Summary: | 碩士 === 國立臺灣大學 === 職能治療研究所 === 95 === Background
Antonovsky presented the concept of “sense of coherence” (SOC). It described that a person could adjust his life well if he could comprehend the experience of life, manage his life events, and gain the meaning of life. This concept has high application potential for psychiatric patients in adjustment of daily life and searching for the meaning of life. Therefore, the purposes of this study were to evaluate the reliability and validity of Chinese sense of coherence scale (SOC-13) in psychiatric patients, to find the correlation between SOC and activity participation, and to reveal the predictability of activity participation, quality of life, motivation, satisfaction of life and depressive symptoms to SOC. According to the study result, we wish to develop an evidence-based interventional model to promote mental health in psychiatric patients in the future.
Methods
This study was a cross-sectional design, collecting patients from psychiatric outpatient department, day-care center and sheltered workshop. We used purposive sampling method, and the inclusion criteria were those who were diagnosed to have schizophrenia and depression, aging 18-65 years, and having the ability to understand and answer the questionnaire. First, we test the reliability and validity of SOC-13, and then to evaluate the phenomenon of SOC. We used descriptive and inferential statistics to study the relationship between SOC-13 and related demographics. We also tried to reveal the correlation between SOC and activity participation, and used stepwise multiple regression to test the predictors to SOC.
Results
We collected 319 effective questionnaires. It had acceptable internal consistency reliability( Cronbach alpha=0.84) and test-retest reliability (r=0.53, p<0.001). The result of constructive validity showed that Chinese SOC-13 had single factor, and support the concurrent validity of SOC-13.
In activity participation, schizophrenic and depressive patients spent significantly more hours and had more negative affects in working activities than in leisure ones. Depressive patients also tend to have more sense of involvement and more positive affects in leisure activities than in working ones. The main common purpose of activity participation for schizophrenic and depressive patients was to provide physical and mental relaxation, and the second purpose was for economy. Another purpose for schizophrenic patients was to be together with others. Depressive patients had other purposes of responsibility and meet others’ expectations. Schizophrenic patients had other characteristics including more constant and limited activity sites and co-participation.
In activity participation and SOC, schizophrenic patients had correlation between SOC and subjective feeling of participation and negative affects of limitation. In depressive patients, there was significant correlation between SOC and activity type, duration, alone or co-participation, and subjective feeling of participation.
In schizophrenic patients, the SOC had significant correlation with quality of life(QOL), satisfaction with life, loss of motivation, depressive symptoms, subjective feeling of participation, and negative affects of limitation. The psychological domain in QOL was the main factor (43%). The psychological domain in QOL, depressed mood, and social relationship in QOL accounted for 47% of variability. In depressed patients, the SOC had significant correlation with QOL, satisfaction with life, automatic and loss of motivation, depressive symptoms, and the sense of involvement, positive affects, self worth. Depressed mood was the main factor (47%). Depressed symptoms, satisfaction with life, physical domain in QOL, and positive affects of participation accounted for 56% of variability.
Conclusion
This study revealed that SOC-13 had acceptable validity and reliability. Because the results were single factors, total scoring was suggested while using this scale.
In participation of activities, Schizophrenic patients had more limited and constant interpersonal relationship, so they had the desire to join others. Depressed patients considered the purpose of responsibility and others’ expectation in the meaningful and regular activities, which indicated that they had to cohere with the important others.
In SOC and activity participation, for schizophrenia we might help them to increase their SOC with activities by promoting sense of involvement, giving positive affects, increasing self worth and decreasing negative affects. In depressed patients, working activities might not be able to increase SOC, and related others played an important role to promote SOC.
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