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題名：電腦輔助認知方案對社區思覺失調症患者之復健成效
書刊名：臺灣職能治療研究與實務雜誌
作者：呂淑貞／陳妍伶／高婷／莊堯安／潘璦琬
作者(外文)：Lu, Shu-jen／Chen, Yen-ling／Kao, Ting／Chuang, Anne／Pan, Ay-woan
出版日期：2015
卷期：11:1
頁次：頁10-23
主題關鍵詞：認知功能；認知復健治療；認知矯治；思覺失調症；Cognitive function；Neurocognitive rehabilitation；Cognitive remediation；Schizophrenia
原始連結：連回原系統網址new window
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  • 被引用次數被引用次數:期刊(2) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:2
  • 共同引用共同引用:0
  • 點閱點閱:7
目的：思覺失調症患者因認知能力不佳，容易阻礙其發揮和貢獻所長並融入社會當中，也會造成醫療與社會成本之增加。因此本研究希望藉由認知復健治療加上職業復健以增進思覺失調症患者的認知功能，進而提升其就業競爭力與穩定性。方法：本研究於新北市、桃園、臺南及高雄四地區收集實驗組共25人，提供十週的職前訓練團體輔以電腦化認知復健治療，以增進其注意力、記憶力及邏輯等認知功能；並於基隆及臺中兩地區收集對照組23人，提供職前訓練團體，但不另外施以認知復健治療。且於治療的前後，研究者評估受試者各項認知功能表現—包括注意力、記憶力、執行功能及症狀。結果：認知測驗方面，兩組在記憶表現上在訓練課程後皆達顯著水準（p ＜ .05 & p ＜ .001），而實驗組成員則特別在視覺立即記憶及聽覺記憶的保留表現上達顯著水準（p ＜ .05）。症狀方面，實驗組的前後測結果顯示，負性症狀有改善，特別是身體化症狀之下降（p ＜ .05）及憂鬱程度之降低（p=.05）。結論：持續十週、每週一次的職前訓練輔以每週三次的電腦化認知復健治療，能促進個案的視覺及聽覺記憶，和試誤學習上的表現，並且可降低個案的負性症狀。職前訓練本身較無上述方面的改善。
Objective: Poor cognitive function of people with psychiatric disabilities limits their ability for full community participation, and results in increased medical and social costs. This study aims to use neurocognitive rehabilitation combined with pre-vocational training to improve the cognition of people with psychiatric disabilities and their capability and stability in work. Methods: Twenty-five participants from 4 intervention groups in New Taipei City, Taoyuan, Tainan, and Kaohsiung and 23 participants from 2 control groups in Keelung and Taichung were recruited. The participants in the experimental group participated in a computer-assisted cognitive rehabilitation therapy and pre-vocational training program for 10 weeks, while the control group was provided with only pre-vocational training. Assessments in cognition-including attention, memory, and executive function-and symptoms were conducted immediately before and after the program. Results: In the performance of cognition, both the experimental and control groups had significant differences in memory before and after the 10- week training program (p ＜ .05 & p ＜ .001). The experimental group showed better immediate visual memory and retained auditory memory (p ＜ .05) after intervention than before intervention. Furthermore, the experimental group also showed better improvement in negative symptoms-especially in somatic symptom (p ＜ .05) and depression (p ＜ .1) after intervention than before intervention. Conclusion: The experimental group combined pre-vocational training program with neurocognitive rehabilitation three times a week, which showed better improved outcomes in the aspect of the visual and auditory memory, learning of trial-and error, and negative symptoms of people with psychiatric disabilities after intervention than before intervention. The control group did not exhibit the aforementioned gains after intervention.
