對於精神疾病病因的瞭解與治療在生物醫學與心理治療方面都隨時間與時並進，但社會大眾對於精神疾病的負面觀感卻未隨之改變，對於精神疾病的烙印亦揮之不去。家屬為病人的第一線照顧者，亦常因家人疾病遭受連帶內化烙印而影響其認知與情緒。
本研究旨在探討精神分裂症病人家屬因家人疾病而遭受連帶內化烙印時，認知層面的疾病觀點之內涵和疾病觀點與負面情緒間的關係。採描述性相關性研究，使用家屬自陳式問卷，包括「精神分裂症病人精神分裂症疾病觀點問卷-家屬版」及「連帶內化烙印量表」，以立意取樣方式針對中部三間不同層級醫院之精神科門診、病房與居家照護精神分裂症病人家屬進行調查，共發出79份問卷，回收有效問卷64份。資料以SPSS 17 for Windows及Statics 8.0進行統計分析，除描述性統計外，並以結構方程模式驗證家屬疾病觀點內涵與疾病觀點和負面情緒間的關係。
本研究共64位家屬(51.6%為女性)參與，年齡介於26歲至77歲間（平均年齡52.5歲；標準差12.3歲）。婚姻狀況有81.3%研究對象已婚，57.9%教育程度為高中以上。病人發病時間則介於1年到42年（平均18.8年，標準差9.4年），其中有67.2%的病人於慢性病房治療與安置。本研究以結構方程模式進行分析，將家屬疾病觀點分別以認知單一內涵模式、認知三內涵模式與替代模式（認知四內涵模式）進行模式分析與比較，結果發現以認知三內涵模式最佳，模式中之疾病認知與負面情緒適配度指標為0.987，調整後適配度指標為0.933，殘差平方根為0.50。亦即 1.家屬對精神分裂症疾病觀點主要受「疾病慢性化」、「家屬對疾病的可控制感」與「疾病可被治療」三個層面影響；2. 家屬連帶內化烙印認知層面之疾病觀點可與大眾烙印之刻板印象呼應；負面情緒亦可與大眾烙印中的偏見及自我烙印中的負面情緒對照；而家屬對精神分裂症疾病觀點與負面情緒兩者間確實具有因果關係。
本研究結果可提昇對家屬連帶內化烙印概念與歷程之瞭解，並可作為臨床實務上改善家屬認知層面之實證基礎。

In the last several decades, many advances have been made in the area of the cause and treatment of mental illness in biomedical and psychological. But compared with biomedical and psychological development, public has long been a step behind in the views on mental illness. Stigma toward schizophrenia affects not only the patients, but also their family. Family who suffered from stigma have more care burden and even mental health problems (e.g. depression or anxiety). Besides, the stigma may interact with the family’s’ illness perception of schizophrenia, further influence their responses to the patient. Previous stigma studies mostly focused on perspectives of the stigmatized individual and the public, few explored courtesy stigma, especially in the family of mental illness patients.
The purpose of this study was to understand the illness perception of the relatives and to explore the correlation between illness perception and negative emotion when the relatives suffer affiliate stigma. The research design was a correlation design utilizing survey methodology. Sixty-four relatives were selected in this study. Data were collected form April to September in 2011. The following self-administered questionnaires were used including 1. Demographic questionnaire; 2. The Illness Perception Questionnaire for Schizophrenia- Relatives version (IPQS-R) and 3. Affiliate Stigma Scale. The analysis used the SPSS 17.0 for Windows statistical software package and Statics 8.0. First, descriptive statistics were computed. Next, structural equation model were calculated to answer questions concerning relationships between the concepts tested.
Sixty-four relatives (51.6% women) aged from 26 to 77 (M=52.5; S.D=12.3) participated in this study. Eighty one % of participants have married; 57.9% have at least high school education. Their families have been diagnosed with schizophrenia for 1 to 42 years (M=18.8; S.D. = 9.4) and approximately 67.2% are hospitalized in the chronic unit.
In this stigma model of the illness cognition and negative emotion, the goodness of fit index is 0.987, adjusted goodness of fit index is 0.933 and the root mean square residual is 0.050. This relationship is in line with previous theoretical model of pubic and self stigma. In the result, the illness perception was impacted by three domains of observed indicators (chronic, control-relatives and treatment).
To conclude, this study may be of importance in understanding the course of relatives’ affiliate stigma, and may have implication to provide the health care workers a new point of view to develop interventions for promoting relatives’ illness perception.

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