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Title: | 臺灣高職學生精神疾病去汙名化之影片介入:隨機對照試驗 Video-based Intervention to Reduce Stigma of Mental Illness in Taiwanese Vocational High School Students: a Randomized Controlled Trial |
Authors: | Yu-Tzeng Wang 王又增 |
Advisor: | 張書森(Shu-Sen Chang) |
Keyword: | 高職學生,精神疾病,去汙名化,影片介入, vocational school students,mental illness,anti-stigma,video intervention, |
Publication Year : | 2018 |
Degree: | 碩士 |
Abstract: | 背景與目的:社會大眾對於精神疾病的汙名、偏見以及差別待遇的行為常造成精神疾病患者的負面經驗與感受,往往導致精神疾病患者主動求助的阻礙。先進國家推行精神疾病去汙名化的介入方案、政策,以期能改善社會大眾對精神疾病的認知、態度與行為。青春期是精神疾病發展的關鍵時期,精神疾病的汙名化可能會阻礙求助與早期治療,同時青春期所形塑的精神疾病負面刻板印象可能會延續到成年時期。近年研究採用影片介入的方式提供教育與接觸,初步顯示減少汙名的成效,然而尚未有針對青少年族群,比較教育與接觸影片之效果,以及對不同精神疾病的差異之研究。本研究旨在比較高職學生在觀看教育或接觸導向之影片後,對憂鬱症與思覺失調症汙名化認知、態度、與社會距離改變之成效。方法:本研究為隨機分派對照實驗,對象為臺灣某所高職之高一學生,將受試者隨機分派至三組:控制組,觀看與精神疾病無關之環保議題影片;知識教育影片組(教育導向),觀看憂鬱症與思覺失調症之知識影片;病患經驗影片組(接觸導向),觀看憂鬱症與思覺失調患者分享罹病與被歧視經驗之影片。所有參與者均以問卷測量精神疾病汙名化(認知、態度、社會社會距離)程度共三次(前測、立即後測、與兩個月後延宕後測),使用廣義估計方程式來檢驗各組汙名化程度變化之差異。結果:本研究一共收錄197名參與者,包括控制組64人、知識教育影片組68人,與病患經驗影片組65人。知識教育影片僅對思覺失調症在立即後測的認知有改善;而病患經驗影片在憂鬱症和思覺失調症之立即後測的社會距離有改善,同時對憂鬱症的態度在立即後測或兩個月延宕後測皆有改善。結論:基於影片之教育與接觸導向之介入,對於青少年的精神疾病汙名程度有立即與延宕之改善成效,但效果因介入導向、精神疾病、與汙名化面向而異。日後需要進一步研究影響成效差異之因素,以及增強與延續影片介入效果之方法,提供未來精神疾病去汙名化介入之指引。 Background and Purpose: Stigma, prejudice, and discriminative behaviors toward mental illness often lead to negative experiences and feelings, which in turn lead to barriers of help seeking, among patients with mental illness. Many developed countries implemented policies to reduce mental illness stigma by improving the awareness, attitude and behavior toward mental illness in the public. Many mental illnesses start during adolescence, and mental illness stigma may prevent help-seeking and early detection. Negative stereotyped perceptions toward mental illness that are shaped during adolescence may also continue into adulthood. Recent studies using video-based interventions that provide education and contact experiences showed some promising effects in reducing mental illness stigma. However, there is no previous study of comparing the effects between video-based education and contact on stigma toward different mental illnesses in adolescents. The purpose of this study is to compare the effects on knowledge, attitude, and social distance toward depression and schizophrenia of video-based education and contact in vocational high school students.Methods: We conducted a randomized controlled trial in first-year students in a vocational high school in Taiwan. Participants were randomly assigned to one of three groups. The control group watched a video of environmental issues not related to mental illness. The education group watched a video that provided information about depression and schizophrenia. The contact group watched a video of patients with depression or schizophrenia sharing their experiences of illness and discrimination. All participants completed a questionnaire that measured the level of mental illness stigma in three aspects (knowledge, attitude, and social distance) at three time points: pre-test, immediate post-test, and two-month follow-up. We examined group differences in changes of mental illness stigma using generalized estimation equation.Results: One hundred and nighty-seven participants were enrolled, including 64, 68, and 65 in the control group, education group, and contact group respectively. Video-based education showed an effect of improving knowledge toward schizophrenia at immediate post-test. Video-based contact experiences showed an effect of improving social distance toward both depression and schizophrenia at immediate post-test as well as improving attitude toward depression at both immediate post-test and two-month follow-up.Conclusion: Video-based education and contact interventions reduced stigma toward mental illness immediately and two months later in adolescents, while the effect varied by intervention (education versus contact), mental illness, and aspects of stigma. There is a need for future research into factors influencing the intervention effect and ways to enhance and prolong the effect of video-based interventions. The findings will inform future interventions aimed at reducing mental illness stigma. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/7544 |
DOI: | 10.6342/NTU201801862 |
Fulltext Rights: | 同意授權(全球公開) |
Appears in Collections: | 公共衛生碩士學位學程 |
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ntu-107-1.pdf | 3.21 MB | Adobe PDF | View/Open |
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