期刊論文
1.王景麗、綦凌燕(2011)。技能訓練對精神分裂症患者認知功能的療效。中國康復醫學雜誌，26(6)，572-574。  延伸查詢new window
2.Bio, D. S.、Gattaz, W. F.(2011)。Vocational rehabilitation improves cognition and negative symptoms in schizophrenia。Schizophrenia Research，126(1-3)，265-269。  new window
3.Bowie, C. R.、McGurk, S. R.、Mausbach, B.、Patterson, T. L.、Harvey, P. D.(2012)。Combined cognitive remediation and functional skills training for schizophrenia: Effects on cognition, functional competence, and real-world behavior。American Journal of Psychiatry，169(7)，710-718。  new window
4.Bozikas, V. P.、Kosmidis, M. H.、Kiosseoglou, G.、Karavators, A.(2006)。Neuropsychological profile of cognitively impaired patients with schizophrenia。Comprehensive Psychiatry，47，136-143。  new window
5.Brekke, J. S.、Raine, A.、Ansel, M.、Lencz, T.、Bird, L.(1997)。Neuropsychological and psychophysiological correlates of psychosocial functioning in schizophrenia。Schizophrenia Bulletin，23(1)，19-28。  new window
6.Carr, V. J.、Dewis, S. A. M.、Lewin, T. J.(1998)。Preattentive visual search and perceptual grouping in schizophrenia。Psychiatry Research，79(2)，151-162。  new window
7.Gitelman, D. R.(2003)。Attention and its disorders。British Medical Bulletin，65(1)，21-34。  new window
8.Greig, T. C.、Zito, W.、Wexler, B. E.、Fiszdon, J.、Bell, M. D.(2007)。Improved cognitive function in schizophrenia after one year of cognitive training and vocational services。Schizophrenia Research，96(1-3)，156-161。  new window
9.Gupta, M.、Holshausen, K.、Mausbach, B.、Patterson, T. L.、Bowie, C. R.(2012)。Predictors of Change in Functional Competence and Functional Behavior After Functional Adaptation Skills Training for Schizophrenia。Journal of Nervous and Mental Disease，200(8)，705-711。  new window
10.Heinrichs, R. W.、Zakzanis, K. K.(1998)。Neurocognitive deficit in schizophrenia: A quantitative review of the evidence。Neuropsychology，12(3)，426-445。  new window
11.Kurtz, M. M.、Seltzer, J. C.、Shagan, D. S.、Thime, W. R.、Wexler, B. E.(2007)。Computer-assisted cognitive remediation in schizophrenia: What is the active ingredient?。Schizophrenia Research，89(1-3)，251-260。  new window
12.McGurk, S. R.、Meltzer, H. Y.(2000)。The role of cognition in vocational functioning in schizophrenia。Schizophrenia Research，45(3)，175-184。  new window
13.McGurk, S. R.、Mueser, K. T.、Derosa, T. J.、Wolfe, R.(2009)。Work, recovery, and comorbidity in schizophrenia: A randomized controlled trial of cognitive remediation。Schizophrenia Bulletin，35(2)，319-335。  new window
14.McGurk, S. R.、Mueser, K. T.、Feldman, K.、Wolfe, R.(2007)。Cognitive training for supported employment: 2-3 year outcomes of a randomized controlled trial。American Psychiatric Association，164(3)，437-441。  new window
15.McGurk, S. R.、Twamley, E. W.、Sitzer, D. I.、McHugo, G. J.、Mueser, K. T.(2007)。A meta-analysis of cognitive remediation in schizophrenia。American Psychiatric Association，164(12)，1791-1802。  new window
16.McGurk, S. R.、Wykes, T.(2008)。Cognitive remediation and vocational rehabilitation。Psychiatric Rehabilitation Journal，31(4)，350-359。  new window
17.Patel, A.、Knapp, M.、Romeo, R.、Reeder, C.、Matthiasson, P.、Everitt, B.、Wykes, T.(2010)。Cognitive remediation therapy in schizophrenia: Cost-effectiveness analysis。Schizophrenia Research，120(1-3)，217-224。  new window
18.Schaefer, J.、Giangrande, E.、Weinberger, D. R.、Dickinson, D.(2013)。The global cognitive impairment in schizophrenia: Consistent over decades and around the world。Schizophrenia Research，150(1)，42-50。  new window
