學術產出-學位論文

題名 從城鄉差異的觀點,評估台灣鄉村型社區心理衛生中心之服務需求:以社會指標分析、關鍵訊息提供者與社區居民的調查等方法研究雲林縣高農業人口地區為例
The Needs Assessment for Rural Community Mental Health Centers in Taiwan Based on the Perspectives of Urban-Rural Differences: A Multi-Method Approach including the Social Indicators Analysis, the Survey of the Key Informants and Community Residents in the High Agricultural Areas of Yunlin County
作者 周才忠
Chou, Tsai Chung
貢獻者 陳嘉鳳
Chen, Chia Feng
周才忠
Chou, Tsai Chung
關鍵詞 社區心理衛生中心
社會指標分析
關鍵訊息提供者調查
社區居民調查
農業危機
鄉村心理衛生服務
心理衛生指標系統
Community Mental Health Center
Social Indicators Analysis
Key Informants Approach
Community Residents Survey
Farm Crisis
Rural Mental Health Services
Mental Health indicators System
日期 2004
上傳時間 19-九月-2009 11:56:06 (UTC+8)
摘要 本研究以城鄉差異觀點,評估台灣鄉村型社區心理衛生中心之服務需求,具體目的有(1)分析台灣縣市及雲林縣鄉鎮與心理衛生有關之各項社會指標,以驗證社區心理衛生相關問題的城鄉差異性;(2)瞭解雲林縣及其鄉鎮關鍵訊息提供者對高度農業地區各項社區心理衛生問題嚴重程度、問題型式、地理分佈與相關在地服務資源之看法;(3)瞭解雲林縣高度農業人口鄉鎮社區居民對其村落各項相關心理衛生問題嚴重程度、問題型式、社區壓力源、因應方式與求助情形之看法;(4)由社區居民調查結果,抽取鄉村心理衛生相關問題之共同因素,並歸納諸項調查研究與指標分析結果,初步擬定出一「台灣鄉村心理衛生指標系統目錄」。

研究方法採用多方法評估策略。社會指標分析方面,共計分析台灣地區23個縣市24項及雲林縣20個鄉鎮市16項心理衛生相關問題,以比較不同農業人口分群其發生率或盛行率之差異。關鍵訊息提供者調查方面,使用自編問卷分別調查雲林縣30位與二崙與水林兩鄉69位政府單位、民間機構或專業個人等。社區居民調查方面,二崙與水林兩鄉共發出2049份問卷,回收1074份(52.4%),有效問卷為967份(41村、97.6%)。統計方法有描述統計、集群分析、t考驗、單因子變異數分析、皮爾森積差相關分析、因素分析等。

研究主要發現如下:(1)高度農業人口地區之老年、低教育程度、喪偶、外籍配偶、身心障礙、意外事故死亡、醫事人員平均服務人口數等比例明顯較高,離婚、全般刑案、竊盜、強盜搶奪、暴力犯罪、強制性交等比例則較低。(2)台灣縣市心理衛生相關嚴重問題社會指標之地理分佈概況不明顯,但雲林縣心理衛生相關嚴重問題比例則以高度農業人口的二崙與麥寮兩鄉明顯較高。(3)雲林縣與二崙、水林兩鄉關鍵訊息提供者皆認為人口外移與老化、老人問題(獨居、貧窮、安養等)、電話詐騙等問題比例較高。雲林縣關鍵訊息提供者主觀覺得口湖、台西與四湖為最亟需心理衛生服務的農業鄉鎮。二崙鄉關鍵訊息提供者主觀覺得大庄、楊賢與港後為該鄉最亟需心理衛生服務的村落。水林鄉關鍵訊息提供者主觀覺得水北、塭底與大山為該鄉最亟需心理衛生服務的村落。(4)二崙與水林兩鄉社區居民認為電話詐騙、人口外移、農產經營影響、人口老化、家庭經濟壓力等問題比例較高,青少女母親(含未婚懷孕)、家庭人數眾多、親友與鄰居死亡頻傳、自殺、性侵害、精神疾病、家庭暴力、家庭虐待等比例較低。(5)二崙與水林兩鄉居民認為「社區孤立與無望感」來自人口老化、多孤獨貧窮老人、人口外流嚴重、生活無聊、缺乏休閒娛樂等因素較多,「犯罪被害擔憂與恐懼」來自竊盜、詐騙、嗑藥吸毒等問題較多,「社區憂鬱現象」來自個人與家庭經濟壓力、失業、農業損害或收益等因素較多。(6)二崙與水林兩鄉居民認為其感受社會壓力源以治安惡化為主,農業壓力源以農產收益與自然災害為主,社區壓力源以治安不佳、衛生環境不良、缺乏休閒娛樂等較多,學校壓力源以城鄉差距大、教育與學習資源不足、課業或升學壓力、教育政策多變等較多,家庭壓力源以經濟收入與子女教養為主,個人壓力源以經濟收入、身體健康、工作壓力等較多。(7)二崙與水林兩鄉居民指出習慣(或主要)抒解或因應壓力方法,以「找人聊天」居首,只有6.5%曾求助於親友之外的專業人員。(8)雲林縣現有7個單位或機構(衛生局─社區心理衛生中心與長期照護管理示範中心、社會局─各課、家庭教育中心、台大醫院雲林分院精神科、雲林區心理衛生諮詢服務中心與生命線協會)共提供37個鄉村心理衛生相關服務項目。

