論文(碩士)--香港中文大學硏究院社會工作學部,1994. / 參考文獻: leaves 1-21(2nd group) / 梁夢熊. / 致謝 / 撮要 / Chapter 第一章： --- 緖論 --- p.1 / Chapter 第二章： --- 精神分裂症的家庭研究 --- p.5 / Chapter 第三章： --- 本研究各種概念的文献探討 --- p.16 / Chapter 第四章： --- 假設及名詞解釋 --- p.49 / Chapter 第五章： --- 研究方法 --- p.63 / Chapter 第六章： --- 研究结果 --- p.73 / Chapter 第七章： --- 討諭 --- p.125 / Chapter 第八章: --- 结論 --- p.147 / Chapter 第九章： --- 建議 --- p.154 / 參考文献 / 附錄A:中文問卷 / 附錄B ：英文問卷

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Au Wing-cheong. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (leaves 73-91). / Abstracts in English and Chinese. / LIST OF ABBREVIATIONS --- p.i / ACKNOWLEDGEMENT --- p.ii / ABSTRACT --- p.iii / LIST OF TABLES --- p.vii / LIST OF FIGURES --- p.viii / LIST OF APPENDICES --- p.ix / Chapter CHAPTER I. --- INTRODUCTION --- p.1 / Chapter CHAPTER II. --- REVIEW OF THE LITERATURE --- p.3 / The construct of community living skills --- p.3 / Assessment tools for community living skills --- p.6 / The St. Louis Inventory of Community Living Skills --- p.9 / Prediction of community level-of-care --- p.12 / Training community living skills in Hong Kong --- p.15 / Chapter CHAPTER III. --- RATIONALE FOR THE STUDY --- p.17 / de-institutionalization movement and community living skills training --- p.17 / Lack of structured community living skills assessment toolsin Hong Kong --- p.20 / The choice of the SLICLS for cross-cultural validation --- p.21 / Chapter CHAPTER IV. --- GENERAL METHODOLOGICAL CONSIDERATIONS --- p.23 / An introduction to the test construction procedures --- p.23 / An outline of the cross-cultural validation process --- p.24 / Issues concerning reliability of rating scales --- p.26 / Issues concerning validity of rating scales --- p.28 / Chapter CHAPTER V. --- METHOD --- p.31 / Translation of the SLICLS --- p.31 / Content validity of the SLICLS-C --- p.32 / Inter-rater reliability of the SLICLS-C --- p.34 / Internal consistency of the SLICLS-C --- p.35 / Construct validity of the SLICLS-C --- p.36 / Concurrent validity of the SLICLS-C --- p.37 / Predictive validity of the SLICLS-C --- p.38 / Ethical considerations --- p.41 / Chapter CHAPTER VI. --- RESULTS --- p.43 / The SLICLS-C --- p.43 / Content validity of the SLICLS-C --- p.44 / Inter-rater reliability of the SLICLS-C --- p.46 / Internal consistency of the SLICLS-C --- p.48 / Construct validity of the SLICLS-C --- p.49 / Concurrent validity of the SLICLS-C --- p.52 / Predictive validity of the SLICLS-C --- p.54 / Chapter CHAPTER VII. --- DISCUSSION --- p.59 / Validity of the SLICLS-C --- p.59 / Reliability of the SLICLS-C --- p.62 / Accuracy of the SLICLS-C in predicting community level of care --- p.63 / Significance of the study --- p.65 / Limitations of the study --- p.67 / Recommendations for further studies --- p.69 / Chapter CHAPTER VIII. --- CONCLUSION --- p.70 / REFERENCES --- p.73 / APPENDICES --- p.92

No description available.

Background: There is currently very little research on recovery from the perspective ofindividuals with recent-onset of psychotic disorders. Forming a better understanding ofthesubjective meaning ofrecovery and recovery experiences during this early phase ofrecovery caninform effective and meaningful service design and practices.Method: Thirty individuals recovering from psychosis and receiving specialized earlyinterventiontreatment were interviewed regarding the meaning and experience of recovery frompsychosis during the early phase (2-5 years) ofthe illness course.Results: Recovery was described as a multidimensional experience that included aspects of"illness recovery," "psychological recovery," and "social recovery." Seven common earlyrecovery experiences were identified. Individual variations in the magnitude ofdescribeddisruption of self and social functioning, duration ofthe illness-acceptance process and theprocess treatment negotiation greatly influenced the experience ofrecovery.Conclusion: Differences in illness acceptance and social recovery trajectories have importantimplications for understanding individual responses to the experience ofpsychosis, its diagnosisand treatment. These differences emphasize the importance of assisting individuals with theconstruction of meaning and the reengagement in social roles following the initial illnessexperience. / Contexte: Il y a actuellement peu de recherche sur la rétablissement du point de vue d'individusaprès un premier épisode de psychose. La formation d'une meilleure compréhension de senssubjectif des expériences de rétablissement pendant cette première phase de rétablissement peutinformer le design efficace et expressif des services et des pratiques.Méthode: Trente individus se rétablissement de la psychose et recevant un traitement depremière intervention spécialisé ont été interviewés à propos du sens et de l'expérience derétablissement de la psychose pendant la première phase (2-5 ans) du cours de maladie.Résultats: La rétablissement a été décrite comme une expérience multidimensionnelle qui ainclus des aspects de "la rétablissement de maladie," "la rétablissement psychologique," et "larétablissement sociale." Identifiées ont été sept premières expériences de rétablissementcommunes. Les variations individuelles dans l'étendue de perturbation décrite de soi et defonctionnement social, la durée du processus d'acceptation de maladie et de la négociation duprocessus de traitement ont beaucoup influencé l'expérience de rétablissement.Conclusions : Les différences dans les trajectoires d'acceptation de maladie et de rétablissementsociale ont des implications importantes pour comprendre les réponses individuelles àl'expérience de psychose, sa diagnose et traitement. Ces différences accentuent l'importanced'assister les individus avec la construction de sens et avec le réengagement dans les rôlessociaux après l'expérience de maladie initiale.

