大學生精神病去污名教育介入成效初探

A Pilot Study of Anti-Stigma Educational Intervention on Psychosis among University Students

研究目的：檢驗「精神病去污名教育介入」對大學生精神病污名化程度之影響以及檢驗有效去污名教育介入的潛在機制。研究方法：本研究對象共計207位大學生，分為實驗組（107人）及對照組（100人），收案時間為2014年5月至2014年6月，測量大學生對於精神病的污名化程度（包含：認知、態度與社會距離）、身心適應狀況，以及基本人口學資料。問卷施測共計三次，分別為前測、後測與一週後追蹤。以廣義估計方程式分析教育介入對實驗組與對照組污名化程度改變的效果；以結構方程模式進行路徑分析，檢驗教育介入對於精神病去污名的影響路徑。研究結果：在控制研究對象之身心適應狀況後，教育介入的實驗組相較於對照組在後測及追蹤的污名化程度顯著下降。路徑分析的結果支持精神病去污名教育介入的「訊號－認知－態度－社會距離」的完全中介效果路徑。研究結論：精神病去污名教育介入能降低大學生對於精神病的污名化程度。大學生可透過教育介入改變其對於精神病的認知，進而影響對待精神病的態度，最終影響與精神病患的社會距離。

Purpose: We investigated the effect of an anti-stigma educational programs on psychosis in undergraduate students. We also examined the mechanism underlying its effects. Methods: A total of 207 undergraduate students (107 in the experimental group and 100 in the control group) were recruited from May to June 2014. Participants completed selfreport questionnaires regarding stigma toward psychosis (i.e., cognition, attitude, and social distance), depressive symptoms, and demographic characteristics. Three waves of surveys were conducted, including pre-test, post-test, and one-week follow-up surveys. Generalized estimating equation analysis was used to examine the effect of the anti-stigma educational intervention program. Structural equation modeling (SEM) was used to examine the path underlying the intervention effect. Results: After controlling for depressive symptoms, the degree of stigma in the experimental group was significantly higher than that in the control group as indicated in the post-test and one-week follow-up survey. The results of the SEM showed the full mediation effect of the path from signal to cognition to attitude to social distance. Conclusions: Our findings indicate that the anti-stigma educational intervention program for psychosis can decrease the degree of stigma experienced by undergraduate students. Cognition can be changed via educational intervention, which influences the attitude toward psychosis, and then the social distance of patients with psychosis.