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不同文化背景下精神障碍患者的求医方式、内化耻辱感及感知社会支持水平:以土耳其的东西方实例比较

Treatment-seeking methods, internalized stigma, and perceived social support levels of patients with mental disorders in different cultures: comparison of Eastern and Western examples in Turkiye.

作者信息

Özdemir Nurgül, Şahin Şengül Kocamer, Özdemir Şiğva Fatima, Türkmen Ali Rıza

机构信息

Faculty of Health Science, Department of Psychiatric Nursing, Gaziantep University, Gaziantep, Turkiye.

Department of Psychiatry, Adana City Research and Training Hospital, University of Health Science, Adana, Turkiye.

出版信息

Nord J Psychiatry. 2025 May;79(4):288-296. doi: 10.1080/08039488.2025.2486380. Epub 2025 Apr 22.

Abstract

PURPOSE

This study investigated treatment-seeking methods, internalized stigma levels, and perceived social support among mental disorder patients in the eastern and western regions of Turkiye.

MATERIALS AND METHODS

The study was conducted between April 10, 2022, and October 10, 2022, in two centers: Mardin Research and Training Hospital Psychiatry Outpatient Clinic (Southeastern Anatolia Region) and Bagcilar Research and Training Hospital Psychiatry Outpatient Clinic (Marmara Region). Simple random sampling method was used in the selection of participants. 238 patients (119 from each center) diagnosed with DSM-5 disorders participated. Assessment tools included the Help-Seeking Behavior Evaluation Form, Short Form of the Attitude Scale for Seeking Psychological Help (ATSPHS), Internalized Stigma Scale in Mental Illnesses (ISMI), and Multidimensional Perceived Social Support Scale (MSPSS). Data were analyzed using descriptive statistics, chi-square tests, and independent -tests.

RESULTS

Patients in the western region reported higher perceived support from family and friends, while those in the eastern region experienced greater internalized stigma, including alienation, stereotype endorsement, perceived discrimination, and social withdrawal. Patients in the eastern region demonstrated a stronger preference for traditional healers. Conversely, patients in the western region were more likely to consult psychiatrists.

CONCLUSION

The study concludes that cultural factors significantly influence patients' attitudes toward treatment and mental health care. It emphasizes the need for culturally sensitive approaches in mental health interventions, particularly in rural and disadvantaged areas. Community-based psychoeducation programs could help reduce stigma and encourage earlier help-seeking behaviors.

摘要

目的

本研究调查了土耳其东部和西部地区精神障碍患者寻求治疗的方法、内化耻辱感水平和感知到的社会支持。

材料与方法

该研究于2022年4月10日至2022年10月10日在两个中心进行:马尔丁研究与培训医院精神科门诊(东安纳托利亚地区)和巴伊库勒研究与培训医院精神科门诊(马尔马拉地区)。采用简单随机抽样方法选取参与者。238名被诊断患有DSM-5障碍的患者参与其中。评估工具包括寻求帮助行为评估表、寻求心理帮助态度量表简表(ATSPHS)、精神疾病内化耻辱感量表(ISMI)和多维感知社会支持量表(MSPSS)。使用描述性统计、卡方检验和独立样本t检验对数据进行分析。

结果

西部地区的患者报告称从家人和朋友那里获得了更高的支持感,而东部地区的患者则经历了更大的内化耻辱感,包括疏离感、刻板印象认同、感知到的歧视和社交退缩。东部地区的患者对传统治疗师表现出更强的偏好。相反,西部地区的患者更有可能咨询精神科医生。

结论

该研究得出结论,文化因素显著影响患者对治疗和精神卫生保健的态度。它强调在精神卫生干预中,特别是在农村和贫困地区,需要采用对文化敏感的方法。基于社区的心理教育项目有助于减少耻辱感并鼓励更早的求助行为。

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