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臺灣思覺失調症患者自我污名及其相關因素之探討
Self-Stigma and Its Correlates Among Patients With Schizophrenia in Taiwan
摘要
目的：思覺失調症患者可能因為精神疾病污名影響到其持續性治療及復健。本研究目的為探討社會人口學特徵、心理社會功能、生活品質與精神疾病污名是否具有關連性。方法：本研究採橫斷式研究，對象為臺灣北部某精神專科醫院日間病房的思覺失調症患者（n=46）。自陳式問卷內容包含個人基本資料、簡式精神症狀量表、羅森伯格自尊量表、一般自我效能量表、思覺失調症生活品質量表及精神疾病自我污名量表。認知功能則以艾倫認知篩檢測驗進行評估。本研究使用t檢定、卡方檢定與逐步迴歸進行分析。結果：研究參與者中有24人（52.2%）為高自我污名組，22人（47.8%）為低自我污名組。高自我污名組的精神症狀分數顯著高於低自我污名組之分數（p＜.01）；反之，高自我污名組的生活品質分數則顯著低於低自我污名組之分數（p＜.01）。迴歸分析結果指出，自尊（β=-0.34, p=.01）及生活品質（β=-0.46, p＜.01）與自我污名具有顯著負相關，精神症狀（β=0.27, p＜.05）及自我效能（β=0.58, p＜.01）與自我污名則呈現顯著正相關。結論：高自我污名的思覺失調症患者相較於低自我污名的患者具有較多精神症狀及較差生活品質。對於思覺失調症患者而言，低自尊、生活品質不佳、高自我效能、精神症狀越明顯者，越容易有較高程度的自我污名。
並列摘要
Objectives: Self-stigma is a barrier to treatment and rehabilitation in patients with schizophrenia. This study aimed to examine the associations between social-demographic variables, psychosocial functions, quality of life, and self-stigma. Methods: This study was a cross-sectional study. Forty-six patients with schizophrenia were enrolled in the study. The questionnaires included personal information, Brief Psychiatric Symptom Rating Scale (BSRS), Rosenberg Self-Esteem Scale (RSES), General Self-Efficacy Scale (GSES), Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4), and Internalized Stigma of Mental Illness (ISMIS). Cognitive function was evaluated using the Allen Cognitive Level Screen (ACLS). T-test, x^2 test, and stepwise regressions were used in this study. Results: Patients with high self-stigma (n=24) had significantly higher scores on the BSRS (p＜ .01) and lower scores on the SQLS-R4 (p＜ .01) than those with low self-stigma (n=22). The regression analysis results showed that self-esteem (β=-0.34, p= .01) and quality of life (β=-0.46, p＜ .01) were negatively associated with self-stigma, whereas psychiatric symptoms (β= 0.27, p＜ .05) and self-efficacy (β=0.58, p ＜ .01) were positively associated with self-stigma. Conclusions: Patients with schizophrenia with high self-stigma have more psychiatric symptoms and poorer quality of life than those with low self-stigma. Patients with schizophrenia who have low self-esteem and quality of life, high self-efficacy, and more psychiatric symptoms tend to have high level of self-stigma.