一位思覺失調症男病患受烙印的自我感受

The Self-Awareness of Stigma as Described by One Taiwanese Man Living with Schizophrenia at Day Care

背景：思覺失調症疾患存有慢性和退化的疾病特徵，儘管規則的接受藥物治療仍存有部份殘餘症狀，不僅造成社會大眾對於精神疾病的歧視和污名化現象，也嚴重影響病患的心理、婚姻、人際、家庭和職業等關係。對重視「家庭關係」和「面子」的華人社會而言，污名化的重要性與影響更甚於西方社會。目的：描述一位在日間病房男性思覺失調症病患受烙印之自我感受，以瞭解個案對於精神疾病的態度、看法、與社會互動情形和受疾病烙印的體會與經驗歷程。方法：使用深入訪談與個案共深度訪談五次，每次60-90 分鐘。結果： 依個案描述將結果歸納為三大主題：「無力感」、「陷入兩難- 告知與保密」、與「婚配阻礙」等結果。結論/ 實務應用：期望藉由此個案報告能幫助第一線精神醫療臨床護理人員瞭解精神疾患受疾病烙印之經驗，以便提供適切介入措施，期能藉此自我醒思對精神疾患烙印觀感，讓病患得到更好的照顧與家庭支持。

Background: Patients with schizophrenic disorder have chronic and regressive features which have residual symptoms even if the patients have received regular medication treatment. These symptoms not only cause discrimination and stigma but also influence patients’ psychological, marital, interpersonal, and occupational aspects. For Chinese, stigma may be much more serious and significant than that of Western people because of social culture and family structure. Purpose: This case report explored the perspectives of stigma as described by one Taiwanese man living with schizophrenia at a day care center. Method: Five in-depth interviews with the patient with each lasted 60 to 90 minutes. Results: Three core themes were explicated after data analysis: Feeling powerless, caught in a dilemma, and marriage block. Conclusions: The findings not only help psychiatric professional understand the experiences of stigma, but also provide suitable intervention for self-reflection of stigma for people with schizophrenia and enhance better caring and support for family.