運用幻聽模擬於改善護生精神健康知識、對精神疾病態度及社會距離之成效

The Effectiveness of Using Auditory Hallucination Simulation to Improve Nursing Students’ Mental Health Literacy, Attitude toward Mental Illness, and Social Distance

郭鈺屏(Yu-Ping Kuo) ； 李明峰(Ming-Feng Lee) ； 林靜蘭(Esther Ching-Lan Lin)

《精神衛生護理雜誌》 11卷1期 (2016/11) Pp. 19-26

https://doi.org/10.6847/TJPMHN.201611_11(1).0002

摘要

背景：改善護生對於精神病患的負面態度，將有助於其照護精神病人的執業意願及照護態度。幻聽模擬被應用於改善民眾或醫護學生對精神病患的污名或刻板印象，然而目前實證證據仍不足。目的：瞭解幻聽模擬教學策略於護生的成效及其學習經驗。方法：以單組前後測之類實驗性研究設計，採方便取樣選取南部某大學護生共64位，提供幻聽模擬之教學策略，以精神健康知識、精神疾病態度以及社會距離為成效指標，並以質性回饋呈現其學習經驗。結果：幻聽模擬可顯著改善護生之精神健康知識、疾病辨識與歸因及對精神疾病的復元態度。多數護生表示更能同理病人經歷精神症狀的痛苦，對此教學策略有正向評價，但經歷煩躁或恐懼感受。結論／實務應用：幻聽模擬可改善護生的精神疾病知識與復元態度，並有助於同理病患的症狀經驗，但也引發負面感受。本研究建議未來宜採取嚴謹之對照組實驗性研究設計，以建立實證知識依據，並考量其所引發不良反應的安全議題。

關鍵字

幻聽模擬 ； 精神健康知識 ； 精神疾病態度 ； 社會距離

並列摘要

It is believed that improving the nursing students’ negative perspectives toward the mental illness will increase their willingness to involve into psychiatric care and caring attitudes. Recently, auditory hallucination simulation (AHS) has been adopted to change the public and healthcare students’ stereotype or stigma toward the mentally-ill patients. However, the empirical evidence is rather insufficient. We, thus, investigate the effects and subjective learning experience of using AHS on undergraduate nursing students. A single-group pretest-posttest quasi-experimental design was conducted with a convenient sample of sixty-four university nursing students who have been recruited from a university in southern Taiwan. All participants were provided AHS as a teaching strategy, and later were assessed with Mental Health Literacy (MHL), Attitude toward Mental illness Scale (AMI), and Social Distance as outcome indicators. Qualitative feedbacks of participants’ subjective learning experience were presented in the study. The study showed that the AHS significantly improved nursing students’ mental health literacy, attribution and recognition, and recovery attitude. Most students agreed that they could have empathized patients’ suffering from psychotic symptoms and highly recommended this teaching strategy; however, they also reported irritable and fearful responses. We concluded that the AHS improved nursing students’ knowledge and perspective on recovery of mental illness. It did not only facilitate students to feel the patients’ symptomatic experience, but also to generate their negative feelings. A rigorous experimental research design with controlled group is suggested in future studies to establish evidence-based knowledge, and safety issues regarding possible adverse effects which should be cautiously considered.

並列關鍵字

auditory hallucination simulation ； mental health literacy ； attitude toward mental illness ； social distance

參考文獻

郭鈺屏、洪瑞黛、黃財尉、許倍甄、蘇惠珍、林靜蘭（2014）．中文版精神疾病態度量表之信效度研究—以高中生為例．護理雜誌，61（6），48-56。[Kuo, Y. P., Hung, J. T., Huang, T. W., Hsu, P. C., Su, H. C., & Lin, E. C. L. (2014). Developing and testing the validity and reliability of the Chinese version attitudes toward mental illness scale in a sample of senior high school students. The Journal of Nursing, 61(6), 48-56.] doi:10.6224/JN.61.6.48

Ando, S., Clement, S., Barley, E. A., & Thornicroft, G. (2011). The simulation of hallucinations to reduce the stigma of schizophrenia: A systematic review. Schizophrenia Research, 133(1), 8-16. doi:10.1016/j.schres.2011.09.011

Brohan, E., Elgie, R., Sartorius, N., & Thornicroft, G. (2010). Self-stigma, empowerment and perceived discrimination among people with schizophrenia in 14 European countries. Schizophrenia Research, 122(1), 232-238.doi:10.1016/j.schres. 2010.02.1065

Brown, S. A. (2008). Emotional reactions to simulations of auditory hallucinations. Journal of Psychopathology and Behavioral Assessment, 30(4), 307-314. doi:10.1007/s10862-008-9085-1

Brown, S. A. (2010). Implementing a brief hallucination simulation as a mental illness stigma reduction strategy. Community Mental Health Journal, 46(5), 500-504. doi: 10.1007/s10597-009-9229-0