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Introdução: Estudos baseados em evidências estimam que grande parte dos pacientes com esquizofrenia apresentam prejuízos cognitivos significantes quando comparados com pessoas saudáveis. Os déficits cognitivos, como de atenção, de memória e, principalmente, das funções executivas, são os domínios fortemente prejudicados em pacientes que desenvolveram a doença. Déficits cognitivos são fortes preditores de resultados funcionais a longo prazo, tais como desempenho nas atividades básicas e instrumentais de vida diária, atividades sociais e profissionalizantes, mais do que os sintomas positivos e negativos. O tratamento farmacológico pode ser efetivo nos sintomas positivos e previnem recaídas, mas não tem o mesmo impacto nos déficits cognitivos, sintomas negativos e na funcionalidade. Algumas evidências sugerem que a combinação farmacológica e psicossocial podem ser eficazes na melhora de certas dimensões específicas da psicopatologia da esquizofrenia. Objetivos: O objetivo deste estudo é avaliar a eficácia da Terapia Ocupacional baseada no Método Occupational Goal Intervention na reabilitação de funções executivas de pacientes com esquizofrenia refratária. Trata-se de um estudo randomizado, simples-cego e controlado. Método: Vinte e cinco pacientes com diagnóstico de esquizofrenia refratária foram randomizados e distribuídos em dois grupos: experimental e controle (placebo). O grupo experimental recebeu 30 sessões de terapia ocupacional baseada no método Occupational Goal Intervention (OGI) e o grupo controle recebeu 30 sessões de atividades artesanais de livre escolha, sem intervenção ativa dos terapeutas. As medidas de desfecho primário avaliaram funções executivas pela bateria BADS e as de desfecho secundário avaliaram a funcionalidade do paciente e o seu desempenho nas atividades básicas e instrumentais de vida diária pelas escalas DAFS-BR e ILSS-BR. Além disso, o impacto da intervenção sobre as funções cognitivas foi avaliada por meio de bateria neuropsicológica que mediu as seguintes funções: atenção, funções executivas, memória e o QI estimado. A escala PANSS foi utilizada para monitorar a gravidade dos sintomas psicopatológicos durante o estudo. A eficácia do estudo foi avaliada por medidas de tamanho de efeito (d de Cohen). Resultados: Os resultados mostram melhoras importantes nas funções executivas e na funcionalidade dos pacientes quando comparados a não intervenção, porém não foram encontradas diferenças em termos de desempenho neuropsicológico entre os dois grupos / Summary: Introduction: Evidence based studies estimate that the majority of patients with schizophrenia have significant cognitive impairment compared with healthy people. Cognitive deficits such as attention, memory and mainly executive functions are the areas heavily affected in patients who developed the disease. Cognitive deficits are strong predictors of long-term functional outcomes, such as performance in basic and instrumental activities of daily living, social and professional activities, more than positive and negative symptoms. Pharmacological treatment may be effective on positive symptoms and prevent relapses but does not have the same impact on cognitive deficits and negative symptoms in functionality. Evidence suggests that the combination of pharmacological and psychosocial treatments can be effective in certain specific dimensions of psychopathology of schizophrenia. Objectives: The aim of this study is to evaluate the efficacy of occupational therapy based on the Occupational Goal Intervention (OGI) method in the rehabilitation of executive functions in patients with resistant schizophrenia. This is a randomized, single-blind and controlled trial. Method: Twenty-five patients with resistant schizophrenia were randomly divided in two groups: experimental and control (placebo). The experimental group received 30 sessions of occupational therapy based on the OGI method and the control group received 30 sessions of free choice craft activities, without active intervention of therapists. The primary outcome measure assessed executive functions by using the BADS battery and secondary outcome measures evaluated the patient\'s functionality and performance in basic and instrumental activities of daily living by using DAFS-BR and ILSS-BR scales. Furthermore, the impact of the intervention on cognitive function was assessed using several neuropsychological tests that measured the following functions: attention, executive functions, memory, and estimated IQ. The PANSS was used to monitor the severity of psychopathological symptoms during the study. The efficacy of the study was assessed by measures of effect size (Cohen d). Results: The results show important improvement in executive functions and functionality of patients when compared to non-intervention, however, were not found differences in neuropsychological performance between the two groups