本研究由社區居民調查結果,共抽取出七個因素構面並分別命名為「一般社區心理衛生問題」、「農業社區心理衛生問題」、「環境污染」、「經濟壓力」、「居住生活風險」、「犯罪」與「家庭婚姻特性」,並歸納諸項調查研究與指標分析結果,初步擬定出一「台灣鄉村心理衛生指標系統目錄」(5大指標向度,14個指標項目)。

文末,研究者並根據研究結果與國內外相關文獻,分別提出鄉村居民心理健康政策、鄉村心理衛生指標系統、農業危機服務、老人心理衛生、社區孤立與無望感、犯罪被害恐懼、環境污染心理影響、鄉村性別與族群心理議題、鄉村學校之預防功能、鄉村心理衛生服務模式等10項建議。
The purposes of this thesis were: (1) to analyze the differences of some social indicators related to mental health of Taiwan (23 cities/counties) and Yunlin county (20 townships). (2) to understand the opinions of the key informants about community mental health problems. (3) to survey community residents of agricultural areas about the subjective perceptions of their mental health. (4) to set up a summative index of Taiwan Rural Mental Health indicators System.

This research used a multi-method strategy. Data collected in the spring of 2005 included 24 social indicators of 23 cities/counties in Taiwan, and 16 social indicators of 20 cities/township in Yunlin, and questionnaires of 99 key informants and 967 community members of Erh-lun and Shui-lin Township of Yunlin County.

Major findings of this study were as follows:

(1)Significant differences were found in the social indicators about the numbers of older population, the lower educational status, the widowed, the foreign spouse, and the disabled, the accidental injury-related deaths in agricultural counties. In contrast, urbanized areas had higher rates of the divorced, all criminal case, larceny, robbery and forceful taking, violent crime, rape, and the average number of people serviced by per medical personnel .

(2)The geographic analysis in terms of the mental health status and service needs of residents revealed no significant differences among 23 cities/counties, but significant differences among 20 cities/township (Yunlin County), Erh-lun and Mailiao had much more problems.

(3)Yunlin County’s key informants indicated that the areas of Kou-hu, Tai-si and Sih-hu have high needs for mental health services. Erh-lun’s key informants indicated that 3 villages have high needs for mental health services. Shui-lin’s key informants indicated that 3 villages have high needs for mental health services.

(4)Most respondents of resident sample ranked the following mental health problems as serious: fraudulent telephone calls, out-migrant, farm crisis, being elderly, and family economic hardship.

(5)Most respondents of resident sample employed “chatting with others” as stress-relieving or coping method. Besides “family and friends”, only about 6.5% of respondents reported that they sought help from mental health professionals or specialists.

