身心障礙污名認知與污名主觀經驗－以精神疾病患者及脊髓損傷者為例

Perceptions of Stigmatization and Stigmatization Experience-The Example of People with Spinal Cord Injuries and Psychiatric Disabilities

唐宜楨(I-Chen Tang) ； 陳心怡(Hsin-Yi Chen) ； 吳慧菁(Hui-Ching Wu) ； 鄭詩蓉(Shih-Rong Cheng) ； 高藝洳(Yi-Ru Kao)

《身心障礙研究季刊》 7卷4期 (2009/12) Pp. 230-244

https://doi.org/10.30072/JDR.200912.0001

摘要

近幾年來，身心障礙污名的研究多著墨於精神疾病的類別。然而，無論是外顯的或是內隱的身心障礙委員別，都會因其障礙或疾病而經歷社會環境裡貶抑其能力或不友善的對待。研究目的及方法：本文以污名為主軸，透過問卷調查的方式來了解167名脊髓損傷者以及73名重度精神疾患對於身心障礙污名的認知、感受以及主觀經驗。研究結果：根據統計結果顯示，大多數的研究參與者皆能自覺社會環境車里的身心障礙污名存在。同時，污名影響身心障礙者生活土的經驗，進而內化自我負面的刻板印象、對自我的貶低。雖然脊髓損傷者類屬於所謂的「外顯身心障礙者」而精神疾患多被認定為「內隱身心障礙者」，但在污名的主觀成受與認知上，精神疾患與脊髓損傷者在「社會疏離」、「個人歧視經驗」、「刻板印象」、「社會撤退」、「抗拒污名」之面向中，發現精神，反患與脊髓損傷者在「刻板印象」的認同上有顯著差異。此外，精神疾患對「身體形象(body image)」、「暴力」以及「能力(capacity)」的知覺成受與脊髓損傷者相較之下有顯著的不同。結論：此研究的結果反應了社會環境千里的身心障礙污名存在。無論是「內隱身心障礙者」或是「外顯身心障礙者」在主觀污名的負面感受與污名內化的情形皆存在。因此，精神疾病去污名化運動並非獨立的孤立事件，應擺回身心障礙去；可名的脈絡，以審梳理解大環境裡身心障礙普遍被受歧視的存在，有其必要。

關鍵字

污名 ； 身心障礙 ； 精神疾患 ； 脊髓損傷

並列摘要

Background: It has been widely noticed that the general public discriminates or holds bias toward people with disability. The stigma associated with disability can undermine social status, social network or work opportunities. In order to avoid rejection, many disabled people develop coping strategies such as withdrawal, avoiding hospitalization or concealing their treatment history. Such coping strategies may cause negative effects on their il1ncss or disability. Furthermore, such reaction may turn the stigmatizing attitudes against themselves which is identified as self-stigma. Method: This study provides quantitative data comparing attitude and subjective experience of disability-related stigma by 73 psychiatric patients to that of a group of 167 people with spinal cord injury. 73 participants (57 male and 16 female) with schizophrenia and bipolar disorder were recruited from a psych iatric recovery home located in Kaoshiung, Taiwan while the data of 167 pcoplc (107 male and 60 female) with spinal cord injury was gathered through an Association of Spina1 Cord Injury. Participants rated the section on perceived disabled-related stigmatization using a four-point response scale. The data was collected between November 2008 and April 2009. Results: The study found that disabi1ity-rclatcd stigma had a negative in f1uence on feelings and attitudes toward their lives Most participants expect certain level of negative reactions from the social cnvironment. In particular, schizophrenia patients anticipated stigmatization and self-stigmatization stronger than people with spinal cord injury. Conclusion: The results underline the necessity to reduce the stigma of disability as a whole.

並列關鍵字

Disability ； psychiatric patients ； spinal cord injury ； stigma

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