目的：體重過重會影響健康，目前國人普遍有體重過重問題已受到相當重視，然而，長期住院慢性精神病患其身體質量指數(Body Mass Index, BMI)≧24kg/平方公尺體重過重盛行率皆較台灣一般民眾為高，本研究旨在探討慢性精神分裂症病患，經過兩個月進行20次徒步併8次衛教課程後，對體重及身體質量指數的影響。方法：採兩組時間序列研究設計，以立意取樣方式，將南區某精障養護所符合BMI值大於24kg/平方公尺有體重過重之慢性精神分裂症病患62名，依樓層之功能分成實驗組32名及對照組30名。研究期間為98年05月起至99年02月止，前半年先瞭解全體受測者體重及BMI值變化，之後，實驗組進行兩個月徒步併衛教課程並提供代幣以增強減重動機，對照組則參與常規性活動，如：宗教團康、手語律動及戶外體能。實驗結束後二個月再追蹤瞭解其體重回增情形。研究工具包括個人基本資料表、減重成果記錄表及體位測量器，並以體重、身體質量指數作為評估指標。所收集之資料以描述性統計、卡方考驗、成對樣本考驗、獨立樣本考驗等統計方法處理分析。結果：樣本的年齡分佈在52.85±8.26歲，男性居多(53.2%)；教育年數分佈在8.97±4.24年；障礙等級以重度者居多(62.9%)；多數者無代謝方面疾病(61.3%)。實驗組與對照組在性別、年齡、教育年數、障礙等級、代謝疾病，皆無顯著差異。在實施徒步合併衛教課程前半年，實驗組與對照組的體重、BMI值變化，無顯著差異。經兩個月徒步合併衛教課程後，實驗組與對照組在體重變化方面，前後測達顯著差異(t=3.64, p=.001; t=3.99, p<.001)；在身體質量指數變化方面，實驗組與對照組前後測達顯著差異(t=3.44, p=.002; t=3.92, p<.001)，顯示全體受試者之體位變化，無論在體重、身體質量指數，均有顯著性的降低。另外，在終止徒步合併衛教課程二個月後追蹤體重回增，發現實驗組與對照組之體位變化，無論在體重、身體質量指數，均有顯著性增加。結論：由研究結果顯示為期兩個月的徒步合併衛教課程有助於慢性精神分裂症病患改善體重及身體質量指數。此外，對照組在體重、身體質量指數也達顯著性的降低值得進一步探討。另外，體重回增原因是否因精障者受限減重動機、認知障礙及飲食習慣問題，需透過持續徒步合併衛教課程之輔助下始可達到減重成效，有待進一步研究探討。本研究結果可做為精神障礙養護機構推展減重計畫之參考。

Objective: The purpose of this study is to explore the effect of a two month program, involving 20 walking sessions combined with 8 health education courses, on the body weight and BMI of chronic schizophrenic patients. Methods: This study used a two groups time series design. Subjects were selected by purposive sampling methods, 62 chronic schizophrenic patients with BMI greater than 24kg/m^2 were selected from a psychiatric sanatorium in southern Taiwan and divided into an experimental group with 32 subjects and a control group with 30 subjects. The experimental group was assigned to a two month walking combined health education program. The control group participated in routine activities. A follow-up measurement the subjects' weight changes was conducted two months after the experiment. The study instruments used included demographic data sheet, weight loss results log and a weight scale, using body weight, BMI as indicators. Results: After two months of walking combined health education program, the changes in body weight in pre and post test among the experimental and control groups showed significant differences (t=3.64, p=.001; t=3.99, p<.001); changes in BMI in the experimental group and control group showed significant differences (t=3.44, p=.002; t=3.92, p<.001), indicating that the changes in body weight of all study subjects, regardless of weight, BMI, were significantly reduced. In addition, the follow up study two months after termination of the walking combined health education program found that the weight and BMI of the both the experimental and control groups were significantly increased. Conclusion: The results demonstrate that the two-month walking combined health education program can assist chronic schizophrenic patients to improve body weight and BMI. The results of this study can be used as a reference in the promotion of weight loss programs in psychiatric sanatorium institutions in Taiwan.