社會資本與個體特質對個體心理健康之影響：一個多層次之研究

The Effects of Social Capital and Individual Characteristics on Individual Mental Health: A Multilevel Study

10.3966/207010632013060039004

張芳華(Fang-Hua Chang)

快樂感 ； 華人健康問卷 ； 精神疾病 ； 鄰里層次公民參與態度 ； 臺灣社會變遷調查 ； Chinese Health Questionnaire (CHQ) ； Happiness ； Mental disorder ； Neighborhood-level civic participation attitudes ； Taiwan Social Change Survey (TSCS)

健康促進與衛生教育學報

39期（2013 / 06 / 01）

87 - 116

繁體中文

目的：本研究目的在分析2005至2010年心理健康的趨勢，並探討社會資本與個體特質對國人目前輕型精神疾病與快樂感受的影響。方法：運用「臺灣社會變遷調查」中18歲以上人口資料，有效樣本分別為2,144人與1,804人，2010年資料的村里數為80個，以比例Z檢定、獨立樣本t檢定、雙雙項分析、多層次邏輯與線性迴歸來分析資料；精神疾病與快樂感受的測量，則分別以「華人健康問卷」和主觀快樂感做為評估依據。結果：精神疾病與快樂感受在五年間未顯著變化，一般民眾的精神疾病盛行率約在25%左右，而多數民眾自覺是快樂的；研究發現，在所有社會資本中，僅人際互動認知與精神疾病有關，而鄰里層次的公民參與態度和所有層次社會資本皆能預測個體快樂程度；性別、自評健康與吸菸行為亦與正、負向心理狀態密切相關。結論：相較於輕型精神疾病，社會資本對一般民眾的快樂感受較有影響力；在預防策略上，建議依不同性別使用不同的文宣內容，降低精神疾病的計畫則應優先針對社經不利鄰里進行友善社會環境的營造，而非先推廣至所有鄰里。

Objectives: This study aimed to analyze the trend of mental health between 2005 and 2010, and to explore the effects of social capital and individual characteristics on individual minor psychiatric disorders and happiness in 2010. Methods: Nationally representative data from Taiwan Social Change Survey (TSCS) consisted of 2, 144 respondents in 2005 and 1,804 respondents in 80 neighborhoods in 2010. Two-sample test for proportions, independent sample t-test, bivariate analysis, multilevel logistic and linear regression were used to analyze the data. Psychiatric disorders and happiness were measured respectively by Chinese Health Questionnaire (CHQ) and perception of subjective happiness. Results: The rates of mental health were not significantly changed in the 5 years. For the general public, the prevalence of psychiatric disorders was about 25% and self-perceived happiness was high. The results found in all of social capital variables, only the perception of interpersonal interaction was significantly associated with mental disorders, while neighborhood-level civic participation attitudes and all of individual-level social capital would predict individual happiness. Gender, self-rated health and smoking were also strongly correlated with the positive and the negative state of mind. Conclusions: The effects of social capital on happiness were more significant than that on minor psychiatric disorders among the general public. As for the preventive strategy, the results suggest the different content of propaganda should be adopted based on gender. Programs concerned about building friendly social environment to reduce high levels of mental disorders, focusing on socio-economic deprived neighborhoods should be prior to general neighborhoods.

