Journal of Taiwan Occupational Therapy Research and Practice
目的:本研究目的旨在瞭解中部某精神專科醫院於所提供之工作復健服務，了解曾經參與第三階工作訓練團體和第四階庇護性工作坊之慢性精神病人，分析其參與工作復健之工作項目種類、人次及工作獎勵金等，以評值及檢討是否提供適當工作復健服務，作為未來在規劃慢性精神病人工作復健計畫之依據。方法:針對中部某精神專科醫院於民國89 年1 月1 日至103 年12 月31 日在職能復健模式第三階工作訓練團體、第四階庇護性工作坊之慢性精神病人，收集職能復健模式五階層及獎勵金資料庫;為求該院之工作訓練職種與就業市場之職業分類有一致性，故於103 年7 月參考「中華民國職業標準分類」，將所有第三階工作訓練團體和第四階庇護性工作坊之工作訓練項目重新分類和編碼，分為:1. 事務工作; 2. 服務工作及售貨; 3. 園藝農牧工作; 4. 非技術工及體力工、技術工; 5. 產業治療，利用SPSS14.0 版統計軟體及excel 樞紐分析進行資料分析，分析其參與之工作項目種類、參與工作訓練人次及工作獎勵金等資訊。結果:工作訓練參與者平均年齡為43.9 歲;性別方面，以男性居多，佔65.5%;在疾病診斷上，以思覺失調症為最大宗，佔84.6%，第二為情感性精神病，佔7.3%，器質性腦徵候群佔3.5%。在第三階工作訓練團體參與人次方面，以清潔工12,371 人次為最多;在第四階庇護性工作坊參與人次方面，前三名為院內工作訓練、代工和清潔大隊。在工作獎勵金總值方面，第三階工作訓練團體累計4,827,030 元，第四階庇護性工作坊累計69,190,690 元，兩階合計工作獎勵金共74,017,720 元。在第三階和第四階每日平均工作獎勵金方面，第三階工作訓練團體每日工作獎勵金平均為20.3 元，在第四階庇護性工作坊每日工作獎勵金平均為74.2 元，最高洗衣坊為340.2 元，中西餐工作坊為217 元次之，洗車坊160 元為第三，最少為院內代工38.4 元。在第四階庇護性工作坊之每小時獎勵金方面，最高為洗衣坊56.7 元，次之為洗車坊53.3 元，第三為中西餐43.4 元，因統計資料長達15 年，平均獎勵金與現況有些差異，故進一步分析民國102-103 年之第四階庇護性工作坊每小時獎勵金，以清潔大隊每小時獎勵金53.5 元為最高，洗衣坊50.3 元為次之，洗車坊41 元為第三，較接近目前該院現況。結論:參考『中華民國職業標準分類』將該院工作訓練職種重新編碼，使該院之工作訓練與國內職業別相關統計能在一致比較基礎下，可相互連結應用;對應到身心障礙者勞動狀況調查，發現該院大宗提供之清潔服務、餐飲等工作復健，與精障者從事之職業、期待或職訓需求相吻合，可見該院提供之工作復健確實能對精障者產生助益。
Objectives: The purpose of this study was to understand the work rehabilitation services provided by a psychiatric hospital in the central part of Taiwan. To understand the chronic psychiatric patients who have participated in the third stage work training groups and the fourth stage sheltered workshops and to analyze their participation in work rehabilitation types of work items, attendance and work incentives, etc. To assess and review whether work rehabilitation was properly provided and to serve as the basis for future work rehabilitation programs for people with chronic psychiatric disorders. Methods: In view of the fact that in a psychiatric hospital in the central part of Taiwan from January 1, 1989 to December 31, 2010 chronic psychiatric patients who have participated in the third stage work training groups and the fourth stage sheltered workshops of Occupational Rehabilitation model to collect the Five Stages and the Reward Database. In order to be consistent with the occupational classification of the job market and the work rehabilitation types of work items, in July 2014, with reference to the “Classification of Occupational Standards of the Republic of China”, the work rehabilitation types of work items of the hospital was recoded and coding of the third stage work training groups and the fourth stage sheltered workshops are divided into 1. Business work 2. Service work and sales 3. Horticulture agriculture and animal husbandry 4. Non-skilled and manual workers, skilled workers 5. Industrial therapy. We utilized SPSS14.0 statistical software and Excel hub analysis to analyze data, including analysis of types of work items, attendance and work incentives, etc. Results: The average age of the participants in work rehabilitation was 43.9 years old; in terms of gender, the majority were male, accounting for 65.5%; in the diagnosis of the disease, the most was schizophrenia, accounting for 84.6%; the second was bipolar disorder, accounting for 7.3 %, organic mental disorder accounted for 3.5%. In terms of participation in the third stage work training groups, cleaners were the most frequent. In the fourth stage sheltered workshops, the top three were in-hospital work training, foundry and cleaning team. In respect of the total value of the third stage work training groups work bonus, the third stage work training group accumulated a total of NTD4,827,030, the fourth stage sheltered workshops accumulated NTD69,190,690 and the total work bonus amounted to NTD74,017,720. The average daily working bonus of the third stage working training groups was 20.3 NTD. The average daily working bonus of the fourth stage sheltered workshops was 74.2 NTD, the highest laundry workshop was 340.2 NTD, the Chinese- Western food workshop was 217 NTD, the car-washing workshop was 160 NTD for the third, and the hospital foundry was the least , 38.4 NTD. In the fourth stage sheltered workshops, the maximum hourly reward for laundry workshop was 56.7 NTD, followed by car washing was 53.3 and the third by Chinese-Western food workshop was 43.4 NTD. Due to the statistical data of up to 15 years ,the average bonus and the current situation is somewhat different, so further analysis of hourly reward for the fourth stage sheltered in 102-103 Republic of China, cleaning team reward 53.5 NTD per hour for the highest, Laundry 50.3 NTD for the second, 41 NTD for the washing workshop for the third, closer to the current status of the hospital. Conclusion: With reference to the “Classification of Occupational Standards of the Republic of China”, the work rehabilitation types of work items of the hospital was recoded so that the work rehabilitation of the hospital and the occupational statistics could be used in conjunction with each other on a consistent and comparative basis. Corresponding to the survey on labor conditions of persons with disabilities, it was found that the hospital provided a large bulk of cleaning and food work rehabilitation are in good agreement with those required for occupation, expectation or vocational training. This shows that the work rehabilitation provided by this hospital can really help people with severe disability.