(6)To set up the initial rural mental health indicator systems of Taiwan: a summative index consists of 14 items and is divided into five dimensions

The recommendations for rural mental health policies, indicator systems, program strategies and rural mental health service delivery issues were also suggested.
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描述 碩士
國立政治大學
心理學研究所
88752010
93
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0887520101
資料類型 thesis
dc.contributor.advisor 陳嘉鳳zh_TW
dc.contributor.advisor Chen, Chia Fengen_US
dc.contributor.author (作者) 周才忠zh_TW
dc.contributor.author (作者) Chou, Tsai Chungen_US
dc.creator (作者) 周才忠zh_TW
dc.creator (作者) Chou, Tsai Chungen_US
dc.date (日期) 2004en_US
dc.date.accessioned 19-九月-2009 11:56:06 (UTC+8)-
dc.date.available 19-九月-2009 11:56:06 (UTC+8)-
dc.date.issued (上傳時間) 19-九月-2009 11:56:06 (UTC+8)-
dc.identifier (其他 識別碼) G0887520101en_US
dc.identifier.uri (URI) https://nccur.lib.nccu.edu.tw/handle/140.119/37080-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 心理學研究所zh_TW
dc.description (描述) 88752010zh_TW
dc.description (描述) 93zh_TW
dc.description.abstract (摘要) 本研究以城鄉差異觀點,評估台灣鄉村型社區心理衛生中心之服務需求,具體目的有(1)分析台灣縣市及雲林縣鄉鎮與心理衛生有關之各項社會指標,以驗證社區心理衛生相關問題的城鄉差異性;(2)瞭解雲林縣及其鄉鎮關鍵訊息提供者對高度農業地區各項社區心理衛生問題嚴重程度、問題型式、地理分佈與相關在地服務資源之看法;(3)瞭解雲林縣高度農業人口鄉鎮社區居民對其村落各項相關心理衛生問題嚴重程度、問題型式、社區壓力源、因應方式與求助情形之看法;(4)由社區居民調查結果,抽取鄉村心理衛生相關問題之共同因素,並歸納諸項調查研究與指標分析結果,初步擬定出一「台灣鄉村心理衛生指標系統目錄」。

研究方法採用多方法評估策略。社會指標分析方面,共計分析台灣地區23個縣市24項及雲林縣20個鄉鎮市16項心理衛生相關問題,以比較不同農業人口分群其發生率或盛行率之差異。關鍵訊息提供者調查方面,使用自編問卷分別調查雲林縣30位與二崙與水林兩鄉69位政府單位、民間機構或專業個人等。社區居民調查方面,二崙與水林兩鄉共發出2049份問卷,回收1074份(52.4%),有效問卷為967份(41村、97.6%)。統計方法有描述統計、集群分析、t考驗、單因子變異數分析、皮爾森積差相關分析、因素分析等。

研究主要發現如下:(1)高度農業人口地區之老年、低教育程度、喪偶、外籍配偶、身心障礙、意外事故死亡、醫事人員平均服務人口數等比例明顯較高,離婚、全般刑案、竊盜、強盜搶奪、暴力犯罪、強制性交等比例則較低。(2)台灣縣市心理衛生相關嚴重問題社會指標之地理分佈概況不明顯,但雲林縣心理衛生相關嚴重問題比例則以高度農業人口的二崙與麥寮兩鄉明顯較高。(3)雲林縣與二崙、水林兩鄉關鍵訊息提供者皆認為人口外移與老化、老人問題(獨居、貧窮、安養等)、電話詐騙等問題比例較高。雲林縣關鍵訊息提供者主觀覺得口湖、台西與四湖為最亟需心理衛生服務的農業鄉鎮。二崙鄉關鍵訊息提供者主觀覺得大庄、楊賢與港後為該鄉最亟需心理衛生服務的村落。水林鄉關鍵訊息提供者主觀覺得水北、塭底與大山為該鄉最亟需心理衛生服務的村落。(4)二崙與水林兩鄉社區居民認為電話詐騙、人口外移、農產經營影響、人口老化、家庭經濟壓力等問題比例較高,青少女母親(含未婚懷孕)、家庭人數眾多、親友與鄰居死亡頻傳、自殺、性侵害、精神疾病、家庭暴力、家庭虐待等比例較低。(5)二崙與水林兩鄉居民認為「社區孤立與無望感」來自人口老化、多孤獨貧窮老人、人口外流嚴重、生活無聊、缺乏休閒娛樂等因素較多,「犯罪被害擔憂與恐懼」來自竊盜、詐騙、嗑藥吸毒等問題較多,「社區憂鬱現象」來自個人與家庭經濟壓力、失業、農業損害或收益等因素較多。(6)二崙與水林兩鄉居民認為其感受社會壓力源以治安惡化為主,農業壓力源以農產收益與自然災害為主,社區壓力源以治安不佳、衛生環境不良、缺乏休閒娛樂等較多,學校壓力源以城鄉差距大、教育與學習資源不足、課業或升學壓力、教育政策多變等較多,家庭壓力源以經濟收入與子女教養為主,個人壓力源以經濟收入、身體健康、工作壓力等較多。(7)二崙與水林兩鄉居民指出習慣(或主要)抒解或因應壓力方法,以「找人聊天」居首,只有6.5%曾求助於親友之外的專業人員。(8)雲林縣現有7個單位或機構(衛生局─社區心理衛生中心與長期照護管理示範中心、社會局─各課、家庭教育中心、台大醫院雲林分院精神科、雲林區心理衛生諮詢服務中心與生命線協會)共提供37個鄉村心理衛生相關服務項目。

