| 摘要: | 對於慢性精神病患的管理而言，有組織、有系統的出院後社區照顧有其必要性，因此精神病患的後續追蹤是非常重要的一環。無線定位系統可以決定無線通訊產品，如行動電話，的所在位置。今天此種技術與服務已純熟，可應用於社區精神醫療照護中。有鑑於此，本研究希望能落實社區精神病患追蹤照護的精神，藉由架構一個完善的醫療定位追蹤系統，可以結合精神科醫療與公共衛生體系，並評估此系統對病患的社會功能與情緒反應，達到完整的精神衛生社區醫療保健服務網絡。
基於目前PHS手機其低功率與待機時間長的優點，所以此追蹤管理照護系統將以PHS手機為初步探討之Target Station設備。因此精神病患在應用此追蹤管理照護系統LBHS (Location-Based Healthcare System)之後，將藉由四個rating scales（The Rosenberg Self -Esteem Scale, The Quality of Life Scale, Brief Psychiatric Rating Scale and Affect Intensity Measure）用以評估此系統對於病患的自信心是否提升、生活滿意度是否增加、病情是否有影響以及情緒是否有波動的現象。
本研究之病患基本資料就描述性分析而言，加入本研究的個案與松山區的精神衛生照護病患結構上相符合，並無太大的差異性。就病人的疾病分類與性別、年齡、婚姻、教育程度之間的相關性而言，在統計上也無顯著性差異。
以The Rosenberg Self-Esteem Scale 與The Quality of Life Scale 評量表而言，本研究之個案其前測與三次後測結果，經Wilcoxon signed rank test檢定後（p值皆為0.000），p值皆小於0.05。而Brief Psychiatric Rating Scale 與Affect Intensity Measure評量表而言，本研究之個案其前測與三次後測結果，經Wilcoxon signed rank test檢定後，p值皆大於0.05。
本研究之個案使用系統次數，與The Rosenberg Self-Esteem Scale後測之結果（p值為0.000），經卡方檢定後p值小於0.05，有顯著的差異性。而個案使用系統次數，與The Quality of Life Scale、The Brief Psychiatric Rating Scale、The Affect Intensity Measure後測之結果沒有顯著的差異性。
本追蹤系統對於病患之自信心與生活滿意度提升，在統計上有顯著差異。但是三次後測之間統計上並無顯著意義；表示使用此系統一段時間後，生活滿意度並不會再提高。而且追蹤系統對於病患之病情與情緒影響，在統計上無顯著差異。表示使用次數的多寡與自信心的提升有明顯相關意義表示使用次數的多寡與生活滿意度的提升、病情的影響、情緒的波動沒有差異。綜合以上推論，本研究之結果顯示定位系統對精神病患而言有正向幫助。
For the management of chronic psychiatric patients, it is necessary to provide the organized and systemic tracing mechanism after the admission. The step of following management plays a very important role in the mechanism. The development of advanced technology will enhance wireless mobile devices as useful tools for location, tracing and care-management. In this study, we deploy LBHS (Location-Based Healthcare System) in the community, which is the application of location-based service combined with wireless communication system. Taking the advantages of lower power, longer battery time and less harm to human health, we use the PHS handset as our target station in this system.
After the patients utilizing the location-based system, we use four rating scales （The Rosenberg Self -Esteem Scale, The Quality of Life Scale, Brief Psychiatric Rating Scale and Affect Intensity Measure）to evaluate the effect of psychiatric patients on their self-esteem, life quality, and disease exacerbation and emotion fluctuation.
The distribution of patients rolled in our study is not different with the distribution in the Sung-Shan Area Health Center. The statistic relationship between the classification of diseases and the sex, age, marriage and education of patients is not significant. After utilization of this system, the patients have more self -esteem to themselves, better quality of their life, no exacerbation of their disease and no influence on their emotion. The more frequency the patients use the system, and the more self-esteem to themselves. Apparently this system can help psychiatric patients to go outside confidently and join our society.
By implementing the Location-Based Healthcare System, the healthcare system can build up a complete network, from prevention, therapy to rehabilitation. Without question, a good healthcare system is the significant key for human being. Using advanced technology of the Location-Based Healthcare System will benefit to the psychiatric patients’ health and improve their quality of life. |
