本研究的目的在於經由生態系統觀點,對精神障礙者的自我概念作深入的探討,以更全面性地統整他們與所處的環境,以及與系統間的互動經驗。由於研究議題的特殊性,及為求對個人獨特經驗及現象本質的深入了解,在研究方法的選擇上,採取質性研究的深度訪談方法,以於南部某醫學中心門診追蹤之五位精神分裂症或躁鬱症精障者為研究對象,進行深度訪談,作為主要資料分析來源。 主要的研究結果分下列三個部份說明:一、「精障者的自我概念與形成」;二、「系統與精障者自我概念的關係」;三、「自我概念的改變」。本研究發現,精障者自我概念的形成及改變,與個體和外在系統的互動經驗息息相關。影響的層面雖然因人而異,然而,自我概念可正向改變的精障者,較容易在原有的生態系統之中,重新詮釋自己的困境,或發展出較好的因應行為,來減少社會價值對自己的影響。 最後並針對研究結果,對未來社區精神障礙服務提出反思及具體的建議,包括其一、「以家庭整體為單位共同合作」。其二、「社區精神衛生服務方向的調整」。其三、「改變社會環境」和其四、「從事社會倡導運動」。
The aim of this study is to understand the self-concept of mental disabilities via the ecological system perspective. By using the ecological system perspective concept, we tried to investigate the self-concept of patients with mental illnesses and their unique interacting experiences with the environment. Qualitative modalities and advancing interviews were used .We recruited five schizophrenic or bipolar patients who could well express themselves and interviewed them by the interview guide. Thematic analysis was used to identify and clarify the themes. After analyzing the data collected from 5 interviewees, we concluded our findings in three dimensions: 1) the self-concept of mental disabilities and its formation; 2) the relation between the system and the self-concept of mental disabilities; and 3) the changes of the self-concept of mental disabilities. We found the formation and changes of the self-concept of mental disabilities are closely related to the interacting experiences between the individuals and their environment. Even though the level of interacting experiences influence differed from person to person, however, the participants with more positive self-concept changes could have more reasonable self-recognition, and either reframe their problems of environment or develop the effective coping behaviors, in order to lessen the influence of social values. Our findings including: 1) Promote the cooperation with the whole family as one unit; 2) Adjust the community mental health services; 3) Engage in the change of our social environment continually, and 4) Engage in social movement and advocacy offer some reflection and further concrete suggestions on the current practice of community mental health services.