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題名 安心專線開案管理電話追蹤關懷之成效分析
An evaluation of the effectiveness of the follow-up care phone calls for the callers to Taiwan An Hsin Hotline作者 余宸佑
Yu, Chen-Yu貢獻者 許文耀
Hsu, Wen-Yau
余宸佑
Yu, Chen-Yu關鍵詞 安心專線
成效評估
自殺追蹤關懷
自殺通報
Taiwan An Hsin Hotline
Effectiveness Evaluation
Suicide Follow-up Care
Suicide Reporting日期 2024 上傳時間 5-Aug-2024 14:49:17 (UTC+8) 摘要 對高自殺風險個案持續的追蹤關懷是重要的。台灣安心專線的開案管理，是於安心專線將具有中、高自殺風險的來電者轉介至台北市生命線，由生命線定期主動致電個案，對這群來電者進行追蹤關懷，嘗試企圖降低其自殺風險或轉介至相關單位。此種電話追蹤關懷已經行之有年，但至今未有任何實證研究探討其成效如何。因此，本研究的目的即是探討台灣安心專線開案管理的成效。本研究的研究問題計有：一、比較開案管理於追蹤過程中，持續電話關懷與被轉介這兩組在開案後的第一通來電的前1/3與後1/3的自殺風險性與情緒困擾，是否有所改變且這兩組是否具有差異。二、檢驗持續電話關懷、被轉介兩組來電者從開案後第一通電話的後1/3到結案前最後一通電話的後1/3的自殺風險性與情緒困擾，是否具有差異，來當為成效評估的效果；同時，本研究將以台灣自殺防治通報系統的資料庫，來檢驗持續電話關懷、被轉介兩組在後續被自殺通報的差異，也作為檢驗成效的指標。 本研究資料為2019年7月至2023年底安心專線的開案管理來電者，於開案後第一通電話與結案前最後一通電話之電話錄音檔、台灣eSOS自殺危機個案處理系統資料庫之紀錄檔，以及自殺通報系統資料。在此段時間，安心專線開案管理個案持續電話關懷組共213人，被轉介組共29人，排除開案後第一通電話或結案前最後一通電話通話時間低於10分鐘而不足以分析以回答本研究問題之錄音檔後，持續電話關懷組仍有84人，被轉介組僅剩17人。因此，本研究隨機抽取20位持續電話關懷組來電者，加上17位被轉介組來電者，一共對37位來電者資料進行研究分析。本研究將錄音檔轉錄成文字謄本後（已去除可辨識個人的資料），以自殺風險評量表(SRS)、情緒狀態評量表(MSRS)對每通來電文字謄本之前1/3時段及後1/3時段，進行自殺風險程度、情緒困擾程度的評分，兩位評分者對SRS和MSRS之評分者間信度Kendall's Tau-b經分析分別為.89以及.86，皆顯示具有良好的評估者信度。此外，本研究也對持續電話關懷、被轉介兩組在結案後，是否因有自殺企圖而被通報至台灣自殺防治通報系統之情形，進行差異檢定。本研究將以變異數分析、共變異數分析、卡方檢定等進行資料分析。研究結果指出，兩組來電者於開案後第一通電話內的自殺風險及情緒困擾程度皆無顯著改善；經過電話追蹤關懷後，持續電話關懷組相較被轉介組的來電者，於結案時自殺風險及情緒困擾程度皆有顯著改善，且在結案後也顯著較少會因為具自殺企圖而被通報至自殺通報系統。上述結果顯示，安心專線的開案管理能夠藉由電話追蹤關懷的過程有效降低來電者的自殺風險，且於結案後仍有不錯的遠程效果，此結果除了給予安心專線實證資料的證據，也提供其他自殺防治單位可參考的介入方式。最後，本研究也對目前研究的限制，以及未來研究若需更進一步探討所可以突破的方向進行討論。
Continuous follow-up and care for individuals at high suicide risk are crucial. Taiwan's An Hsin Hotline manages high suicide risk cases by transferring them to Taipei Lifeline, which regularly contacts these individuals to monitor and reduce their suicide risk or refer them to relevant services. This telephone follow-up care has been practiced for years, but its effectiveness has not been empirically studied. This study aims to evaluate the effectiveness of follow-up care phone calls provided by An Hsin Hotline. Research questions: 1.Compare suicide risk and emotional distress levels between the first and last third of the initial call for groups which received telephone follow-up care, and those referred to other services, to see if there are any changes and if these two groups differ. This will verify whether the findings of Shaw & Chiang (2019) on one-time callers to An Hsin Hotline are also applicable to those under follow-up care calls 2.To evaluate the effectiveness of the intervention, we examine differences in suicide risk and emotional distress levels between the initial call and the last call before case termination in both groups, and use the data from Taiwan Suicide Prevention System to compare subsequent suicide attempts. The study use data from July 2019 to the end of 2023, including