國軍心輔人員處遇自殺未遂個案理論模型之驗證

本研究係根據胡正申(2005)以紮根理論發現之「國軍心輔人員處遇自殺未遂個案理論模型」為基礎，持續運用結構方程模式，突破紮根理論限制，觀察模型變項間之方向、強度和影響效果，以驗證性因素分析和模型適配度考驗，實證模型之結構關係。　　研究過程，藉由預備性研究，編製與發展具有信效度之「國軍心輔人員處遇自殺未遂個案量表」，作為正式研究之測量工具。正式測量之目的在測量「國軍心輔人員處遇自殺未遂個案之理論模型」，而整個模型中自殺個案的「問題成因」和「干預條件」為潛在外衍(自)變項，心輔人員干預自殺個案之「處遇策略」、「處遇行動」和「處遇結果」為潛在內衍(依)變項，再以結構方程模式之結構模式和測量模式，觀察估計參數與模型之適配度。　　研究結果證實：1.「國軍心輔人員處遇自殺未遂個案之理論模型」之整體與內部結構關係，具有良好的適配度；2.模型中自殺個案的「問題成因」對「處遇策略」有直接效果，且「問題成因」會經由「處遇策略」的中介，再對「處遇行動」產生間接效果，最後影響「處遇結果」；2.模型中「干預條件」對「處遇策略」有直接效果，且「干預條件」會經由「處遇策略」之中介，對「處遇行動」產生間接效果，最後影響「處遇結果」，此路徑為整體模型中效果最強之徑路關係；3.模型中「干預條件」對「處遇行動」有直接效果，再由「處遇行動」對「處遇結果」產生間接效果。　　最後，本研究從政策、實務、研究及未來發展方向，提出幾項建議。政策面：1.連結社會資源體系；2.深化個案處遇品質；3.落實自殺防治教育。實務面：1.重視長期處遇方案；2.貫徹實務工作模式；3.健全資料個案管理。研究方面：1.執行軍中自殺防治專題研究；2.加強學術交流研究計畫；3.連結基層部隊實況。未來研究發展方向：1.進行縱貫性研究比較；2.執行模型間比較性研究。

關鍵字

自殺行為；心理輔導人員；三級預防體系

並列摘要

Based on the “Theoretical model of national army psychological counselors’ treatment for cases of attempted suicide”, this study used structural equation modeling, broke the limitation of theories to observe the direction, intensity, and effects of the variables in the model, and used confirmatory factor analysis and model fit test to prove the structural relationship of the model. In the course of the study, the “Scale of national army psychological counselors’ treatment for cases of attempted suicide” of reliability and validity was compiled as a formal measuring tool in the study according to preliminary studies. The purpose of formal measurement is to assess the “Theoretical model of national army psychological counselors’ treatment for cases of attempted suicide.” In this model, the “causes of problems” and “intervening conditions” of cases of attempted suicide were used as latent independent variables, while the “strategies of treatment”, “actions of treatment”, and “results of treatment” of psychological counselors’ intervention in cases of attempted suicide were used as latent dependent variables. The measuring parameters and model fit were observed by using the structural model and measuring model of structural equation modeling. Research results indicated that: 1) the overall and internal structural relationships of the “Theoretical model of national army psychological counselors’ treatment for cases of attempted suicide” has a good fit; 2) the “causes of problems” in the model of cases of attempted suicide have direct effects on the “strategies of treatment”, and indirect effects on “actions of treatment” through the intervention of “strategies of treatment” and ultimately influence the “results of treatment”; 2) in this model, “intervening conditions” have direct effects on “strategies of treatment”, and indirect effects on “actions of treatment” through the intervention of “strategies of treatment”, and ultimately influence the “results of treatment”; this pathway is the pathway of the strongest effects; 3) in this model, “intervening conditions” has direct effects on “actions of treatment” and “actions of treatment” has indirect effects on “results of treatment”. The study proposed several suggestions to the aspects of policies, practice, research, and direction of future development. As for the aspect of policies: 1) connect with the system of social resources; 2) improve the quality of treatment to cases; 3) put the education of suicide prevention into practice. As for the aspect of practice: 1) put emphasis on long-term treatment scheme; 2) carry out the model of practical work; 3) complete the management of data and cases. As for the aspect of research; 1) implement the researches on the project of suicide prevention in army; 2) strengthen the research projects of academic exchange; 3) connect with the real status of basic-level army. As for the aspect of direction of future development: 1) conduct longitudinal comparative studies; 2) conduct comparative studies among models.