CAJ | 학술논문

目的：了解康复期精神分裂症患者病耻感体验现状，考察社会支持与其病耻感的关系。方法采用自制一般情况调查表，Link病耻感量表和社会支持问卷对213名具有自知力的精神分裂症患者进行测试。结果①患者“贬低-歧视感知”维度的平均得分为2.5794分；应对方式中“保密”、“退缩”维度的平均得分为2.5804、2.5103分，但“教育”、“挑战”、“分离”三个维度平均得分都低于量表中点2.5分；在情感体验方面，“误解”和“不同/羞耻”两个维度平均得分都高于量表中点2.5分；②精神分裂症患者社会支持、主观支持、客观支持都与病耻感各个维度呈负相关(均P <0.05)，患者对社会支持的利用度分别与贬低-歧视感知(r =-0.306，P <0.01)、保密(r =-0.259，P<0.01)、退缩(r=-0.412，P<0.01)、挑战(r=-0.216，P<0.01)、误解(r=-0.178，P<0.05)及不同/羞耻(r=-0.292，P<0.01)呈负相关。结论精神分裂症患者普遍感知到较高水平的病耻感，认为自己不能被理解，感到与他人不同，通常采取保密、退缩的应对方式；应对精神分裂症患者的病耻感给予充分关注，消除人们对精神分裂症患者的歧视和偏见，提高患者的社会支持利用度，促进患者全面康复。
목적：료해강복기정신분렬증환자병치감체험현상，고찰사회지지여기병치감적관계。방법채용자제일반정황조사표，Link병치감량표화사회지지문권대213명구유자지력적정신분렬증환자진행측시。결과①환자“폄저-기시감지”유도적평균득분위2.5794분；응대방식중“보밀”、“퇴축”유도적평균득분위2.5804、2.5103분，단“교육”、“도전”、“분리”삼개유도평균득분도저우량표중점2.5분；재정감체험방면，“오해”화“불동/수치”량개유도평균득분도고우량표중점2.5분；②정신분렬증환자사회지지、주관지지、객관지지도여병치감각개유도정부상관(균P <0.05)，환자대사회지지적이용도분별여폄저-기시감지(r =-0.306，P <0.01)、보밀(r =-0.259，P<0.01)、퇴축(r=-0.412，P<0.01)、도전(r=-0.216，P<0.01)、오해(r=-0.178，P<0.05)급불동/수치(r=-0.292，P<0.01)정부상관。결론정신분렬증환자보편감지도교고수평적병치감，인위자기불능피리해，감도여타인불동，통상채취보밀、퇴축적응대방식；응대정신분렬증환자적병치감급여충분관주，소제인문대정신분렬증환자적기시화편견，제고환자적사회지지이용도，촉진환자전면강복。
Objective To explore the perceived stigma and the relationship between the perceived stigma and social support. Methods Total 213 patients with rehabilitation schizophrenia involved in the survey using the Stigma Scale for mental illness, social support rating scale and the self-designed general condition questionnaire. Results ①The mean score of the perceived devaluation-discrimination scale was 2.5794 points. The mean scores of secrecy and flinching was 2.5804, 2.5103 points, but the means of education, challenging and separating were significant lower than the 2.5 mid-point;the means score of stigma-related feelings were significant higher than the 2.5 midpoint.②The perceived stigma was negatively correlated to social support, subjective support and objective support (P< 0.05). The utility of support was negatively correlated to devaluation-discrimination (r = -0.306, P< 0.01), secrecy (r = -0.259, P< 0.01), flinch-ing (r= -0.412, P< 0.01), challenging (r=-0.216, P<0.01), misunderstand (r= -0.178, P< 0.05) and difference/shame (r=-0.292, P<0.01). Conclusion People with schizophrenia frequently suffer from stigma, and feel that people are unable to understand their situation. The use of secrecy and flinching are the most frequently endorsed way of cop-ing with stigma. The perceived stigma needs our more concerns so as to diminish discrimination and bias against them, enhance their utility of social support and ultimately promote their general rehabilitation.