Pathways to Care and Help-Seeking Experience Prior to Self-Harm: A Qualitative Study in Taiwan

自傷前求醫途徑與求助經驗：一項台灣質性研究

吳佳儀(Chia-Yi Wu) ； Rob Whitley ； Robert Stewart ； 劉珣瑛(Shen-Ing Liu)

《The Journal of Nursing Research》 20卷1期 (2012/03) Pp. 32-42

https://doi.org/10.1097/JNR.0b013e3182466e64

摘要

背景 求助行為是自我傷害的一個保護因子，但鮮少有研究探討自傷者如何及為何求助於一般人與專業人員的協助。目的 探索台灣自我傷害者於自傷前之求助經驗與就醫途徑。方法 本研究運用質性訪談及內容分析法，藉由選樣方格選取參與者，並以標準訪談指引，深度訪談二十位介於18－55歲的自傷者之求助歷程與求醫經驗。結果 受訪者表示，求醫歷程中的轉介者包括了朋友、家人、健康醫療工作者或是透過其自行就醫。求助經驗與護病關係、社會支持及治療遵從性有關，這些亦是受訪者提到影響求醫過程最主要的主題。結論／實務應用 來自一般非正式與醫療照護的支持性態度和持續性照護，可能是促進求助行為最重要的因素，但來自重要他人的負面影響可能會引發自傷行為。自殺／自傷防治策略中，應特別注意與多重就醫有關的存藥行為及重要他人的負面關係影響所導致的自傷行為。

關鍵字

自我傷害 ； 求助行為 ； 社會支持 ； 求醫途徑

並列摘要

Background: Help-seeking behavior may protect people from harming themselves. However, few studies have discussed how and why people access lay or professional help prior to self-harm.Purpose: This study explored the subjective experiences of individuals with deliberate self-harm in terms of help-seeking behavior and medical care pathways.Methods: Researchers performed qualitative in-depth interviews and content analysis and used a sampling grid to recruit participants. Twenty emergency attendees between the ages of 18-55 years were interviewed on their help-seeking pathways and experiences using a standardized topic guide.Results: Participants identified friends, family members, healthcare personnel, and their own initiative as the primary medical care pathways. Analysis showed help-seeking experiences significantly related to the physician-patient relationship, social support, and treatment adherence. These factors were also identified as prominent themes related to medical help-seeking behavior.Conclusions: Supportive attitudes and continuous care from formal and informal sources of help may facilitate help-seeking behavior, whereas negative influences from close friends or relatives may trigger a self-harm episode. Medication stockpiling and the negative aspects of close relationships should be addressed and minimized to raise the effectiveness of self-harm or suicide prevention efforts.

並列關鍵字

deliberate self-harm ； help-seeking behavior ； social support ； pathways to care

參考文獻

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