。五個分項成績：慣用手、非慣用手、雙手、慣用手加非慣用手加雙手、及組合與性別、年齡、診斷及學歷無達到統計上顯著差異（ > .05）；與工作性質及復健慰勞金具統計上顯著差異（ < .001）。結論：四家社區復健中心精神病人的手部靈巧度表現大致上女性較男性為佳，復健慰勞金的高低與5個分項成績具有顯著性的正相關。然而，不同的工作性質具有顯著的差異性，在5個分項成績表現，發現競爭性就業組之手部靈巧度表現最佳、工作助理組次之、工作訓練組較差。推論手部靈巧度愈佳，工作效率愈好，工作表現愈能滿足職場相關工作技能等要求。手部靈巧度亦可作為臨床工作者訂定復健目標的參考。
Objective: The Community Rehabilitation Center that provides individual psychiatric rehabilitation programs for clients is one kind of community psychiatric rehabilitation services in Taiwan. The purposes of this study were to discuss the hand dexterity the clients in these centers and the difference that induced by the gender, age, educational backgrounds and the characteristics of job oriented programs. Methods: The sample was from the four Community Rehabilitation Centers that belonged to a psychiatric hospital in Taipei City. The demographic data was collected by chart review and the results of Purdue Pegboard Test were collected in groups by four senior occupational therapists. Purdue Pegboard Test is a standardized test and used to assess the dexterity of hand functions. Results: Two hundred and five clients were from the four Community Rehabilitation Centers. There were 44.4% (91) males, 81.5% schizophrenia, 58.0% graduated from senior high school, and the average age was 39.01 years old. The average of the 5 subtests were 6.33 (average deviation = 2.39) by the dominated hand, 3.00 (average deviation = 2.24) by the non-dominated hand, 4.33 (average deviation = 2.05) by both hands, 15.33 (average deviation = 6.27) by the sum of the dominated, non-dominated, and both hands, and 5.33 (average deviation = 7.59) by assembly. Conclusions: The hand dexterity of female was slightly better than male in these four centers. The remunerations by the job oriented training programs were positive significant relative with the 5 subtests. There was no significant difference between the four centers and the 5 subtests. Finally, there was a significant difference between different job oriented programs and the 5 subtests. The hand dexterity of the clients in competitive employment was much better than that of the job oriented training assistants in these four centers. The hand dexterity of the job oriented training assistants was much better than that of the clients accepted job oriented training programs. In this study, we suggest that better hand dexterity satisfied the job skill concerned requirement for psychiatric clients. Besides, the dexterity of hand function could be one of the references for clinicians to set the goals of rehabilitation programs.