Wang Charlotte, Fang Hsiu-Ju, Lu Hsin-Yang, Chen Chen-Fen
Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan.
Master of Public Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan.
J Med Internet Res. 2025 Apr 28;27:e59037. doi: 10.2196/59037.
As populations age, the demand for long-term care services steadily increases. The effectiveness of government-promoted long-term care policies and the public's access to relevant service information are demonstrably influenced by media representation. In addition, prior research has suggested that news framing can mitigate the negative influence (the Werther effect) with a more hopeful framing (the Papageno effect), thereby reducing the public's susceptibility to negative news.
This study investigates the phenomenon of suicides and homicides in long-term care reported in the news, in which family caregivers or care receivers died by suicide or homicide. We examined changes in the media's reporting framework before and after the implementation of Taiwan's Long-Term Care Plan 2.0 in 2017. We further examined the consistency between the content of news reports and the information provided by the media on long-term care services and suicide prevention (eg, hotlines).
Content analysis and text-mining techniques were used to analyze 433 news reports covering 95 cases of suicides and homicides in long-term care in Taiwan from 2009 to 2021. A random-effects model was applied to examine term frequency transition post implementation.
The majority (>60%) of the cases involved family caregivers' homicide-suicide. The term "family moral tragedy" has been replaced by "long-term care tragedy" in recent discourse. This shift is evident in a decline in the frequency of "family moral tragedy" since 2017, with usage decreasing by 32.4% in headlines and by 24% in news content. The term frequency of "care burden" has significantly increased from 0.0006 (SD 0.0008) to 0.017 (SD 0.0461; t=3.006; P=.003). While linguistic characteristics of the content have remained consistent, there were statistically significant differences in medical and ethics-related terms. The media tends to provide more suicide prevention information (eg, hotlines; >50%), offering relatively limited coverage on long-term care services (<25%).
The news media have the potential to change the public's response to specific issues. Our findings suggest that government efforts to encourage media coverage of positive experiences with long-term care services can be a preventative measure against caregiving suicides and homicides. Moreover, government initiatives should focus on strengthening media publicity and enhancing media literacy within the long-term care sector. By empowering the media to provide readers with clear channels for seeking help, such as hotlines, the media will contribute positively to the mental health of family caregivers. Finally, an annual database on family caregiver homicide-suicide should be established. In that case, the government could identify potential risk factors and inform the formulation and revision of relevant policies and services via this database, ultimately contributing to preventing suicides and homicides in long-term care and achieving public health goals.
随着人口老龄化，长期护理服务的需求稳步增长。政府推行的长期护理政策的有效性以及公众获取相关服务信息的情况，显然受到媒体报道的影响。此外，先前的研究表明，新闻框架可以通过更积极的框架（帕帕盖诺效应）减轻负面影响（维特效应），从而降低公众对负面新闻的敏感度。
本研究调查新闻报道中所呈现的长期护理机构内发生的自杀和他杀现象，即家庭照顾者或受照顾者死于自杀或他杀的情况。我们考察了2017年台湾长期护理2.0计划实施前后媒体报道框架的变化。我们还进一步考察了新闻报道内容与媒体提供的长期护理服务及自杀预防信息（如热线电话）之间的一致性。
运用内容分析和文本挖掘技术，对2009年至2021年台湾地区433篇涵盖95起长期护理机构内自杀和他杀事件的新闻报道进行分析。应用随机效应模型来考察计划实施后的词频变化。
大多数（>60%）案例涉及家庭照顾者的他杀-自杀事件。近期话语中，“家庭道德悲剧”一词已被“长期护理悲剧”所取代。这一转变在自2017年以来“家庭道德悲剧”的词频下降中体现得很明显，在标题中的使用率下降了32.4%，在新闻内容中的使用率下降了24%。“护理负担”的词频从0.0006（标准差0.0008）显著增加到0.017（标准差0.0461；t=3.006；P=0.003）。虽然内容的语言特征保持一致，但在医学和伦理相关术语方面存在统计学上的显著差异。媒体倾向于提供更多的自杀预防信息（如热线电话；>50%），而对长期护理服务的报道相对有限（<25%）。
新闻媒体有可能改变公众对特定问题的反应。我们的研究结果表明，政府鼓励媒体报道长期护理服务积极经验的努力可以作为预防照顾者自杀和他杀的一项措施。此外，政府举措应注重加强媒体宣传并提高长期护理领域的媒体素养。通过使媒体能够为读者提供清晰的求助渠道，如热线电话，媒体将对家庭照顾者的心理健康产生积极贡献。最后，应建立一个关于家庭照顾者他杀-自杀事件的年度数据库。这样一来，政府可以识别潜在风险因素，并通过该数据库为相关政策和服务的制定与修订提供信息，最终有助于预防长期护理机构内的自杀和他杀事件并实现公共卫生目标。
