Yang Lawrence H, Phelan Jo C, Link Bruce G
Department of Epidemiology, School of Public Health, Columbia University New York, NY 10032, USA.
Cultur Divers Ethnic Minor Psychol. 2008 Jan;14(1):10-8. doi: 10.1037/1099-9809.14.1.10.
In this study we examined community attitudes of efficacy and shame to investigate the factors that may underlie mental health service underutilization among Chinese Americans. We administered an experimental vignette to assess beliefs of efficacy and shame toward using traditional Chinese medicine (TCM) as opposed to Western health services in a sample of 90 Chinese Americans obtained through a national telephone survey. Contrary to predictions, beliefs of efficacy for treating mental disorders were found to be greater for Western psychiatric services when compared with TCM. As predicted however, Chinese Americans perceived greater community attitudes of shame when accessing Western psychiatric services as opposed to TCM to treat a mental disorder. Furthermore, these differences in community attitudes of shame only occurred among respondents who received a psychiatric condition vignette, but not with respondents who were administered a vignette of a physical disorder. These findings suggest that perceived shame may play an important role in help seeking and that integration of TCM with Western psychiatric care may have implications for reducing shame for Chinese Americans.
在本研究中，我们调查了社区对疗效和羞耻感的态度，以探究美籍华裔心理健康服务利用率低背后可能存在的因素。我们通过全国电话调查选取了90名美籍华裔样本，采用实验性 vignette（情景描述）来评估使用传统中医（TCM）而非西方医疗服务时的疗效和羞耻感信念。与预测相反，与中医相比，西方精神科服务在治疗精神障碍方面的疗效信念更高。然而，正如预测的那样，美籍华裔在使用西方精神科服务而非中医治疗精神障碍时，感受到社区的羞耻感更强。此外，这些社区羞耻感态度的差异仅出现在收到精神疾病 vignette 的受访者中，而收到身体疾病 vignette 的受访者中则没有。这些发现表明，感知到的羞耻感可能在寻求帮助方面发挥重要作用，并且将中医与西方精神科护理相结合可能对减少美籍华裔的羞耻感有影响。