Introdução: Estudos baseados em evidências estimam que grande parte dos pacientes com esquizofrenia apresentam prejuízos cognitivos significantes quando comparados com pessoas saudáveis. Os déficits cognitivos, como de atenção, de memória e, principalmente, das funções executivas, são os domínios fortemente prejudicados em pacientes que desenvolveram a doença. Déficits cognitivos são fortes preditores de resultados funcionais a longo prazo, tais como desempenho nas atividades básicas e instrumentais de vida diária, atividades sociais e profissionalizantes, mais do que os sintomas positivos e negativos. O tratamento farmacológico pode ser efetivo nos sintomas positivos e previnem recaídas, mas não tem o mesmo impacto nos déficits cognitivos, sintomas negativos e na funcionalidade. Algumas evidências sugerem que a combinação farmacológica e psicossocial podem ser eficazes na melhora de certas dimensões específicas da psicopatologia da esquizofrenia. Objetivos: O objetivo deste estudo é avaliar a eficácia da Terapia Ocupacional baseada no Método Occupational Goal Intervention na reabilitação de funções executivas de pacientes com esquizofrenia refratária. Trata-se de um estudo randomizado, simples-cego e controlado. Método: Vinte e cinco pacientes com diagnóstico de esquizofrenia refratária foram randomizados e distribuídos em dois grupos: experimental e controle (placebo). O grupo experimental recebeu 30 sessões de terapia ocupacional baseada no método Occupational Goal Intervention (OGI) e o grupo controle recebeu 30 sessões de atividades artesanais de livre escolha, sem intervenção ativa dos terapeutas. As medidas de desfecho primário avaliaram funções executivas pela bateria BADS e as de desfecho secundário avaliaram a funcionalidade do paciente e o seu desempenho nas atividades básicas e instrumentais de vida diária pelas escalas DAFS-BR e ILSS-BR. Além disso, o impacto da intervenção sobre as funções cognitivas foi avaliada por meio de bateria neuropsicológica que mediu as seguintes funções: atenção, funções executivas, memória e o QI estimado. A escala PANSS foi utilizada para monitorar a gravidade dos sintomas psicopatológicos durante o estudo. A eficácia do estudo foi avaliada por medidas de tamanho de efeito (d de Cohen). Resultados: Os resultados mostram melhoras importantes nas funções executivas e na funcionalidade dos pacientes quando comparados a não intervenção, porém não foram encontradas diferenças em termos de desempenho neuropsicológico entre os dois grupos / Summary: Introduction: Evidence based studies estimate that the majority of patients with schizophrenia have significant cognitive impairment compared with healthy people. Cognitive deficits such as attention, memory and mainly executive functions are the areas heavily affected in patients who developed the disease. Cognitive deficits are strong predictors of long-term functional outcomes, such as performance in basic and instrumental activities of daily living, social and professional activities, more than positive and negative symptoms. Pharmacological treatment may be effective on positive symptoms and prevent relapses but does not have the same impact on cognitive deficits and negative symptoms in functionality. Evidence suggests that the combination of pharmacological and psychosocial treatments can be effective in certain specific dimensions of psychopathology of schizophrenia. Objectives: The aim of this study is to evaluate the efficacy of occupational therapy based on the Occupational Goal Intervention (OGI) method in the rehabilitation of executive functions in patients with resistant schizophrenia. This is a randomized, single-blind and controlled trial. Method: Twenty-five patients with resistant schizophrenia were randomly divided in two groups: experimental and control (placebo). The experimental group received 30 sessions of occupational therapy based on the OGI method and the control group received 30 sessions of free choice craft activities, without active intervention of therapists. The primary outcome measure assessed executive functions by using the BADS battery and secondary outcome measures evaluated the patient\'s functionality and performance in basic and instrumental activities of daily living by using DAFS-BR and ILSS-BR scales. Furthermore, the impact of the intervention on cognitive function was assessed using several neuropsychological tests that measured the following functions: attention, executive functions, memory, and estimated IQ. The PANSS was used to monitor the severity of psychopathological symptoms during the study. The efficacy of the study was assessed by measures of effect size (Cohen d). Results: The results show important improvement in executive functions and functionality of patients when compared to non-intervention, however, were not found differences in neuropsychological performance between the two groups