call recordings, Taiwan eSOS system records, and suicide prevention system data. After excluding recordings where the duration of the first or last call was less than 10 minutes, which is insufficient for analysis, the study analyzed data from 20 individuals in the telephone follow-up care group and 17 in the referred group. Transcribed recordings were scored using the Suicide Risk Scale (SRS) and Mental State Rating Scale (MSRS). Inter-rater reliability was high (Kendall's Tau-b: SRS = .89, MSRS = .86). Results showed no significant improvements in SRS and MSRS scores during the initial call. However, after telephone follow-up care, the telephone follow-up care group showed significant improvement in both scores at case termination and were less likely to be reported for suicide attempts after termination. This study provides empirical evidence for the effectiveness of follow-up car phone call by An Hsin Hotline, and offers insights for other suicide prevention organizations. Limitations and future research directions were also discussed.參考文獻 林怡彤、黃金蘭、許文耀(2024)。以語言標記探討安心專線的對談成效及其運作機制(正在投稿中)。 社團法人台北市生命線協會(2023)。111年「安心專線」成果報告。取自http://www.lifeline.org.tw/data/analytic/tel/419 衛生福利部心理健康司(2023)。歷年全國自殺死亡資料統計暨自殺通報統計。取自https://dep.mohw.gov.tw/DOMHAOH/cp-4904-8883-107.html 衛生福利部心理健康司(2024)。自殺防治手冊系列15關懷訪視指引。取自https://dep.mohw.gov.tw/DOMHAOH/cp-4903-54125-107.html 蕭富聰. (2021). 自殺死亡者求助熱線末通來電之情緒困擾與自殺風險程度初探. 臺灣諮商心理學報, 9(1), 51-70. Barmann, B. C. (1980). Therapeutic management of chronic callers to a suicide prevention center. Journal of Community Psychology, 8(1), 45-48. Borges, G., Angst, J., Nock, M. K., Ruscio, A. M., & Kessler, R. C. (2008). Risk factors for the incidence and persistence of suicide-related outcomes: a 10-year follow-up study using the National Comorbidity Surveys. Journal of affective disorders, 105(1-3), 25-33. Boslaugh, S. (2007). Secondary data sources for public health: A practical guide. Cambridge University Press. Ghanbari, B., Malakouti, S. K., Nojomi, M., Alavi, K., & Khaleghparast, S. (2016). Suicide prevention and follow-up services: a narrative review. Global journal of health science, 8(5), 145. Gilbert, P., & Allan, S. (1998). The role of defeat and entrapment (arrested flight) in depression: an exploration of an evolutionary view. Psychological medicine, 28(3), 585-598. Gould, M. S., Kalafat, J., HarrisMunfakh, J. L., & Kleinman, M. (2007). An evaluation of crisis hotline outcomes. Part 2: Suicidal callers. Suicide and Life-Threatening Behavior, 37(3), 338-352. Gould, M. S., Lake, A. M., Galfalvy, H., Kleinman, M., Munfakh, J. L., Wright, J., & McKeon, R. (2018). Follow‐up with callers to the National Suicide Prevention Lifeline: Evaluation of callers’ perceptions of care. Suicide and Life‐Threatening Behavior, 48(1), 75-86. Kalafat, J., Gould, M. S., Munfakh, J. L. H., & Kleinman, M. (2007). An evaluation