Exploring the Relationship Between Illness Perceptions and Negative Emotions in Relatives of People With Schizophrenia Within the Context of an Affiliate Stigma Model

連帶烙印模式中思覺失調症病人家屬疾病覺知與負面情緒之相關研究

10.1097/jnr.0000000000000124

黃建豪(Chien-Hao Huang)；黎士鳴(Shih-Ming Li)；徐畢卿(Bih-Ching Shu)

思覺失調症 ； 家屬 ； 疾病覺知 ； 連帶烙印 ； 結構方程模式 ； schizophrenia ； relatives ； illness perception ； affiliate stigma ； SEM

The Journal of Nursing Research

24卷3期（2016 / 09 / 01）

217 - 223

英文

背景 疾病烙印不只影響病人本身，同時也影響家屬。在連帶烙印模式中，認知因素會影響個體的情緒反應，進一步影響其照顧行為。目的 本研究主要研究目的為以連帶烙印模式為理論基礎，1.探討疾病覺知認知指標與烙印負向情緒之相關性；與2.驗證連帶烙印的理論模式。方法 本研究採描述性研究，以思覺失調症病人家屬為收案對象。收案地點在臺灣中部二家醫院進行。研究經IRB審核通過，有意願參加研究者皆填寫同意書，共62位家屬同意，並完成「基本資料調查表」、「思覺失調症疾病覺知-家屬版」及「連帶內化烙印量表」等自陳式問卷。在進行驗證模式前，先以SPSS因素分析進行疾病覺知分量表之認知題項選取。資料以STATISTICA 6.0軟體的相關分析與結構方程模式來驗證連帶烙印模式。結果 以「疾病慢性化」、「疾病可控制感」與「疾病可被治療」三項家屬疾病覺知的向度作為認知成份之指標，此認知指標與連帶烙印的負面情緒相關為.42；與經結構方程式驗證連帶烙印模式的調整配適度為.786。結論／實務應用 本研究結果顯示，可透過連帶烙印的模式，瞭解家屬的疾病覺知與負面情緒之關係，以作為未來衛教策略的基礎。

Background: Stigma affects patients with schizophrenia and may influence perceptions of the illness, which may affect how family members interact with and care for these patients. Purpose: The aims of this study were to (a) explore the relationship between perceptions of schizophrenia and the negative emotions of family members within the context of an affiliate stigma model, and (b) validate the proposed affiliate stigma model. Methods: A cross-sectional design was used. Eligibility for participation was limited to the relatives of patients with schizophrenia. The participants were recruited from two regional psychiatric hospitals in central Taiwan. The study was approved by an Institutional Review Board, and all potential participants signed informed consent before enrollment. Sixty-two participants completed the set of self-administered questionnaires, including (a) a demographic questionnaire, (b) Affiliate Stigma Scale, and (c) the Illness Perception Questionnaire for Schizophrenia-Relatives version. Canonical correlations and structural equation modeling in STATISTICA 6.0 were used to validate the model of illness perceptions and negative emotions. Results: (a) There were three domains of perception regarding schizophrenia for the relatives of patients: disease chronicity, disease in control, and disease treatability. The correlation between these dimensions and negative emotion was r = .42. (b) The adjusted goodness of fit for the proposed affiliate stigma model was .79. Conclusions: The results of this study suggest that the affiliate stigma model is an appropriate resource for developing practical disease management strategies for the relatives of patients with schizophrenia.

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