本研究由社區居民調查結果,共抽取出七個因素構面並分別命名為「一般社區心理衛生問題」、「農業社區心理衛生問題」、「環境污染」、「經濟壓力」、「居住生活風險」、「犯罪」與「家庭婚姻特性」,並歸納諸項調查研究與指標分析結果,初步擬定出一「台灣鄉村心理衛生指標系統目錄」(5大指標向度,14個指標項目)。

文末,研究者並根據研究結果與國內外相關文獻,分別提出鄉村居民心理健康政策、鄉村心理衛生指標系統、農業危機服務、老人心理衛生、社區孤立與無望感、犯罪被害恐懼、環境污染心理影響、鄉村性別與族群心理議題、鄉村學校之預防功能、鄉村心理衛生服務模式等10項建議。
zh_TW
dc.description.abstract (摘要) The purposes of this thesis were: (1) to analyze the differences of some social indicators related to mental health of Taiwan (23 cities/counties) and Yunlin county (20 townships). (2) to understand the opinions of the key informants about community mental health problems. (3) to survey community residents of agricultural areas about the subjective perceptions of their mental health. (4) to set up a summative index of Taiwan Rural Mental Health indicators System.

This research used a multi-method strategy. Data collected in the spring of 2005 included 24 social indicators of 23 cities/counties in Taiwan, and 16 social indicators of 20 cities/township in Yunlin, and questionnaires of 99 key informants and 967 community members of Erh-lun and Shui-lin Township of Yunlin County.

Major findings of this study were as follows:

(1)Significant differences were found in the social indicators about the numbers of older population, the lower educational status, the widowed, the foreign spouse, and the disabled, the accidental injury-related deaths in agricultural counties. In contrast, urbanized areas had higher rates of the divorced, all criminal case, larceny, robbery and forceful taking, violent crime, rape, and the average number of people serviced by per medical personnel .

(2)The geographic analysis in terms of the mental health status and service needs of residents revealed no significant differences among 23 cities/counties, but significant differences among 20 cities/township (Yunlin County), Erh-lun and Mailiao had much more problems.

(3)Yunlin County’s key informants indicated that the areas of Kou-hu, Tai-si and Sih-hu have high needs for mental health services. Erh-lun’s key informants indicated that 3 villages have high needs for mental health services. Shui-lin’s key informants indicated that 3 villages have high needs for mental health services.

(4)Most respondents of resident sample ranked the following mental health problems as serious: fraudulent telephone calls, out-migrant, farm crisis, being elderly, and family economic hardship.

(5)Most respondents of resident sample employed “chatting with others” as stress-relieving or coping method. Besides “family and friends”, only about 6.5% of respondents reported that they sought help from mental health professionals or specialists.

