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  • 學位論文

從社會支持對壓力因應之影響檢視自殺防治政策

A Review of Suicide Prevention Policy from Social Support Impact on Stress Coping

指導教授 : 黃心怡

摘要


為了預防及降低自殺行為的發生,我國自殺防治政策分別針對高自殺風險者與全體民眾制定出數項策略,其中作為推動核心的「推展守門人概念」與「關懷訪視」,即是希望鼓勵眾人相互關懷、通報高自殺風險個案,再由自殺關懷訪視員給予專業協助的方式來建立起防護網絡。但策略能否發揮效用,仍須回到個體的層面視之,因為文獻顯示,個體的社會支持程度與壓力因應型態都將影響其面對重大事件所採取的態度與行為,甚至是對外求助的意願。因此,本研究係從社會支持與壓力因應型態的角度出發,藉由質化訪談與方案評估的方式,檢視兩項策略於地方的政策意涵、實施計畫、策略成效、成功的執行經驗以及執行困境,釐清是否所有高自殺風險者都可透過「推展守門人概念」與「關懷訪視」達到增補社會支持的效果?並於最後針對執行困境提出建議。 研究結果發現基隆市與新北市在兩項策略的政策意涵上仍與中央相同,僅實施計畫視地區特性而各有差異。至於策略成效上,「關懷訪視」則較「推展守門人概念」更易發揮增補社會支持的效果,原因在於社會支持低、壓力因應負面者的負面形象降低了周遭他人介入的意願,造成社會支持低、壓力因應負面者較難以從守門人策略中獲取協助的現象。此外,組織協力、守門人訓練不足、案量過重以及訪視標準僵化等缺失也為兩項策略的執行困境,故未來若欲持續發展「推展守門人概念」與「關懷訪視」,則須正視此些問題並加以改善。

並列摘要


The government of Taiwan takes some suicide prevention policies, gatekeeper and aftercare program, for the citizens, especially high-risk population, to decrease the suicide rate and establish a defensive network. Gatekeeper is trying to encourage citizens to concern with each other and to report high suicide risk cases. Following the reporting, aftercare program managers will provide professional assistance for high suicide risk cases. According to the literature review, when human being faces the major life events, their attitude, behavior, and will for seeking help are influenced by their own social support and stress coping style. By in-depth interviews and program evaluation, this study tries to analyzes the two policies in several dimensions, containing policy meaning, implementation plans, policy effectiveness, successful implementation experience and implementation difficulties, in local government. Besides, this study also examines whether high-risk population could obtain social support from gatekeeper or aftercare program. This research finds that the policy meaning of gatekeeper and aftercare program in Keelung City and New Taipei City still accord with central government, but some implementation plans vary from place to place. In terms of social support, the aftercare program is more effective than gatekeeper. Because it is difficult to gain the help from others when the individuals have negative images which come from low social support and negative stress coping. The individuals who cope with stress negatively are still hard to obtain social support from gatekeeper. Furthermore, gatekeeper and aftercare program also emerge some dilemmas, such as inefficient collaboration, insufficient gatekeeper training, heavy caseload, and rigid visiting stander. If we want to sustainably carry out gatekeeper and aftercare program in the future, we should confront those dilemmas and seek methods to improve them.

參考文獻


黃靖雯,2010,《國中生生活壓力、壓力因應策略與物質使用之相關研究》,高雄:高雄醫學大學醫學社會學與社會工作學研究所碩士論文。
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