思覺失調症患者接受精神衛生專業服務之烙印經驗

The Stigma Experience of Schizophrenic Patients Receiving Mental Health Services

本研究旨在瞭解思覺失調症患者接受精神衛生專業人員服務時之主觀烙印經驗與感受。以立意取樣於臺灣南部某醫學中心選定合乎研究標準：(1)診斷為思覺失調症；(2)曾有精神科住院經驗或正在日間病房住院；(3)精神症狀穩定，不影響會談者；(4)能以國台語溝通，有適當口語表達，並願意表達感受者。排除有暴力風險與有其它精神疾病診斷者。經人體試驗委員會審核通過，以半結構訪談指引進行面對面訪談，共訪談10位。最後利用紮根理論分析方法進行資料分析。結果顯示「規訓的雙重桎梏」為核心概念，由三主題組成：(1)感知規訓的存在；(2)判斷工作態度；(3)絆與伴──形成經驗。本研究結果有助專業人員重新檢視自我對精神疾病患者之態度。

The purpose of this study was to explore the experience of stigma perceived by persons with schizophrenia within the premises of mental health services. The study was conducted in southern Taiwan. A purposive sample was selected amongst prospective participants solicited from a medical center and a community rehabilitation centre. The including criteria were persons who: (a) were diagnosed as schizophrenic; (b) had received inpatient psychiatric care or were being treated in a psychiatric daycare ward; (c) whose psychiatric symptoms did not interfere the interviews; and (d) could communicate in Chinese or Taiwanese, had adequate oral communication skills and were willing to express subjective feelings. Persons with schizophrenia who have a tendency for violence or acts of violence and have had other mental illness were excluded. This qualitative study was based on interviews with 10 schizophrenic persons. Data were analyzed with the grounded theory methodology. The main idea that emerged from the data analysis was a “Double bind of discipline”. The discipline is a three-part process in which persons with schizophrenia identify whether mental health professionals stereotyped them as schizophrenics or regarded them as human individuals. The process was successively: (a) Perception of the existence of discipline; (b) Evaluation of work attitude; and (c) Trammels and companion-from experience. The results of this study may help mental health professionals to re-examine themselves of the stigmatic attitude toward people with schizophrenia.