(6)To set up the initial rural mental health indicator systems of Taiwan: a summative index consists of 14 items and is divided into five dimensions

The recommendations for rural mental health policies, indicator systems, program strategies and rural mental health service delivery issues were also suggested.
en_US
dc.description.tableofcontents 第一章 緒論                        1
 第一節 研究動機與目的                1
 第二節 研究問題與名詞解釋                7
第二章 文獻探討                     14
 第一節 鄉村心理衛生相關問題之探討分析         14
 第二節 美國鄉村心理衛生服務的發展演進與相關經驗    20
 第三節 台灣鄉村心理衛生服務的問題狀況與發展需求    30
 第四節 社會指標在心理衛生領域之運用經驗        32
 第五節 國內外鄉村心理衛生相關研究文獻         34
第三章 研究方法與設計                  42
 第一節 研究對象與取樣方法               43
 第二節 研究地區之地理與人文概況            54
 第三節 測量工具及實施程序               59
 第四節 資料處理                    62
第四章 研究結果與討論                  64
第一節 台灣地區23縣市心理衛生相關之社會指標及城鄉
差異分析與地理圖示               64
第二節 雲林縣20鄉鎮市心理衛生相關之社會指標及城鄉
差異分析與地理圖示              111
第三節 雲林縣「縣市」與「鄉鎮」關鍵訊息提供者對各
項社區心理衛生問題嚴重程度、問題型式、地理
分佈及相關在地服務資源等之看法的調查結果   142
第四節 雲林縣高度農業人口鄉鎮社區居民對其村落各項
相關心理衛生問題嚴重程度之主觀評定及社區壓
力源、因應方式、求助情形等調查之結果分析   171
第五節 由社區居民調查結果,抽取鄉村心理衛生相關問
題之共同因素,並歸納調查研究與指標分析結果
,以建構「台灣鄉村心理衛生指標系統之目錄」  201
第五章 結論與建議                   208
 第一節 結論                     208
 第二節 建議                     212
參考文獻                        219
 中文部分                       219
 英文部分                       223

附錄一 美國心理衛生人口特徵輪廓系統之社會指標目錄   233
附錄二 台灣鄉村型社區心理衛生中心服務需求評估─
關鍵訊息提供者調查問卷(一)《雲林縣》       242
附錄三 台灣鄉村型社區心理衛生中心服務需求評估─
關鍵訊息者調查問卷(二)《二崙鄉》       247
附錄四 台灣鄉村型社區心理衛生中心服務需求評估─
關鍵訊息者調查問卷(二)《水林鄉》     250
附錄五 台灣鄉村型社區心理衛生中心服務需求評估─
社區居民調查問卷《二崙鄉》 253
附錄六 台灣鄉村型社區心理衛生中心服務需求評估─
社區居民調查問卷《水林鄉》 256
附錄七 關鍵訊息提供者及社區居民調查問卷專家效度
與審核徵詢名單 259
附錄八 行文雲林縣衛生局之研究計畫公函
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dc.language.iso en_US-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0887520101en_US
dc.subject (關鍵詞) 社區心理衛生中心zh_TW
dc.subject (關鍵詞) 社會指標分析zh_TW
dc.subject (關鍵詞) 關鍵訊息提供者調查zh_TW
dc.subject (關鍵詞) 社區居民調查zh_TW
dc.subject (關鍵詞) 農業危機zh_TW
dc.subject (關鍵詞) 鄉村心理衛生服務zh_TW
dc.subject (關鍵詞) 心理衛生指標系統zh_TW
dc.subject (關鍵詞) Community Mental Health Centeren_US
dc.subject (關鍵詞) Social Indicators Analysisen_US
dc.subject (關鍵詞) Key Informants Approachen_US
dc.subject (關鍵詞) Community Residents Surveyen_US
dc.subject (關鍵詞) Farm Crisisen_US
dc.subject (關鍵詞) Rural Mental Health Servicesen_US
dc.subject (關鍵詞) Mental Health indicators Systemen_US
dc.title (題名) 從城鄉差異的觀點,評估台灣鄉村型社區心理衛生中心之服務需求:以社會指標分析、關鍵訊息提供者與社區居民的調查等方法研究雲林縣高農業人口地區為例zh_TW
dc.title (題名) The Needs Assessment for Rural Community Mental Health Centers in Taiwan Based on the Perspectives of Urban-Rural Differences: A Multi-Method Approach including the Social Indicators Analysis, the Survey of the Key Informants and Community Residents in the High Agricultural Areas of Yunlin Countyen_US
dc.type (資料類型) thesisen
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