The changes in ex-mental patients attending a psychiatric rehabilitation program with holistic care.

摘要

It is well documented that most patients with chronic mental illness suffer from severe psychosocial dysfunction. Recent studies also suggest many patients have spiritual problems. A review of the present psychiatric rehabilitation services in Hong Kong shows that it lacks structured rehabilitation programs especially the informal community programs in the form of self-help group (SHG). Furthermore, spiritual support is also neglected in most if not all of the psychiatric rehabilitation programs.;A mixed research method with three studies was adopted to examine the changes of the participants in the program. In the first study, a non-equivalent group design was used to measure the changes indexed by objective outcome indicators. A control group (N = 154) with no randomization but matched with the experimental group (N = 109) was used for comparison. In the second study, in-depth interviews with the participants (N = 20) were used to measure their subjective experiences in the group. In the third study, repertory grid tests based on 19 informants were used to measure the changes in terms of the self-identity system.;The findings in Study 1 showed that those who joined the SHG had more friends and more satisfaction socially than those without joining the group. Duration of attendance, religious and group involvement were three key factors related to the change of functioning of the group members. In Study 2, the subjective experiences of the participants were positive and they perceived positive changes in the group. SHG was also perceived as a useful means to reduce loneliness and enhance rehabilitation. The findings based on the repertory grid method in Study 3 showed that there were perceived positive changes in the self-identity system of the informants. They perceived themselves more similar to the ideal self and an ideal ex-mental patient while more dissimilar to an unsuccessful person.;An integration of findings from all three studies suggests that the program was beneficial to their participants in the physical, psychological, social and spiritual aspects with dominant positive changes in the psychosocial dimension. The findings also underscore the therapeutic forces available in small groups and the positive effect of the long-term nature of SHG. Furthermore, the study indicates the importance of spiritual intervention and its therapeutic values in psychiatric rehabilitation.;This research aims to study the changes and the related factors in ex-mental patients attending the psychiatric rehabilitation program with holistic care organized by a Christian non-government organization, which has successfully formed 12 SHGs within the past 10 years. This holistic care rehabilitation program is characterized by a SHG approach with a holistic care content in which spiritual support is much emphasized. Spiritual intervention is in the form of hymn singing, Bible reading, personal sharing and intercessions.