精神障礙者家屬社會支持、權能感與烙印感之相關性探討

Abstract

長久以來，因為精神疾病的「不正常」，使得精神障礙者長期被污名與歧視，連帶導致家屬也成為被污名的一群。家屬在面對大眾的污名，產生自我烙印的現象，情緒受到影響、行為上退縮、認知上自我貶抑。本研究試圖驗證社會支持（正式與非正式）、權能感這兩大概念是否能夠成為抗烙印策略的因子，協助精神障礙者家屬跳脫自我烙印的陷阱；同時也試圖檢視社會支持與權能感之關係，希冀能作為充權實務之基礎。故本研究之研究目的有五：（1）檢視台灣目前精神障礙者家屬自我烙印的狀況（2）檢視台灣精神障礙者家屬權能感狀況（3）檢視台灣精神障礙者家屬所獲得的正式與非正式社會支持的狀況（4）檢視台灣目前精神障礙者家屬社會支持、權能感與烙印感之關係互動（5）期待本研究對於精神障礙者家屬的政策提供具體的建議。 本研究採取量化之研究典範，以結構式問卷調查為資料收集方式，研究對象為精神障礙者家屬，以立意取樣方式選取臺北市、臺北縣共5間社會福利機構、2間康復之家、1間社區復健中心、台北市某平宅以及網際網路，同時也透過研究者私人網絡進行抽樣。本次研究調查資料回收有效問卷數共177份。 研究結果分成三個部分。家屬的權能感部分，雙變項分析結果顯示當家屬的教育程度與家庭總收入越高，家屬的權能感就越高；同時，權能感的程度也與家屬本身是否參與家屬團體、以及精神障礙者對家務的協助顯著相關。在烙印感的部分，研究結果也顯示當家屬為女性、精神障礙者為男性，家屬烙印感會較深；檢視權能感與烙印感之間的關係，研究結果顯示這兩個變項是強烈且顯著的負相關，當家屬的權能感越高，自我烙印的程度也就越低。最後在多變量分析的結果顯示：家屬的權能感越高、與精神衛生專業人員的協同合作程度越好、家中幫忙照顧的人數越多，以及精障者本身對家庭的協助越多，精神障礙者家屬的烙印感程度也就越低。 立基於本次研究調查發現，研究者提出針對精神障礙者家屬增強權能以及降低烙印的實務與政策方針，並針對未來研究方向提出相關建議。

For decades, people with mental illness have been viewed as “abnormal people,” different from other people in the society. While they were stigmatized and discriminated against due to illness, their healthy family members shared the same stigmatized suffering due to no illness. Not only stigmatized from the public, their family members internally stigmatized themselves by experiencing shameful and guilt feelings, which affected their moods, withdrew themselves from the public, and devalued themselves as persons. This study intended to examine how empowerment and social support could buffer the feeling of stigmatization. The implications about practice and policy suggestions were included to discuss strategies of buffering the feeling of stigmatization or improving the feeling of empowerment. A quantitative research approach was used to examine the relationship among stigmatization, social support, and empowerment. Structured survey questionnaire was used to interview family members of people with mental illness. This study purposively sampled five social welfare agencies, two half-way houses, one community rehabilitation center, and one public housing project in Taipei area. Some interviewees were recruited through the Internet and my own private network. Finally, as a total, 177 valid questionnaires were completed for further statistical analyses. Findings included three parts. Regarding on the sense of family members’ empowerment, the bi-variant analyses study indicated the level of empowerment was higher in family members with higher educational level and higher family income level. And, the level of empowerment was found correlated with whether family members attended support group and how much people with mental illness helped with house chores. As for the self-stigma, the findings indicated that the level of self-stigma was higher in female family members and males with mental illness. When testing the relationship between the levels of empowerment and the level of self-stigma, the analysis indicated the two variables were strongly and negatively correlated. When the higher level of empowerment family members felt, the lower level of self-stigmatization family members felt. Finally, multi-variant analyses indicated that the lower level of self-stigmatization family members felt had to do with the higher level of empowerment, more helpers from the families, receiving more collaborative support from mental health professionals, and more assistance from people with mental illness. Based on the abovementioned findings, this study included practical strategies and policy suggestions as effective measures on buffering or reducing the level of self-stigmatization among family members who cared for people with mental illness.