毒癮愛滋感染者社會網絡與社會適應之探討

A Study on Social Network and Social Adjustment among HIV-Positive Injection Drug Users.

陳怡伶(Yi-Ling Chen)

指導教授 ： 宋麗玉

國立暨南國際大學/人文學院/社會政策與社會工作學系/碩士(2008年)

https://doi.org/10.6837/NCNU.2008.00079

摘要

本研究之主要目的在了解（一）毒癮愛滋感染者社會網絡互動的情形、（二）社會適應之歷程、（三）社會網絡關係對於社會適應歷程所產生的影響。藉由受訪者回顧毒癮時期與感染愛滋疾病後所產生的變化，以了解其社會網絡關係與社會適應所產生的差異與影響。研究中以質化之深度訪談法進行資料蒐集，共計十二位受訪。研究對象的選取含括兩種途徑：其一以「台南縣嘉南療養院」為研究場域，透過專業醫護人員的推薦來尋求適合的研究對象；二是透過此領域之專業人員介紹，以滾雪球的抽樣方法來尋找適合且願意的研究對象。本研究結果歸納為以下重點：
一、非正式網絡關係中，受訪者因為毒與愛滋的雙重因素，而產生了一種「延續」或「扭轉」的社會網絡脈動。『延續』是伴隨過去毒癮標籤與烙印的負向關係，因感染愛滋疾病而強化了負向關係的發展；『扭轉』是代表非正式網絡關係的轉化，過去毒癮行為所形成的負向互動關係，卻因感染愛滋疾病而出現修補與重建的契機，受訪者也因生命有限與自我省思下激發自我復元與改變的動力。

二、正式網絡關係中，隨著政策與觀念以「預防」與「治療」的概念出發，推行減害計畫不僅有效降低因靜脈注射而感染愛滋的人數外，也間接影響毒癮者有效重返規律生活。另外，正式網絡也成為「獲得資訊」與「協助調適」的重要途徑，尤其當受訪者缺乏非正式網絡支持時，正式網絡儼然成為『生命中最後一道防護網』。

三、負向自我標籤與情緒反應是受訪者常見的反應，包括對過去生命的遺憾、未來無望、自責、愧疚、焦慮等，但缺陷的自我與情緒反應並不足以形容毒癮愛滋感染者的全貌，因為疾病反而讓生命有了新的詮釋與轉機，學習改變與復元也是毒癮愛滋感染者人生的新選擇。

四、影響毒癮愛滋感染者社會適應的因素，主要分為三大層面：個人（自我價值、情緒反應、情緒調適方法）、人際（非正式與正式網絡關係）與環境（工作狀態、疾病曝光程度、社會接納程度），而三者間具有循環與交互影響的作用。

五、依據受訪者之社會適應型態能區分為五大取向，分別為「內外權能展現取向」、「內在權能復元取向」、「外在充權調適取向」、「孤獨自責取向」、「隨遇而安取向」。依循五取向之脈絡，研究者延伸出最為理想之核心類屬：「內外權能實現取向」。
根據研究發現，研究者提出幾點建議（一）對愛滋感染者之處遇策略：協助重新調整自我認知、提昇工作訓練方案與學習因應情緒之調適方法、激發個人復元因子與優勢；（二）對非正式之處遇策略：提供網絡成員之衛教資訊、協助建立網絡間溝通平台、成立家屬支持團體；（三）對正式網絡之處遇策略：建立個管模式、提升減害計畫之彈性、促進專業人員與社會大眾對愛滋患者之尊重、接納。本研究結果分析與研究限制皆於文中提出說明，提供未來相關研究與實務之參考。

關鍵字

毒癮愛滋感染者 ； 社會網絡 ； 社會適應

並列摘要

This study explored the social network and social adjustment among HIV-Positive Injection drug users. The participants’ narratives revealed the changes on social network and relationships during drug addiction and after the infection of HIV, Qualitative method was utilized to capture the profound experiences of this population. Totaled 12 participants were interviewed by using semi-structured interviewing technique. The participants were selected through two ways: one from the recommendations of the physicians at the Jianan Mental Hospital in Tainan County; the other from the snowball sampling suggested by the specialists’ in this field. The major findings of this study were as follows:
1.Regarding informal support network, HIV+ had either “extended” the prior negative relations of some subjects with networkers, or “reversed” the prior relations, because facing life or death caused the changes in subjects’ perspectives and induced self-recovery and changes.
2.The implementation of harm reduction programs had not only effectively reduced the number of intravenous injection among the people with HIV+, but also indirectly helped the drug addicts return to normal life. Thus, formal support network has become the last resort among the subjects while informal support was exhausted..
3.Negative emotional reactions and self-labeling were common responses, including past life regret, hopelessness, self-blame, guilt, and anxiety. One the other hand, the disease also brought new perspective and transformation to some of the subjects, and then brand new choices of life ensued.
4.The factors that affect the social adjustment included individual (self-worth, emotional reactions, emotional oriented adjustment method), interpersonal (informal and formal network relationship) and environmental (work status, the exposure of the disease, and social acceptance) levels. Moreover, the three levels of factors had interactive impact of the subjects.
5.Based on the status of social adjustment, the subjects were categorized into five major types of orientation. Overall, the core category of the subjects extracted was “demonstration of internal and external power”.

Based on the findings, the investigator made some suggestions:
1.Concerning the treatment tactics for HIV-Positive Injection drug users: to help them re-adjust their self-cognition; to design and implement effective work training programs, and help them learn effective coping methods for negative emotions,; to help them to rediscover their strengths and work toward recovery.
2.Regarding the treatment tactics for informal relationship: to provide psychosocial education for network members; to help them on the communications with network members; to form support groups for their family members.
3.Concerning the treatment tactics for formal support: to establish case management services; to increase the flexibility of the harm reduction programs; to advocate professionals and the publics to treat AIDS patients with respect and acceptance.

並列關鍵字

HIV-Positive injection drug users ； Social Network ； Social Adjustment

參考文獻

中文部分

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