臺灣博碩士論文加值系統

在我們的社會當中，精神疾病患者往往是最被汙名、歧視、邊緣化，也是處在最不利位置與最脆弱的一群。對精神疾病患者而言，一般人對精神疾病的負面印象與錯誤的假設，往往和疾病本身一樣具有傷害性。本研究目的主要是希望瞭解一般人在直接接觸精神疾病患者後，是否會改變對其之負面態度，進一步了解改變的是負面態度中的哪些面向，又有哪些因素會影響改變與否及改變的程度與方向，再探討改變的原因為何。本研究使用之汙名化量表為「對精神疾病態度之量表」，在參與者接觸精神疾病患者前與後進行施測以得量化資料，最後進行焦點團體訪談以得質性資料，再進行分析與討論。研究參與者共123人，85%為護理實習生，87%為女性，99%落於16-25歲，62%為閩南人，皆未婚，87%家庭月收入落於10萬元以下，64%無親友為精神疾病患者，53%曾接觸精神疾病患者。結果發現：1.收入較高者與先前未曾直接或間接接觸過精神疾病患者者，在接觸精神疾病患者前，對其抱持較負面之態度；2.不同人口學特質之參與者及所有參與者，在比較接觸精神疾病患者前後對精神疾患態度量表總分與六個子因素分數，於各面向與方向有不同之表現；3.實習生相較於學生志工，在接觸精神疾病患者後，於分隔因素、刻板因素及整體態度之去汙名效果較顯著；收入高者較收入低者於刻板因素之去汙名效果較顯著。基於上述研究結果，運用社會接觸假說讓參與者直接與精神疾病患者接觸，確實可以改變其對於精神疾病患者之態度，但改變之面向、方向與潛力並不完全相同，改變之原因與動力也需要被重視。本研究希望藉由實際應用社會接觸假說，驗證是否能減少對精神疾病患者之負面態度，並對於改變之內容、原因、動力與方向作分析，以對將來設計接觸活動提出具體有效之建議，進而促進對精神疾病患者之去汙名化。

In our society, the psychiatric patients are usually the most stigmatized, discriminated, marginalized, disfavored and fragile. For them, the negative beliefs and false assumptions are as harmful as the disease itself. The purpose of this research is to know if people changed their negative attitudes toward the psychiatric patients after contacting with them, which aspects of negative attitudes changed, which factors decided change or not, the degree and the direction of changing, and why they changed. We used Attitude Scale for Mental Illness as measurement tool for stigma toward psychiatric patients. Pre- and post-test data were gathered before and after the participants contacted with the psychiatric patients, then focus group interview was applied for qualitative data gathering. A total of 123 participants were recruited, 87% were girls,85%were intern students, 99% were 16 to 25 years old, 62% were Taiwanese, 87% monthly family income fewer than 100,000NTD, 64% had no family member or friend with psychiatric disorder, 53% had ever contacted with psychiatric patients, and all unmarried. The results revealed：1. The higher income, without friends and family member with psychiatric disorder, and never contact with psychiatric patients groups had more stigmatized attitude toward psychiatric patients before contact than the compared groups. 2. Comparing the pre- and post-test total score and subscores, total participants and each demographic subgroups had different changing profile (significant or not, positive or negative change). 3. The intern group is more changeable in separatism, stereotyping and total score compared to the student volunteer group; the higher income group is more changeable in stereotyping score compared to the lower income group. The result of this research confirmed applying social contact hypothesis could change the general negative attitude toward psychiatric patients. However, the aspects, directions and potential of changing were different among subgroups, and the dynamics and reasons of changing are also important. By analyzing above results, we want to design more effective and concrete contact programs and facilitate the destigmatization of psychiatric patients.

封面.............................................................................................................I
致謝...........................................................................................................II
中文摘要..................................................................................................III
英文摘要..................................................................................................IV
目錄..........................................................................................................VI
表目錄...................................................................................................VIII
圖目錄......................................................................................................IX

第一章緒論................................................................................................1
第一節研究背景與動機............................................................................1
第二節研究目的與問題............................................................................2
第二章文獻探討........................................................................................3
第一節精神疾病與精神疾病患者............................................................3
第二節汙名化............................................................................................7
第三節接觸假說與去汙名化..................................................................15
第四節研究假設......................................................................................26
第三章研究方法......................................................................................27
第一節研究參與者與場域......................................................................27
第二節研究設計及步驟..........................................................................28
第三節研究工具......................................................................................31
第四節資料分析......................................................................................35
第四章研究結果......................................................................................39
第一節基本資料描述統計......................................................................39
第二節接觸前人口學特質差異分析......................................................40
第三節接觸前後是否改變與改變方向…..............................................42
第四節接觸前後改變之人口特質因素..................................................46
第五節焦點團體訪談結果......................................................................48
第五章討論與建議..................................................................................53
第一節結果討論......................................................................................53
第二節研究限制......................................................................................61
第三節研究貢獻與建議..........................................................................62
參考文獻..................................................................................................64
附錄一志工服務內容與實習課表 ........................................................76
附錄二焦點團體訪談大綱......................................................................80
附錄三對精神疾病態度之量表..............................................................81
附錄四焦點團體訪談內容......................................................................85

表目錄
表1對精神疾病態度之量表之內容效度分析.......................................33
表2基本資料表.......................................................................................39
表3不同人口學特質之精神疾患態度前測分數變異數分析結果.......41
表4不同人口學特質之精神疾患態度前後測分數T檢定....................44
表5不同人口學特質之精神疾患態度改變分數變異數分析結果.......47
表6不同人口學特質之精神疾患態度改變之組內和組間差異……...59

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