目的：本研究旨在了解某精神專科醫院慢性精神病人參與職能復健模式第三、四及五階每月參與工作訓練人數、項目、產值（參與工作訓練時間、工作獎勵金）之變化情形；考慮慢性精神病人人口學、健康狀況和活動及參與後，比較病房別、工作訓練團體別、庇護工作坊別、復健機構別、工作訓練別等間參與工作訓練時間及工作獎勵金之差異情形。方法：本研究係屬回溯及前瞻性因果關係研究；針對目的一之樣本取自某精神專科醫院

2011 年 9 月 1 日至 2013 年 8 月 31 日慢性病房住院病人及附設社區復健中心學員共 747名，共得 11,485 人次數，目的二之樣本取自某精神專科醫院 2013 年 4 月 1 日至 8 月 31日慢性病房住院病人及附設社區復健中心學員共 437 名樣本，共計 2,076 人次數。研究資料以樞紐分析、描述性統計、廣義性估計模式分析性統計法進行分析。結果：2011 年9 月 1 日至 2013 年 8 月 31 日其工作訓練項目數增加 10 項（第三階 6 項，第四階 4 項）；第三階工作訓練時間減少0.4小時，但每月平均工作獎勵金則反而從188元增加至204元。而第五階在每月平均工作訓練時間及平均工作獎勵金，第二年皆比第一年增加，如 49.4小時／月提高至 53 小時／月，1,176 元／月增加至 1,290 元／月，且年總獎勵金也從第一年 1,521,934 元增加至第二年 1,797,787 元，大幅提升 275,853 元。另，在考慮第三、四及五階慢性精神病人人口學、健康狀況和活動及參與後，病房別及庇護性工作坊之平

均工作時間及工作獎勵金的每月改變量大部分無顯著差異。結論：2 年間第三階至五階工作訓練項目數增加 10 項（第三階 6 項，第四階 4 項）；第三階層工作產值增加（平均工作時數減少，獎勵金增加）；而第五階在工作產值（工作訓練時間及工作獎勵金）逐年大幅提升。另，在病房別及庇護性工作坊之平均工作時間及工作獎勵金的每月改變量大部分皆無顯著差異，顯示所有樣本之病房及工作坊皆持續努力發展工作訓練之復健。建議未來應建立第三階及第四階明確分級制度，依工作訓練種類及工作所需能力來訂定工作產值比（時薪），以能更順利推動進階機制及激發病人進階之潛能。

This study aims to explore the changes in the monthly number of job training, projects, and production value (participation in work training time, work incentives ) in the third, fourth, and fifth training stage of the functional rehabilitation model for chronic mental patients in a mental hospital. Moreover, after considering the demographics, health status, activities and participation of chronic mental patients, we compared the differences in participation training time and work incentives among wards, work training groups, sheltered workshops, rehabilitation centers and work trainings. The study was retrospective and prospective. The purpose one: samples recruited from chronic mental inpatient in psychiatric hospital of September 1, 2011 to August 31, 2013 and clients in rehabilitation centers total 747 clients (a total of 11,485 documents). The purpose two: samples recruited from a chronic mental inpatient in psychiatric hospital of April 1, 2013 to August 31, 2013 and clients in rehabilitation center total 437 samples (a total number of 2,076 documents). Research data were analyzed by Pivot, descriptive statistic, generalized estimating equation, and analytical statistical. The results showed that the number of job training increased 10 items from September 1, 2011 to August 31, 2013 (third training stage increased 6 items, fourth training stage increased 4 items). The average of monthly working hours were 9.8 hours in third stage (September 1, 2011 to August 31, 2012). The average of monthly working hours was 9.4 hours in third stage (September 1, 2012 to August 31, 2013). In the second year, although the average of monthly job training time decreased by 0.4 hours, but the average of monthly work incentives are increased from 188 to 204 dollars. It’s revealed that increased in production capacity. The average of working hours and job training incentives in fifth stage were increased. Compared to the first year, the average of working hours increased from 49.4 hours/month to 53 hours/month and the average of job training incentives increased from 1176 dollars/month to 1290 dollars/month in second year. And the total incentive also increased from 1,521,934 dollars to 1,797,787 dollars, significantly increasing 275,853 dollars. After considering demographics, health status, activity and participation of chronic mental patients in third, fourth and fifth stage, the average change of working time and work incentives were no significant differences between wards and sheltered workshops. It displays that chronic housing of wards, job training group and sheltered workshops and rehabilitation work training can be balanced development. It is suggested that establishing explicit classification system about stage three and four, therefore we can depend on the type of work and the ability of job training to set the production value ratio (hourly wage), it’s also more successful in  promoting and stimulating the patient’s advanced potential.