1. 王叢桂、羅國英(2008)。華人對情緒智能與人情世故的認知：性別與世代的差異。應用心理研究，39，215-251。
   連結：
2. 張珏、徐欣萍(2008)。笑與健康研究的回顧：中西方觀點。台灣衛誌，27，282-291。
   連結：
3. 黃玉賢、游淑華、林梅鳳(2009)。從一位女性憂鬱患者的視角看罹病經驗與婆媳關係。中華心理衛生學刊，22(1)，27-50。
   連結：
4. 黃銘福、黃毅志(2010)。影響臺東縣國二學生心理幸福之因果機制：家庭社經地位與社會網絡何者重要。教育與社會研究，21，1-37。
   連結：
5. 溫福星、邱皓政(2009)。多層次模型方法論：階層線性模式的關鍵議題與試解。台大管理論叢，19，263-294。
   連結：
6. 溫福星、邱皓政(2009)。組織研究中的多層次調節式中介效果：以組織創新氣氛、組織承諾與工作滿意的實證研究為例。管理學報，26，189-211。
   連結：
7. 劉嘉年(2009)。社會經濟狀況、一般健康狀態、健康行為與社區成年民眾憂鬱情緒的關係。台灣衛誌，28，300-311。
   連結：
8. 章英華、杜素豪、廖培珊(2006)。台灣社會變遷調查計劃第五期第一次調查計畫執行報告。臺北市:中央研究院社會學研究所
9. 章英華、杜素豪、廖培珊(2011)。台灣社會變遷調查計劃第六期第一次調查計畫執行報告。臺北市:中央研究院社會學研究所
10. Adan, A.,Sanchez-Turet, M.(2000).Effects of smoking on diurnal variations of subjective activation and mood.Human Psychopharmacology: Clinical and Experimental,15,287-293.
11. Aida, J.,Hanibuchi, T.,Nakade, M.,Hirai, H.,Osaka, K.,Kondo, K.(2009).The different effects of vertical social capital and horizontal social capital on dental status: S multilevel analysis.Social Science & Medicine,69(4),512-518.
12. Almedom, A. M.(2005).Social capital and mental health: An interdisciplinary review of primary evidence.Social Science & Medicine,61(5),943-964.
13. Araya, R.,Dunstan, F.,Playle, R.,Thomas, H.,Palmer, S.,Lewis, G.(2006).Perceptions of social capital and the built environment and mental health.Social Science & Medicine,62(12),3072-3083.
14. Borghesi, S.,Vercelli, A.(2012).Happiness and health: Two paradoxes.Journal of Economic Surveys,26(2),203-233.
15. Borgonovi, F.(2008).Doing well by doing good; The relationship between formal volunteering and self-reported health and happiness.Social Science & Medicine,66(11),2321-2334.
16. Chan, A. L.,Yang, T. C.,Chen, J. X.,Yu, L. H.,Leung, H. W.(2006).Cost of depression of adults in Taiwan.International Journal of Psychiatry in Medicine,36(1),131-135.
17. Cheng, T. A.(1988).A community study of minor psychiatric morbidity in Taiwan.Psychological Medicine,18,953-968.
18. Chiao, C.,Weng, L. J.,Botticello, A. L.(2011).Social participation reduces depressive symptoms among older adults: An 18-year longitudinal analysis in Taiwan.BMC Public Health,11,292-300.
19. Chong, M. Y.,Wilkinson, G.(1989).Validation of 30- and 12-item versions of the Chinese Health Questionnaire (CHQ) in patients admitted for general health screening.Psychological Medicine,19(2),495-505.
20. Chuang, Y. C.,Chuang, K. Y.(2008).Gender differences in relationships between social capital and individual smoking and drinking behavior in Taiwan.Social Science & Medicine,67(8),1321-1330.
21. De Moor, M. H. M.,Beem, A. L.,Stubbe, J. H.,Boomsma, D. I.,De Geus, E. J. C.(2006).Regular exercise, anxiety, depression and personality: A population-based study.Preventive Medicine,42,273-279.
22. De Silva, M. J.,Huttly, S. R.,Harpham, T.,Kenward, M. G.(2007).Social capital and mental health: A comparative analysis of four low income countries.Social Science & Medicine,64(1),5-20.
23. Hamano, T.,Fujisawa, Y.,Ishida, Y.,Subramanian, S.,Kawachi, I.,Shiwaku, K.(2010).Social capital and mental health in Japan: A multilevel analysis.PLoS One,5(10),1-7.
24. Harpham, T.,Grant, E.,Rodriguez, C.(2004).Mental health and social capital in Cali, Colombia.Social Science & Medicine,58,2267-2277.
25. Hung, C. H.,Wang, H. H.,Chang, S. H.,Jian, S. Y.,Yang, Y. M.(2012).The health status of postpartum immigrant women in Taiwan.Journal of Clinical Nursing,21,1544-1553.
26. Kuroki, M.(2011).Does social trust increase individual happiness in Japan?.Japanese Economic Review,62(4),444-459.
27. Lindstrom, M.,Mohseni, M.(2009).Social capital, political trust and self-reported psychological health: A population-based study.Social Science & Medicine,68,436-443.
