心理衛生社會工作者之文化傾向及精神疾病汙名與復元導向服務知識和態度之相關研究

Abstract

復元導向服務是心理衛生領域的發展趨勢，其跨文化的適用性時常被討論，而個人主義-集體主義傾向是跨文化研究的重要概念。雖然過去研究並未指出個人主義-集體主義傾向與復元導向服務知識和態度之中介因素，然而精神疾病汙名一直是心理衛生領域的重要變項，將對服務提供者產生影響，其中包含對於復元導向服務的態度，甚至對於該知識的認同。而心理衛生社會工作者又是其中重要但少被討論的群體，故本研究欲以全臺心理衛生社會工作者為研究對象，透過網路問卷進行調查，探討心理衛生社會工作者之文化傾向、精神疾病污名與復元導向服務知識和態度的關係。問卷包含「個人主義-集體主義傾向量表」、「精神疾病污名量表」與「復元導向服務知識和態度量表」三部分，並在實際施測之前邀請3位實務工作者針對問卷之用詞提供建議與回饋。針對實際回收到的83份問卷先各自進行因素分析，因素分析結構與過去研究大致相同，唯有「復元導向服務知識和態度量表」差異較大，但該簡化量表與原始完整量表有高度相關，且為了與現有實證研究比較而保留原始因素結構，整體問卷之Cronbach's α分別為.56、.82、.69。 針對研究問題，運用統計軟體SPSS，以描述性統計、t 檢定、單因子變異數分析、Pearson積差相關、階層迴歸等統計方法進行資料分析。研究主要發現如下： 一、 心理衛生社會工作者之文化傾向較偏向「水平」特性，其中精神疾病汙名以婚配阻礙最高；復元導向服務知識和態度整體而言則介於「不清楚」和「同意」之間，且較偏向不清楚。 二、 心理衛生社會工作者的文化傾向不會影響其精神疾病污名。 三、 心理衛生社會工作者的垂直個人主義傾向、垂直集體主義傾向越高，其復元導向服務知識和態度越高。 四、 心理衛生社會工作者的精神疾病污名在個人主義-集體主義傾向與復元導向服務知識和態度間並非扮演中介角色。 最後根據研究結果，本研究建議可透過介紹精神疾病之課程，提升心理衛生社會工作者對於精神疾病之認識的同時，降低精神疾病污名，並藉由優勢取向的復元相關訓練，提升其復元導向服務知識和態度。

The developmental trend in the field of mental health is recovery-oriented services, the cross-cultural applicability of which is often discussed; in addition, the individualism-collectivism tendency is an important concept in studying cross-cultural research. Although past studies do not point out the Intervening Variables of individualism-collectivism tendency and the knowledge and attitude of recovery-oriented services, the stigma of mental health diseases has always been an important variable in the field of mental health. It affects the attitudes of service providers, and even has a further impact on their identification of such knowledge. Wherein, mental health social workers is an important and rarely discussed group. Therefore, the research subjects of this study are Taiwan's mental health social workers. Online questionnaire is used to conduct this investigation on the exploration of the relationship between the cultural tendencies of mental health social workers, the stigma of mental health diseases and their knowledge of and attitude towards recovery-oriented services. The questionnaire contains three parts: the "Individualism-Collectivism Tendency Scale", "The Stigma of Mental Health Diseases Scale" and "The Knowledge and Attitude of Recovery-Oriented Services Scale". Factor analyses were conducted on the 83 returned questionnaires. The analytical structure of these factor analyses are about the same as past research, it is only that the differences in "The Knowledge and Attitude of Recovery-Oriented Services Scale" are a bit larger by comparison. But, the said simplified scale is highly correlated with the original complete scale, and the original factor structure is preserved in order to compare it with the existing empirical research. The overall questionnaire Cronbach's α values are .56, .82 and .69 respectively. SPSS statistical software is adopted, and the Descriptive Statistics, t Test, ANOVA, Pearson Product-Moment Correlation Analysis and hierarchical regression analysis methods are used to conduct data analysis on the specific topic in this research. Major findings in this research are as follows: 1. The cultural tendencies of mental health social workers lean more towards the "horizontal" trait, in which, the stigma of mental health diseases hinders marriage the most; overall, for Knowledge and Attitude of Recovery-Oriented Services, it trends between "not sure" and "agree", and leans towards "not sure". 2. The cultural tendencies of mental health social workers have no impact on the stigma of mental health diseases. 3. Concerning mental health social workers, the higher their vertical tendency in individualism and collectivism, the higher their knowledge of, and the better their attitude towards Recovery-Oriented Services. 4. For mental health social workers, the stigma of mental health diseases plays an intermediary role between the Individualism-Collectivism Tendency and the Knowledge and Attitude of Recovery-Oriented Services.

Lastly, this study makes the following recommendations, based on the research findings: that with the introduction of relevant courses about mental health diseases, the mental health social workers' understanding of mental health diseases may be improved, and their stigma towards mental health diseases may be reduced. In addition, with the use of strength-based training pertaining to recovery services, their knowledge of, and attitude towards recovery-oriented services may also be improved.