個人及脈絡層次因子與公眾對於憂鬱症患者社會距離之關係：多層次分析
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2020
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研究背景：為減少公眾對於憂鬱症患者的社會距離，瞭解其影響機制具有其必要性。過去關於憂鬱症患者社會距離的研究大多聚焦於個人層次，較少探討脈絡層次之影響。
研究目的：本研究欲探討臺灣公眾之個人層次及脈絡層次變項與憂鬱症患者社會距離之關聯性，並檢驗個人層次變項對於憂鬱症患者社會距離的影響是否與脈絡層次變項有跨層次的交互作用。
研究方法：本研究以隨機撥號 (Random-Digit-Dialing) 電腦輔助電話訪問 (Computer-Assisted Telephone Interview)，針對台灣2016年20歲至65歲公眾進行資料收集，共計800份有效問卷納入分析。個人層次變項包含：性別、年齡、教育程度、感知危險性、恐懼情緒反應；脈絡層次變項包含：精神復健機構密度、都市化程度。本研究使用多層次模式 (Multilevel Models) 進行分析。
研究結果：在個人層次變項中，男性、年齡越大、對於憂鬱症患者感知危險性或恐懼情緒反應越大，其對於憂鬱症患者社會距離越大；教育程度則與社會距離無相關。控制個人層次變項後，精神復健機構密度與社會距離之間的主要效果沒有顯著相關，但與感知危險性對於社會距離的影響具有交互作用，意即公眾對於憂鬱症患者感知危險性較高且居住於精神復健機構密度越高的縣市，其對於憂鬱症患者的社會距離越大；都市化程度與社會距離呈正相關，但與個人層次變項間對於社會距離的影響則無顯著的跨層次交互作用。
研究結論：本研究結果不僅有助於瞭解公眾對於憂鬱症患者社會距離之個人及脈絡影響因子及作用。未來當探討個人對憂鬱症患者社會距離之影響時，不能忽略環境脈絡所產生的可能修飾效果。本研究提供未來擬定憂鬱症去污名政策與介入措施的實證研究基礎。
Background: When identifying ways to reduce the social distance of depression among the general public, it is crucial to understand contributing factors. To date, research regarding social distance toward patients with depression has mainly focused on the individual-level factors rather than context-level factors. Objective: This study explored the influences of individual-level and context-level variables on the social distance of depression among the general public in Taiwan. We further examined whether there is an interaction between individual and context variables in the association with social distance of depression. Methods: The data of this study was collected using random-digit-dialing and computer-assisted telephone interview survey from Taiwanese adults aged 20 to 65 years in 2016. A total of 800 questionnaires were included in study analysis. The individual-level variables included gender, age, educational attainment, perceived dangerousness, and emotional reaction of fear. The context-level variables included the psychiatric rehabilitation services density and urbanization degree among cities and counties. All effects were tested using multilevel analysis. Results: With regard to individual-level variables, males, older adults, people with more perceived dangerousness, and those with emotional reaction of fear were associated with more social distance toward patients with depression. There was no relation between educational attainment and social distance. After controlling for individual-level variables, the main effect between the psychiatric rehabilitation services density and social distance was not significant. There was an interaction between psychiatric rehabilitation services density and perceived dangerousness in the association with social distance. Which means that individual who had higher perceived dangerousness and lived in higher psychiatric rehabilitation services density area might result in greater social distance. There was a significant main effect of urbanization degree on social distance but no significant interaction between urbanization degree and individual factors in the association with social distance. Conclusion: These findings help to understand the individual and context factors that affect social distance of depression. When doing related research, we should take into consideration that the effect of interaction between individual and context factors on social distance. The findings provide evidence-based research on policies and interventions with the aim of reducing the public stigma of depression.
Background: When identifying ways to reduce the social distance of depression among the general public, it is crucial to understand contributing factors. To date, research regarding social distance toward patients with depression has mainly focused on the individual-level factors rather than context-level factors. Objective: This study explored the influences of individual-level and context-level variables on the social distance of depression among the general public in Taiwan. We further examined whether there is an interaction between individual and context variables in the association with social distance of depression. Methods: The data of this study was collected using random-digit-dialing and computer-assisted telephone interview survey from Taiwanese adults aged 20 to 65 years in 2016. A total of 800 questionnaires were included in study analysis. The individual-level variables included gender, age, educational attainment, perceived dangerousness, and emotional reaction of fear. The context-level variables included the psychiatric rehabilitation services density and urbanization degree among cities and counties. All effects were tested using multilevel analysis. Results: With regard to individual-level variables, males, older adults, people with more perceived dangerousness, and those with emotional reaction of fear were associated with more social distance toward patients with depression. There was no relation between educational attainment and social distance. After controlling for individual-level variables, the main effect between the psychiatric rehabilitation services density and social distance was not significant. There was an interaction between psychiatric rehabilitation services density and perceived dangerousness in the association with social distance. Which means that individual who had higher perceived dangerousness and lived in higher psychiatric rehabilitation services density area might result in greater social distance. There was a significant main effect of urbanization degree on social distance but no significant interaction between urbanization degree and individual factors in the association with social distance. Conclusion: These findings help to understand the individual and context factors that affect social distance of depression. When doing related research, we should take into consideration that the effect of interaction between individual and context factors on social distance. The findings provide evidence-based research on policies and interventions with the aim of reducing the public stigma of depression.
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公眾污名, 憂鬱症, 精神復健機構, 都市化程度, 多層次分析, public stigma, depression, psychiatric rehabilitation services, urbanization degree, multilevel analysis