社區居民與病患家屬對精神病患態度之探討

THE COMMUNITY AND FAMILY'S ATTITUDES TOWARD THE MENTALLY ILL

涉及精神病患的社會支持網絡建立的工作，必先清楚這些網絡中的成員對精神病患的態度。社區居民與病患家屬是社區網絡中的重要資源，因此，瞭解他們對精神病患的態度，才可能提供未來有關社區支持系統模式的設計。本研究隨機抽樣草屯地區的居民305位，及中部地區的療養院所之門診病患家屬198位，進行有關精神病患態度、概念、與語意量表的測試。研究結果如下：(1)社區居民與病患家屬對精神病患傾向同情、人本、照顧的「慈悲」與「社區心理衛生意識」的正向態度，而較不持強制管理或不願接近的「權威取向與社會限制」的負向態度；且病患家屬明顯地比社區居民更具正向態度，而不具負向態度。(2)社區居民與病患家屬都不認為精神病患是無效能、不活動、或具負面情緒的，但是病患家屬傾向將精神病患評價為無價值的、詭詐的、失敗的。(3)社區居民與病患家屬認為精神病患會胡思亂想、疑心病、與較大情緖變化的精神狀態偏差，以及喃喃自語、大吵大鬧、儍笑等的行為偏差，而社區居民比病患家屬更明顯地認定精神病患具有癡獃或「瘋子」的個性偏差。本研究並嘗試說明這些結果與態度改變及家庭支持間的關係。過去多位學者指出精神病患者與其親屬間的情緖關係品質，將影響該位患者是否會再發病（relapse）的因素之一（Vaughn & Leff, 1976；Vaughn, Snyder, Jones, Freema, & Fallon, 1982）。筆者過去曾對精神病患進行某些行為改變，治療效果在患者外宿後，便大打折扣。因此針對有關精神病患的治療效果，其層面不應再侷限於病患個體的處理。有關患者如何面對社會情境的因應及社會份子對其之影響，都應考慮在內。職是之故，如何增進病患的社會支持網絡，對將病患的治療有所影響（Nuechterlein & Dawson, 1984）。

To establish the social support system for the mentally ill, it is necessary to understand the attitudes of the members within the social network toward them. The community and the family are two important resources in this system. Understanding their attitudes toward the mentally ills will help to design a model of the social support system in the future. This study compares these two groups in semantic differentials, concept, and attitude toward mental patients. The results show that: 1. Both groups tend to hold positive attitudes such as sympathy, humanism, benevolence, and the ideology of mental health of the community toward the mentally ill. The family comparatively has more of these tendencies. 2. Neither group thinks that the mentally ill are important, inactive or negatively emotional; however, the family show more tendency to think the patients cheating, valueless, and being failure. 3. Both groups believe that the mentally ill have abnormal mentality and behaviors. The community shows a more obvious tendency to believe that the patients have problems in character. This study tries to reveal the relationships of these results with family supports and changes of the attitudes.