정신분열병 환자의 직업재활 프로그램 모형 개발에 관한 연구 = (A) Study on Development of Vocational Rehabilitation Program Models for Schizophrenic Patients

다국어 초록 (Multilingual Abstract)

This study is research on developing a practical vocational rehabilitation program according to the level of social skills and needs of schizophrenic patients in each stage of this program as a final step in social rehabilitation.
First of all, this study used the vocational rehabilitation program of Dr. Liberman, and a 7 stage vocational rehabilitation program as a result of analyzing the process of current Korean vocational rehabilitation programs. As well, it assessed the general attributions and social skills of 297 schizophrenic patients in all the community mental health centers. The following is the result of surveying and analyzing schizophrenic patients' need during their progress in vocational rehabilitation.
First, there was no correlation between general attributions(age, sex, academic background, marital status, total treatment periods), vocational history, and social skills(the critical indicator in vocational rehabilitation for schizophrenic patients).
Second, the higher social skilled group of schizophrenic patients have more needs in each stage of a total vocational rehabilitation program than the lower skilled group. Therefore, it is discovered that social skills in schizophrenic patients are the most important indicator in their treatment and rehabilitation.
Third, the result of assessing the need for social skills in schizophrenic patients at each stage of vocational rehabilitation should a significant relationship with the stage of ① job skill training, ② work skill assessment, ③ sheltered employment, but no significant relationship with ④ work adjustment training, ⑤ transitional employment, ⑥ job finding, ⑦ job maintenance.
Therefore, the vocational rehabilitation program for schizophrenic patients as a result of this study is dualized as ① a common process which is composed of preparation process; social skills training and assessment, job skill training, and sheltered employment and ② an individualized process which is composed of job finding and job maintenance, and it would be 5 stage process as a total.
At first, schizophrenic patients didn't want to be in social skills training and preparation because of the duplication of contents in work adjustment training and work skill assessment in the 7 stages of rehabilitation in this study. As well, it was proposed that social skills training process be a first stage and be followed by subordinate process which assess as social skills as occasion demands in order to prevent unnecessary duplication due to the similarity of these two processes to social skills training and to directly connect with social skills training and vocational rehabilitation program.
Then comes the job skill training process which is a common stage after the social skills training and assessment process. Schizophrenic patients learn job skills depending on their ability and needs and then go to the sheltered employment stage.
This study excluded the sheltered employment stage from the vocational rehabilitation program model. The transitional employment stage can be unstable employment for the schizophrenic patients who have already completed the vocational rehabilitation program because they are subject to social prejudice and disadvantage to schizophrenic patients. Therefore, the sheltered employment in this study should be extended to community as a concept including transitional employment and also wages should be realized.
Next, job finding and job maintenance in the individualized process were not selected as considering stigma of schizophrenic patients but was made up of individualized process including two stages as job finding and job maintenance as a requisite process in vocational rehabilitation program. Therefore, it should be divided into two groups of schizophrenic patients - one who wants to find a job individually and another who wants to go through the mental health agency and facility. The latter can attend an individualized program continuously and the former be provided opportunity to attend whenever they want to.
The model of vocational rehabilitation program as a result of this research study reflected the need of each process of vocational rehabilitation program by the survey and assessment of Korean schizophrenic patients. This model can be adjusted especially to the mental health agency and facility like community mental health center or social rehabilitation facility to improve effectiveness for vocational rehabilitation in Korean situation. This can be more effective when the mental health professionals apply this model to vocational rehabilitation for schizophrenic patients as a team approach in their agency.
To apply the result of this study to a practical setting for a vocational rehabilitation for schizophrenic patients, suggestions are made as follows:
The social skills training process, the first stage in this model, should be expanded and reinforced more than in current vocational rehabilitation programs. The whole process in this program model should be connected with community for vocational rehabilitation for schizophrenic patients.
In conclusion the vocational rehabilitation program for schizophrenic patients should be practiced in community, demerits be ameliorated, and the subordinate programs in each stage be supplemented and identified.

목차 (Table of Contents)

• Ⅰ. 서론 = 1
• 1. 문제의 제기 = 1
• 2. 연구의 의의와 목적 = 5
• 3. 연구의 범위와 한계 = 7
• Ⅱ. 이론적 배경 = 8
• 1. 정신분열병 환자의 직업재활의 연구동향 = 8
• 2. 정신분열병 환자의 직업재활 = 10
• 3. 정신분열병 환자의 직업재활 프로그램 = 23
• Ⅲ. 연구방법 = 52
• 1. 연구설계 = 52
• 2. 조사대상 = 54
• 3. 조사도구 = 54
• 4. 자료수집 = 58
• 5. 자료분석 = 59
• Ⅳ. 조사결과 = 60
• 1. 조사대상자의 일반적 속성 = 60
• 2. 일반적 속성과 사회기술능력 = 62
• 3. 사회기술능력에 따른 직업재활 욕구의 차이 = 63
• 4. 영역별 사회기술능력이 직업재활 욕구에 미치는 영향 = 67
• 5. 사회기술능력 상위집단의 직업재활 욕구 = 71
• 6. 사회기술능력이 직업재활 욕구에 미치는 영향 = 74
• Ⅴ. 고찰 = 76
• 1. 일반적 속성과 사회기술능력 = 76
• 2. 사회기술능력에 따른 직업재활 욕구의 차이 = 78
• 3. 사회기술능력이 직업재활 욕구에 미치는 영향 = 79
• Ⅵ. 정신분열병 환자의 직업재활 프로그램 모형 = 89
• Ⅶ. 결론 및 제언 = 99
• 참고문헌 = 102
• 영문초록 = 122
• 부록 = 125