The stigma scale (The Stigma Scale) can actually measure the degree of stigma of mental health problems nowadays. Although The Stigma Scale is a convenient and effective self-report assessment tool, there is no Chinese version in Taiwan. Therefore, this study aims to: (1) two stage translation of The Stigma Scale; (2) item analysis and streamline the number of items; (3)check the reliability and validity of the streamlining The Stigma Scale. Participants with chronic schizophrenia come from a psychiatric teaching hospital and a hospital center in south of Taiwan. After the exploratory factor analysis and the item analysis of the pre-test by 151 patients and the literature analysis, we found that the stigma of mental health problems includes three domains, discrimination, positive perception and disclosure. According to dimensions of analysis we retained 22 questions after selection, and test to 215 formal samples for confirmatory factor analysis, reliability and validity. Results showing: (1) The content validity is .92; (2) the internal consistency reliability after selection ranged from .83 ~ .93, one-month test-retest reliability Cronbach's coefficient ranged from .55 ~ .73; (3) confirmatory factor analysis showed that the "The Stigma Scale" has an acceptable model fit, ideal reliability and validity, and suitable for assessing the sense of the stigma of domestic patients with mental disorders. Also can be used on medical services and clinical assessment.

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Timely access to child mental health services is a widespread concern. Many children with diagnosable disorders do not receive help. Untreated disorders can cause significant child and family impairment. Barriers to treatment can impede access. Few specialists, long wait lists and clinic-based services can be problematic. Families encounter treatment barriers related to travel (i.e., time off work or school; inconvenience; financial burden), stigma, and child resistance to therapy. Alternative models of care are needed. Distance telephone treatment (e.g., Strongest Families), can bridge the access gap. There is little understanding about the participants’ experience with distance treatment. The research objectives were: 1. to establish if therapeutic alliance exists between a) a parent-coach and b) a child-coach, when distance treatment is delivered by telephone with no face-to-face contact; 2. to explore the parents’ distance experiences and opinions; 3. to develop and validate the Treatment Barrier Index (TBI) scale derived from participants’ experiences; and 4. to use the TBI to examine treatment barrier differences (and therapeutic processes) between two delivery systems (Distance vs Face-to-face). Therapeutic alliance exists between adult-coach and child-coach with distance treatment. Participants found distance treatment to be more private and felt less stigmatized because of visual anonymity, compared to their opinions of face-to-face services. The TBI results indicated fewer perceived barriers with distance treatment. A significant difference was found between delivery systems in terms of perceived barriers, therapeutic alliance and self-disclosure as a group of variables. This suggests that there may be differences in therapeutic processes between systems. Therapeutic alliance scores were enhanced with distance treatment and found to positively correlate with self-disclosure and outcome scores; suggesting that these processes are important in the context of distance intervention. Cost-effective distance systems using non-professionals may be one way to increase access to child mental health services. Although some families may prefer the physical presence of face-to-face services, others prefer distance services. The results from these studies may help to inform system design improvements aimed at increasing service access. Improving models of care to meet participants’ needs could lead to increased service utilization, ultimately improving child health outcome.

Made available in DSpace on 2014-12-17T15:39:00Z (GMT). No. of bitstreams: 1 PriscillaCBA_DISSERT.pdf: 1344177 bytes, checksum: d76b3c3ce16850a293fa70d3ea50fea2 (MD5) Previous issue date: 2012-09-10 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The increase in survival time and cure requires more extensive care about the quality of life of cancer patients, which begins soon after diagnosis. Thus, it seems reasonable to the emphasis on development of studies covering the psychosocial variables, such as stigma, treatment of childhood cancer aiming thereby to the attention of the overall needs of the child. Thus, this research aims to investigate the perception of stigma and quality of life in children with cancer. This is a cross-sectional research and understanding of the descriptive type, the type specimen being adopted for convenience. This consisted of thirty children with cancer and thirty children without chronic disease. The instruments used were the Quality of Life Questionnaire, the Perceived Stigma Scale and Technical Drawing Story with a Theme. The results indicate that the chronic condition, no interfered significantly in satisfaction with the quality of life in children with cancer and identified that the quality of life is not related to the stigma. Comparison with children with no chronic disease with infants with cancer, no significant differences were observed. However, the group mean contrast was lower, suggesting a greater impairment in quality of life of children with cancer compared to those without chronic disease. It is worth noting that the psychosocial effects and the limitations imposed by disease and treatment are presented as important factors in the design mode of subjective manifestations of children with cancer. Therefore, it is expected that knowledge elucidated by this study will assist, greatly to the promotion of improved emotional, biological and social development itself and the involvement of children with cancer treatment / O aumento do tempo de sobrevida e cura exige cuidados mais amplos em rela??o ? qualidade de vida dos pacientes com c?ncer, que tem inicio logo ap?s o diagn?stico. Deste modo, parece acertado a ?nfase dada ao desenvolvimento de estudos que abranjam as vari?veis psicossociais, como o estigma, no tratamento do c?ncer infantil visando assim ? aten??o das necessidades globais da crian?a. Destarte, esta pesquisa se prop?s a investigar a percep??o de estigma e a qualidade de vida em crian?as com neoplasia. Trata-se de uma pesquisa de corte transversal do tipo descritiva e compreensiva, sendo adotado o tipo amostra por conveni?ncia. Esta foi constitu?da por trinta crian?as com c?ncer e trinta crian?as sem doen?a cr?nica. Os instrumentos utilizados foram o Question?rio de Qualidade de Vida, a Escala de Percep??o de Estigma e a t?cnica de Desenho Est?ria com Tema. Os resultados apontam que a condi??o cr?nica n?o interferiu de modo significativo na satisfa??o com a qualidade de vida nas crian?as com neoplasia e identificou-se que a qualidade de vida n?o est? relacionada com o estigma. Quanto ? compara??o de crian?as sem doen?a cr?nica com os infantes com neoplasia, n?o foram observadas diferen?as significativas. Contudo a m?dia do grupo contraste apresentou-se menor, sugerindo um maior preju?zo na qualidade de vida das crian?as com c?ncer em rela??o ?s sem doen?a cr?nica. Ressaltase ainda que as repercuss?es psicossociais e as limita??es impostas pela doen?a e pelo tratamento se apresentam como fatores importantes no modo de estrutura??o das manifesta??es subjetivas das crian?as com c?ncer. Assim sendo, espera-se que o conhecimento elucidado por este estudo venha a colaborar, sobremaneira, para a promo??o da melhora emocional, biol?gica e social e do pr?prio desenvolvimento e envolvimento das crian?as com c?ncer no seu tratamento