精神分裂症更名為思覺失調症對於去汙名化之效果

The Effect of Reducing Stigma by Renaming Schizophrenia

邱一航(Yi-Hang Chiu)

指導教授 ： 高美英

臺北醫學大學/人文暨社會科學院/醫學人文研究所/碩士(2015年)

摘要

精神疾病的汙名化對於病人、家屬、與社會皆是一個沉重的存在。其形成因素錯綜複雜。台灣於2014年將舊稱精神分裂症更名為思覺失調症，期待能減少國人對schizophrenia的汙名化。

本研究的目的在於探討「精神分裂症」更名為「思覺失調症」的去汙名化效果。過程藉由調查目前對思覺失調症(舊稱精神分裂症)的汙名化情形，並比較「精神分裂症」與「思覺失調症」之公眾汙名、自我汙名的程度與社會距離，之後探討更名之去汙名化效果，與影響因素。

本研究採橫斷式研究，以台北醫學大學醫學系與護理學系一年級和四年級學生為母群體，採用便利抽樣方法，共發放360份問卷，計回收235份，回收率為65%，再扣除填答不完整問卷後，有效樣本數為222份。本研究工具包含「汙名量表」、「汙名感受量表」、「社會距離量表」、「接觸經驗」以及「基本資料」等五個項目。在推論性統計分析方面以SPSS 17.0進行描述性統計分析、成對樣本T檢定，檢驗不同的科系、年級、選科對精神分裂症/思覺失調症之公眾汙名、自我汙名以及社會距離之間的差異。本研究亦針對七位醫學系二至四年級的學生進行深度訪談，質性資料參考Colaizzi提出的方法進行分析並整理。

本研究的結果顯示「精神分裂症」更名為「思覺失調症」後，在汙名量表、汙名感受量表與社會距離量表分數皆顯著降低。代表更名有助於改善公眾汙名、自我汙名，並縮短社會距離。其效果和系別無關，但和年級與將來選科傾向有關連性。對於希望將來選擇精神科服務的學生來說，因其對精神疾病的接受度原本即較高，汙名化情形較輕，故更名效果較不明顯。
本研究以將來的醫療照護核心成員的醫護學生為對象，進行更名去汙名化效果的探討，結合社會、臨床與教育的觀點，希望能作為將來更進一步去汙名行動、公共政策與醫學教育發展的參考。

關鍵字

更名、汙名、社會距離、精神分裂症、思覺失調症、醫護學生

並列摘要

The stigma often associated with serious mental illnesses is a huge burden to patients, their families and the society as whole. The emergence of a stigma is a complex process. In 2014, Taiwan renamed the concept of schizophrenia in an attempt to reduce the stigma associated with this disease entity.

The purpose of this study is to understand the effect of renaming schizophrenia. We investigated the stigma associated with schizophrenia and compared the change in public-stigma, self-stigma and social distance by renaming it. We then investigated factors that could explain the reduced stigma.

This is a cross-sectional and availability sampling study. From the 360 medical and nursing students from Taipei Medical University who completed the questionnaire, a total of 222 were included in the study. The response rate was 65%. The questionnaire contained several parts: the stigma scale, the perceived stigma scale, social distance scale, experience of contacting and basic data. We used SPSS descriptive analysis and paired-t test to analyze the quantitative data. We also interviewed seven medical students. The qualitative data was analyzed according to Colaizzi’s method.

This study showed that the public-stigma, social-stigma and social distance improved by renaming schizophrenia. The college that they pertained to seemed irrelevant to the effect. However, both students’ number of years in school and their inclination for certain specialties in medicine were found to be related to the effect of reducing stigma. This effect was also not significant in those interested in pursuing psychiatry in the future and this may be explained by their higher acceptance of mental illnesses compared with their cohort.

Our study subjects were medical/nursing students who will become an integral part of the medical team in the future. We hope that the results of this study can be of use in the implementation of future public policies and changes in medical education that promote a higher acceptance of schizophrenia by reducing the stigma associated with it.

並列關鍵字

rename, stigma, social distance, schizophrenia, medical and nursing student

參考文獻

中文文獻（按作者姓氏筆畫排序）

周志玉 (2005)。憂鬱症污名研究：可控制性歸因、危險與依賴刻板印象對歧視行為的影響。 中原大學心理學系碩士學位論文。

官達人 (2002)。社區居民對精神病患的態度調查。國立陽明大學醫務管理研究所碩士論文。

洪嘉雯 (2005)。社區民眾對不同精神病症狀的歸因、危險知覺及社會距離研究。私立中原大學心理學系碩士論文。

查玲俐 (2007)。警專學生對東南亞外籍配偶刻板印象與社會距離之研究。臺灣師範大學社會教育學系學位論文碩士論文。