19.Surti, T. S.、Corbera, S.、Bell, M. D.、Wexler, B. E.(2011)。Successful computer-based visual training specifically predicts visual memory enhancement over verbal memory improvement in schizophrenia。Schizophrenia Research，132(2/3)，131-134。  new window
20.Tolman, A. W.、Kurtz, M. M.(2012)。Neurocognitive predictors of objective and subjective quality of life in individuals with schizophrenia: A meta-analytic investigation。Schizophrenia Bulletin，38(2)，304-315。  new window
21.Tsai, M. T.、Wen, J. K.、Lin, H. N.、Soong, W. T.、Chen, C. C.(1978)。Application of Self-Rating Symptom Scales to Psychiatric Outpatients。Bulletin of Chinese Society of Neurology and Psychiatry，4，47-56。  new window
22.Tsai, M. T.、Lin, H. N.、Wen, J. K.、Soong, W. T.、Chen, C. C.(1979)。The Development of the "Taita Symptom Check List" for Self-Rating by Psychiatric Patients。Bulletin of Chinese Society of Neurology and Psychiatry，5，19。  new window
23.Tsang, H. W. H.、Leung, A. Y.、Chung, R. C. K.、Bell, M.、Cheung, W. M.(2010)。Review on vocational predictors: A systematic review of predictors of vocational outcomes among individuals with schizophrenia: An update since 1998。Australian and New Zealand Journal of Psychiatry，44(6)，495-504。  new window
24.Velligan, D. I.、Mahurin, R. K.、Diamond, P. L.、Hazleton, B. C.、Eckert, S. L.、Miller, A. L.(1997)。The functional significance of symptomatology and cognitive function in schizophrenia。Schizophrenia Research，25(1)，21-31。  new window
25.Wexler, B. E.、Bell, M. D.(2005)。Cognitive remediation and vocational rehabilitation for schizophrenia。Schizophrenia Bulletin，31(4)，931-941。  new window
26.Wykes, T.、Huddy, V.、Cellard, C.、McGurk, S. R.、Czobor, P.(2011)。A meta-analysis of cognitive remediation for schizophrenia: Methodology and effect sizes。The American Journal of Psychiatry，168(5)，472-485。  new window
27.Green, M. F.(1996)。What are the functional consequences of neurocognitive deficits in schizophrenia?。American Journal of Psychiatry，153(3)，321-330。  new window
28.Green, M. F.、Kern, R. S.、Braff, D. L.、Mintz, J.(2000)。Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the "right stuff"?。Schizophrenia Bulletin，26(1)，119-136。  new window
29.Stroop, J. R.(1935)。Studies of Interference in Serial Verbal Reactions。Journal of Experimental Psychology，18(6)，643-662。  new window
圖書
1.褚增輝(1997)。褚氏注意力測驗。臺北市：華健國際企業。  延伸查詢new window
2.高尚仁(1996)。心理學新論。台北市：揚智圖書有限事業公司。  延伸查詢new window
3.花茂棽、張本聖、林克能、楊建銘、盧小蓉、陳心怡(2005)。魏氏記憶量表。台北市：中國行為科學社。  延伸查詢new window
4.Ingram, R. E.、Price, J. M.(2001)。Vulnerability to Psychopathology: Risk across the Lifespan。New York, NY：Guilford Press。  new window
5.川島隆太(2006)。激腦大作戰--大腦功能活化訓練。新北市：新文京開發。  延伸查詢new window
6.Heaton, R. K.、Staff, P. A. R.(2008)。Computerised Wisconsin Card Sorting Test Version 4 (WCST)。Odessa, FL：Psychological Assessment Resources Inc.。  new window
7.Pfleger, U.(1996)。Computerunterstütztes kognitives trainingsprogramm mit schizophrenen patienten。New York, NY：Waxmann。  new window
8.Sternberg, Robert J.、李玉琇、蔣文祁(2005)。認知心理學。臺北：雙葉書廊有限公司。  延伸查詢new window
圖書論文
1.Cadenhead, K. S.、Braff, D. L.(2000)。Information processing and attention in schizophrenia: Clinical and functional correlates and treatment of cognitive impairment。Cognition in Schizophrenia: Impairments, importance, and treatment strategies。New York, NY：Oxford University Press。  new window
2.Nestor, P. G.、ÓDonnell, B. F.(1998)。The mind adrift: attentional dysregulation in schizophrenia。Oxford Textbook of Psychokpathology。New York, NY：Oxford University Press。  new window
 
 
 
 
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