of crisis hotline outcomes. Part 1: Nonsuicidal crisis callers. Suicide and Life-threatening behavior, 37(3), 322-337. King, R., Nurcombe, B., Bickman, L., Hides, L., & Reid, W. (2003). Telephone counselling for adolescent suicide prevention: Changes in suicidality and mental state from beginning to end of a counselling session. Suicide and Life-Threatening Behavior, 33(4), 400-411. Middleton, A., Woodward, A., Gunn, J., Bassilios, B., & Pirkis, J. (2017). How do frequent users of crisis helplines differ from other users regarding their reasons for calling? Results from a survey with callers to Lifeline, Australia's national crisis helpline service. Health & Social Care in the Community, 25(3), 1041-1049. Mishara, B. L., & Daigle, M. S. (1997). Effects of different telephone intervention styles with suicidal callers at two suicide prevention centers: An empirical investigation. American journal of community psychology, 25(6), 861-885. Mishara, B. L., Chagnon, F., Daigle, M., Balan, B., Raymond, S., Marcoux, I., ... & Berman, A. (2007). Which helper behaviors and intervention styles are related to better short-term outcomes in telephone crisis intervention? Results from a silent monitoring study of calls to the US 1-800-SUICIDE network. Suicide and Life-Threatening Behavior, 37(3), 308-321. Mousavi, S. G., Zohreh, R., Maracy, M. R., Ebrahimi, A., & Sharbafchi, M. R. (2014). The efficacy of telephonic follow up in prevention of suicidal reattempt in patients with suicide attempt history. Advanced biomedical research, 3. O’Connor, R. C. (2011). The integrated motivational-volitional model of suicidal behavior. Crisis. Pan, Y. J., Chang, W. H., Lee, M. B., Chen, C. H., Liao, S. C., & Caine, E. D. (2013). Effectiveness of a nationwide aftercare program for suicide attempters. Psychological medicine, 43(7), 1447-1454. Shaw, F. F. T., & Chiang, W. H. (2019). An evaluation of suicide prevention hotline results in Taiwan: caller profiles and the effect on emotional distress and suicide risk. Journal of affective disorders, 244, 16-20. Shneidman, E. S. (1993). Commentary: Suicide as psychache. Journal of Nervous and Mental Disease. Steele, I. H., Thrower, N., Noroian, P., & Saleh, F. M. (2018). Understanding suicide across the lifespan: a United States perspective of suicide risk factors, assessment & management. Journal of forensic sciences, 63(1), 162-171. Vaiva, G., Ducrocq, F., Meyer, P., Mathieu, D., Philippe, A., Libersa, C., & Goudemand, M. (2006). Effect of telephone contact on further suicide attempts in patients discharged from an emergency department: randomised controlled study. Bmj, 332(7552), 1241-1245. Williams, J. M. G., & Williams, M. (2001). Suicide and attempted suicide: Understanding the cry of pain. Mark Williams. World Health Organization. (2014). Preventing suicide: A global imperative. World Health Organization. 描述 碩士
