本研究目的是由深入探討八對慢性精神分裂症病患及其配偶在夫妻治療中，所呈 現的關注主題與溝通型態。採用敘述性的質性研究方法，個案來源於蕭淑貞等人（民 80 ） 國科會研究「精神分裂患者其家庭養育功能與其子女社會行為發展問題」，在本研究中，研 究者採觀察式參與和護理治療法進行收集資料。於連續三個月的治療過程中，每次以一小時 為原則，就其關心主題進行討論；徵得其同意採現場錄音，當治療結束後立即文字化，將病 患及其配偶在治療中所表達的言語和行為，寫成敘述體式過程記錄，以內容分析法，將治療 過程的主題與溝通行為加以系統分析、歸類。 研究結果發現，病患夫妻所關注的主題，可歸納為疾病資訊過程、個人內在認同過程、人際 互動過程三項建構類目。在每一主題之下，病患夫妻所表達的溝通型態，可歸納為促進溝通 、阻礙溝通二個向度，其中包含同理性、表達性、壓抑性、排斥性四項概念類目。此研究之 結果，可增加對居家照顧中夫妻治療有關的知識；及對精神分裂病患夫妻關注主題與溝通型 態的了解，提供臨床服務、護理研究及教育方面的參考應用價值；期望能配合病患回歸社區 之趨勢，提昇護理專業照顧之能力。

　　　　　The purpose of this study was to explore the concered themes and communication patterns of chronic schizophrenic patients and their spouses in the process of couple therapy. The research used the quilitative research design. Eight couples were tape recorded for one hour discussion across three months during the therapy. Data were transcribed into narratives and systematically analyzed and categoried. Results showed that the concerned themes during the therapy process could be categoried as illness information processing, intrapersonal identity processing, and inter-personal interaction processing. Communication patterns expressed by the couples under each theme could be viewed as facilitating or hindering communication; empathetic, expressive, suppressive, and rejected were categoried. Study findings highlighted the major foci during couple therapy of schizophrenic patients and their spouses were on the illness information. Couple therapy could improve communication pattern and facilitate change. The significance of the result demonstrated that nurse could take active roles in couple therapy.