28. Mitchell, C. D.,LaGory, M.(2002).Social capital and mental distress in an impoverished community.City Community,1(2),199-222.
29. Norrish, J. M.,Vella-Brodrick, D. A.(2009).Positive psychology and adolescents: Where are we now? Where to from here?.Australian Psychologist,44(4),270-278.
30. O'Campo, P.,Salmon, C.,Burke, J.(2009).Neighbourhoods and mental well-being: What are the pathways?.Health & Place,15(1),56-68.
31. Poortinga, W.(2006).Social relations or social capital? Individual and community health effects of bonding social capital.Social Science & Medicine,63,255-270.
32. Putnam, R. D.(1993).Making democracy work: Civic traditions in modern Italy.Princeton:Princeton University Press.
33. Rostila, M.(2011).The facets of social capital.Journal for the Theory of Social Behavior,41,308-326.
34. Schmitz, N.,Kruse, J.,Kugler, J.(2004).The association between physical exercises and health-related quality of life in subjects with mental disorders: Results from a cross-sectional survey.Preventive Medicine,39(6),1200-1207.
35. Sirven, N.,Debrand, T.(2012).Social capital and health of older Europeans: Causal pathways and health inequalities.Social Science & Medicine,75(7),1288-1295.
36. Song, L.,Lin, N.(2009).Social capital and health inequality: Evidence from Taiwan.Journal of Health and Social Behavior,50(2),149-162.
37. Stafford, M.,Silva, M. D.,Stansfeld, S.,Marmot, M.(2008).Neighborhood social capital and common mental disorder: Testing the link in a general population sample.Health & Place,14(3),394-405.
38. Su, J. A.,Weng, H. H.,Tsang, H. Y.,Wu, J. L.(2009).Mental health and quality of life among doctors, nurses and other hospital staff.Stress and Health,25,423-430.
39. Tokuda, Y.,Fujii, S.,Inoguchi, T.(2010).Individual and country-level effects of social trust on happiness: The Asia barometer survey.Journal of Applied Social Psychology,40,2574-2593.
40. Townsend, A. L.,Biegel, D. E.,Ishler, K. J.,Wieder, B.,Rini, A.(2006).Families of persons with substance use and mental disorders: A literature review and conceptual framework.Family Relations,55,473-486.
41. Tsai, Y. F.,Yeh, S. H.,Tsai, H. H.(2005).Prevalence and risk factors for depressive symptoms among community-dwelling elders in Taiwan.International Journal of Geriatric Psychiatry,20,1097-1102.
42. Westerhof, G. J.,Keyes, C. L. M.(2010).Mental illness and mental health: The two continua model across the lifespan.Journal of Adult Development,17(2),110-119.
43. World Health Organization(2004).Mental health promotion.Avenue Appia, Geneva:Author.
44. World Health Organization(2001).The world health report 2001-Mental health: New understanding, new hope.Avenue Appia, Geneva:Author.
45. Yang, M. J.,Yang , M. S.,Shih, C. H.,Kawachi, I.(2002).Development and validation of an instrument to measure perceived neighbourhood quality in Taiwan.Journal of Epidemiology & Community Health,56(7),492-496.
46. Yip, W.,Subramanian, S. V.,Mitchell, A. D.,Lee, T. S.,Wang, J.,Kawachi, I.(2007).Does social capital enhance health and well-being? Evidence from rural China.Social Science & Medicine,64(1),35-49.
47. 周玉慧、朱瑞玲(2008)。變遷中的臺灣民眾心理需求、疏離感與身心困擾。臺灣社會學刊，41，59-95。
48. 林振順、林信安、林信仲(2008)。九十六年度全民健保醫療支出概況分析。藥學雜誌，24(4)，45-54。
49. 唐貺怡、黃春太、姜逸群、黃雅文、胡益進(2008)。臺灣地區國中一年級學生的社會資本與心理健康之研究。健康促進暨衛生教育雜誌，28，47-64。
50. 張智嵐、袁聖琇、黃美芳(2008)。探討憂鬱症成因與症狀之性別差異。輔導季刊，44(1)，33-42。

1. Liang, Chuan-Chuan,Chang, Mei-Ying(2016).Exploring factors related to willingness to pay for telehealth services: a 2013 national survey in Taiwan.臺灣公共衛生雜誌,35(2),187-198.
2. 蔡財富(2017)。從社會資本解析罕見疾病患者的網絡支持。護理雜誌，64(5)，18-23。
3. 陳李綢(2014)。中學生正向心理健康量表之編製研究。教育研究與發展期刊，10(4)，1-22。