國立政治大學
心理學系
109752006資料來源 http://thesis.lib.nccu.edu.tw/record/#G0109752006 資料類型 thesis dc.contributor.advisor 許文耀 zh_TW dc.contributor.advisor Hsu, Wen-Yau en_US dc.contributor.author (Authors) 余宸佑 zh_TW dc.contributor.author (Authors) Yu, Chen-Yu en_US dc.creator (作者) 余宸佑 zh_TW dc.creator (作者) Yu, Chen-Yu en_US dc.date (日期) 2024 en_US dc.date.accessioned 5-Aug-2024 14:49:17 (UTC+8) - dc.date.available 5-Aug-2024 14:49:17 (UTC+8) - dc.date.issued (上傳時間) 5-Aug-2024 14:49:17 (UTC+8) - dc.identifier (Other Identifiers) G0109752006 en_US dc.identifier.uri (URI) https://nccur.lib.nccu.edu.tw/handle/140.119/152918 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 心理學系 zh_TW dc.description (描述) 109752006 zh_TW dc.description.abstract (摘要) 對高自殺風險個案持續的追蹤關懷是重要的。台灣安心專線的開案管理，是於安心專線將具有中、高自殺風險的來電者轉介至台北市生命線，由生命線定期主動致電個案，對這群來電者進行追蹤關懷，嘗試企圖降低其自殺風險或轉介至相關單位。此種電話追蹤關懷已經行之有年，但至今未有任何實證研究探討其成效如何。因此，本研究的目的即是探討台灣安心專線開案管理的成效。本研究的研究問題計有：一、比較開案管理於追蹤過程中，持續電話關懷與被轉介這兩組在開案後的第一通來電的前1/3與後1/3的自殺風險性與情緒困擾，是否有所改變且這兩組是否具有差異。二、檢驗持續電話關懷、被轉介兩組來電者從開案後第一通電話的後1/3到結案前最後一通電話的後1/3的自殺風險性與情緒困擾，是否具有差異，來當為成效評估的效果；同時，本研究將以台灣自殺防治通報系統的資料庫，來檢驗持續電話關懷、被轉介兩組在後續被自殺通報的差異，也作為檢驗成效的指標。 本研究資料為2019年7月至2023年底安心專線的開案管理來電者，於開案後第一通電話與結案前最後一通電話之電話錄音檔、台灣eSOS自殺危機個案處理系統資料庫之紀錄檔，以及自殺通報系統資料。在此段時間，安心專線開案管理個案持續電話關懷組共213人，被轉介組共29人，排除開案後第一通電話或結案前最後一通電話通話時間低於10分鐘而不足以分析以回答本研究問題之錄音檔後，持續電話關懷組仍有84人，被轉介組僅剩17人。因此，本研究隨機抽取20位持續電話關懷組來電者，加上17位被轉介組來電者，一共對37位來電者資料進行研究分析。本研究將錄音檔轉錄成文字謄本後（已去除可辨識個人的資料），以自殺風險評量表(SRS)、情緒狀態評量表(MSRS)對每通來電文字謄本之前1/3時段及後1/3時段，進行自殺風險程度、情緒困擾程度的評分，兩位評分者對SRS和MSRS之評分者間信度Kendall's Tau-b經分析分別為.89以及.86，皆顯示具有良好的評估者信度。此外，本研究也對持續電話關懷、被轉介兩組在結案後，是否因有自殺企圖而被通報至台灣自殺防治通報系統之情形，進行差異檢定。本研究將以變異數分析、共變異數分析、卡方檢定等進行資料分析。研究結果指出，兩組來電者於開案後第一通電話內的自殺風險及情緒困擾程度皆無顯著改善；經過電話追蹤關懷後，持續電話關懷組相較被轉介組的來電者，於結案時自殺風險及情緒困擾程度皆有顯著改善，且在結案後也顯著較少會因為具自殺企圖而被通報至自殺通報系統。上述結果顯示，安心專線的開案管理能夠藉由電話追蹤關懷的過程有效降低來電者的自殺風險，且於結案後仍有不錯的遠程效果，此結果除了給予安心專線實證資料的證據，也提供其他自殺防治單位可參考的介入方式。最後，本研究也對目前研究的限制，以及未來研究若需更進一步探討所可以突破的方向進行討論。 zh_TW dc.description.abstract (摘要) Continuous follow-up and care for individuals at high suicide risk are crucial. Taiwan's An Hsin Hotline manages high suicide risk cases by transferring them to Taipei Lifeline, which regularly contacts these individuals to monitor and reduce their suicide risk or refer them to relevant services. This telephone follow-up care has been practiced for years, but its effectiveness has not been empirically studied. This study aims to evaluate the effectiveness of follow-up care phone calls provided by An Hsin Hotline. Research questions: 1.Compare suicide risk and emotional distress levels between the first and last third of the initial call for groups which received telephone follow-up care, and those referred to other services, to see if there are any changes and if these two groups differ. This will verify whether the findings of Shaw & Chiang (2019) on one-time callers to An Hsin Hotline are also applicable to those