一般民眾自殺預防守門人自我效能、助人信心與助人意圖：臺灣全國電話調查研究

Abstract

研究背景：過往針對一般民眾的自殺防治守門人自我效能（SE）之研究有限。 研究目的：本研究旨在探索臺灣一般成年民眾中文版的守門人自我效能量表（GKSES）之因素結構， 此量表共有9則子題；同時，本研究亦對守門人自我效能與助人信心及意圖之間的關係。 研究方法：本研究使用之資料來自2022年一項臺灣全國代表性電話調查，有效問卷共997份。研究首先以探索性因素分析（exploratory factor analysis）測量中文版GKSES的潛在因素，然後運用羅吉斯迴歸（logistic regression）分析自我效能與助人信心及意圖之間的關係。 研究發現：根據初步的因素分析萃取得出的二因子架構，據此將中文版GKSES分成SE-skill以及SE-knowledge兩個次量表。SE-skill（技巧）由五項與自殺風險偵測及因應技巧有關的題目所構成，SE-knowledge（知識）由四項與憂鬱、自殺及高自殺風險者可使用之資源的知識題目所構成。控制共變項及SE子量表後，SE-skill與助人信心及所有助人意圖（包括三項被建議的助人行動以及兩項不被建議的助人行動）呈正相關；SE-knowledge與助人信心及意圖採取一項被建議的助人行動（會幫助對方找專業人員，例如心理師、身心科醫師）呈正相關。 研究結論：自殺防治守門人培訓及訓練課程需著重加強一般民眾運用直接問句詢問自殺風險，以及清楚傳達「不建議這樣做」的訊息，例如：不應試圖說服對方自殺是不對的、或告訴對方自殺會令家人和朋友傷心。

Background: There were limited previous investigations of the gatekeeper self-efficacy (SE) in the general population. Aims: This study aimed to explore the factor structure of the Mandarin version of the nine-item Gatekeeper Self-Efficacy Scale (GKSES), and their associations with helping confidence and intentions in the Taiwanese adult population. Methods: Data was extracted from a nationally representative computer-assisted telephone survey conducted in 2022 (n=997). Exploratory factor analysis was conducted to examine the factor structure of the Mandarin version of the GKSES. Logistic regression analysis was performed to assess the associations between gatekeeper SE and helping confidence and intentions. Results: The EFA yielded a two-factor structure, and accordingly, the GKSES was divided into two components, SE-skill and SE- knowledge. SE-skill comprised five items related to the skills in detecting and managing suicide risk. SE-knowledge included four items associated with knowledge about depression, suicide and resources available for at-risk individuals. After adjusting for covariates and SE components, SE-skill was associated with helping confidence and the intentions to adopt all five helping actions (including three recommended actions and two unrecommended actions), while SE-knowledge was associated with helping confidence and intention to take only one recommended helping action (i.e., to help make an appointment with a professional). Conclusions: Suicide prevention gatekeeper training and educational activities should focus on encouraging people to ask direct questions about suicide risk and providing them with clear messages about “what not to do” (e.g., persuading the person that suicide is wrong or that suicide would hurt their friends and family).