under follow-up care calls 2.To evaluate the effectiveness of the intervention, we examine differences in suicide risk and emotional distress levels between the initial call and the last call before case termination in both groups, and use the data from Taiwan Suicide Prevention System to compare subsequent suicide attempts. The study use data from July 2019 to the end of 2023, including call recordings, Taiwan eSOS system records, and suicide prevention system data. After excluding recordings where the duration of the first or last call was less than 10 minutes, which is insufficient for analysis, the study analyzed data from 20 individuals in the telephone follow-up care group and 17 in the referred group. Transcribed recordings were scored using the Suicide Risk Scale (SRS) and Mental State Rating Scale (MSRS). Inter-rater reliability was high (Kendall's Tau-b: SRS = .89, MSRS = .86). Results showed no significant improvements in SRS and MSRS scores during the initial call. However, after telephone follow-up care, the telephone follow-up care group showed significant improvement in both scores at case termination and were less likely to be reported for suicide attempts after termination. This study provides empirical evidence for the effectiveness of follow-up car phone call by An Hsin Hotline, and offers insights for other suicide prevention organizations. Limitations and future research directions were also discussed. en_US dc.description.tableofcontents 表目次 vi 圖目次 vii 第一章、緒論 1 第二章、文獻探討 3 第一節、台灣安心專線開案管理的自殺追蹤服務 3 第二節、國外熱線主動致電關懷個案的成效 6 第三節、開案管理成效指標的測量 10 第四節、對不同開案管理個案的分組 12 第五節、研究問題與假設 13 第三章、研究方法 16 第一節、研究資料 16 第二節、研究工具 17 第三節、量表評分方式與評分者間信度 19 第四節、資料分析方法 20 第四章、研究結果 23 第五章、討論 41 第一節、兩組開案管理者於一通電話內的成效 41 第二節、安心專線開案管理電話追蹤關懷的成效 44 第三節、對於被轉介組來電者的分析結果討論 46 第四節、電話總時間與開案管理成效之間的關係 47 第五節、研究貢獻、限制與未來方向 47 參考文獻 51 zh_TW dc.format.extent 2386691 bytes - dc.format.mimetype application/pdf - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0109752006 en_US dc.subject (關鍵詞) 安心專線 zh_TW dc.subject (關鍵詞) 成效評估 zh_TW dc.subject (關鍵詞) 自殺追蹤關懷 zh_TW dc.subject (關鍵詞) 自殺通報 zh_TW dc.subject (關鍵詞) Taiwan An Hsin Hotline en_US dc.subject (關鍵詞) Effectiveness Evaluation en_US dc.subject (關鍵詞) Suicide Follow-up Care en_US dc.subject (關鍵詞) Suicide Reporting en_US dc.title (題名) 安心專線開案管理電話追蹤關懷之成效分析 zh_TW dc.title (題名) An evaluation of the effectiveness of the follow-up care phone calls for the callers to Taiwan An Hsin Hotline en_US dc.type (資料類型) thesis en_US dc.relation.reference (參考文獻) 林怡彤、黃金蘭、許文耀(2024)。以語言標記探討安心專線的對談成效及其運作機制(正在投稿中)。 社團法人台北市生命線協會(2023)。111年「安心專線」成果報告。取自http://www.lifeline.org.tw/data/analytic/tel/419 衛生福利部心理健康司(2023)。歷年全國自殺死亡資料統計暨自殺通報統計。取自https://dep.mohw.gov.tw/DOMHAOH/cp-4904-8883-107.html 衛生福利部心理健康司(2024)。自殺防治手冊系列15關懷訪視指引。取自https://dep.mohw.gov.tw/DOMHAOH/cp-4903-54125-107.html 蕭富聰. 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