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| Title: | 於安心專線經常來電者中，列管與非列管個案的特性差異探討
The Characteristics Differences Between Surveilled Cases and Non-Surveilled Cases Among frequent Callers to Anxin Hotline |
| Authors: | 洪子原
Hung, Tzu-Yuan |
| Contributors: | 許文耀
Hsu, Wen-Yau
洪子原
Hung, Tzu-Yuan |
| Keywords: | 經常來電者
列管個案
來電議題
訴說方式
自殺風險性
Frequent callers
Surveilled cases
Calling issues
Narrative style
Suicide risk |
| Date: | 2024 |
| Issue Date: | 2025-08-04 14:04:48 (UTC+8) |
| Abstract: | 安心專線已逐漸成為臺灣民眾所信賴之心理諮詢專線，發揮自殺防治功能。安心專線主要提供危機處理、自殺防治和提供轉介資源，屬於單次性質的服務，然而有一類來電者雖並非處於危機中或有自殺風險，卻仍不斷來電，因造成佔線，影響到其他有緊急需求的來電者，過去研究也指出會影響接線員產生疲乏、憤慨或被操弄的感受 ，來電者也可能過度依賴於自殺防治熱線，而不自身去嘗試解決問題。
安心專線的督導會對這些來電者進行自殺風險評估，若為無自殺風險或情緒困擾，來電頻率又高到影響他人進線，以及騷擾、性脅迫等的來電者，便會將之列為列管個案，來電時會轉至一支專用電話，以降低佔線的情形。然而，目前尚未有研究探討過安心專線列管個案這個群體，且因過去對於經常來電者是否具有自殺風險性的研究結果又分為兩類，其一認為經常來電者的自殺風險性至少是和其他來電者一樣的，另一類結果則認為多數經常來電者只是來尋求社會支持，大部分的來電並非具有自殺危險性。然而安心專線將經常來電者區分為列管和非列管個案，並將列管個案的來電限縮在一條電話線之中，這樣的處遇方式，目前並沒有實徵基礎作為依據，萬一列管個案具有自殺風險性，違背了安心專線的宗旨。
同時，這群列管個案並非完全沒有自殺企圖史，過去的文獻指出曾有自殺企圖史者，其自殺風險性是具有可能的，因，安心專線的經常來電者之中，列管和非列管來電的內容有何差異？而使某些經常來電者會被列為列管個案，而有些經常來電者則是可以和其他來電者一樣不受限制地來電？本研究旨在提供實徵資料，特別在於自殺風險上，作為經常來電者在安心專線區分的參考。同時，本研究亦根據過去研究考量了接線員的因素，是否因為接線員是先知道來電者受到列管，而對其反應有所不同而影響到列管個案的來談內容或是訴說方式？本研究將以 2022 年於安心專線中，一年內接通 100 通以上的來電者定義為經常來電者，這其中包含列管和非列管個案，為了排除自殺企圖史的影響，本研究先篩選出具自殺企圖史的經常來電者，並抽取 10 位列管個案，再以個案配對法，抽取人口學以及臨床相關變項相符的 10 位非列管個案。每位來電者抽取 2022年度最近一通超過 15 分鐘的來電進行分析，並藉由內容分析法分析兩組在來談內容、訴說方式及其內涵、接線員對兩組來電者之反應以及兩組來電者對於接線員反應方式之回應的差異。
本研究透過內容分析法對來電議題分析的結果顯示，列管和非列管個案在來電議題的表面意涵上沒有太大的差異，代表列管和非列管個案都可能論及自殺或是情緒困擾相關字眼，同時，和自殺、情緒困擾相關的壓力議題亦然。然而進一探索訴說方式及其內涵可以發現，列管個案難以將困擾具體地訴說，多數僅是感受或較為表淺的詞彙，且話題容易不斷轉換，或是來電僅想要抱怨。而非列管個案則相對能夠具體陳述自己的問題，也較為明瞭困擾、需求為何，因也能在接線員對於這兩組的反應方式是一視同仁的情況下，較容易與接線員進行合作性的問題解決討論以降低情緒困擾或自殺想法。
也就是說，本研究認為雖然從來電議題來看，列管個案和非列管個案都可能談論到自殺相關的議題，但並不見得就能說明他們都具有自殺風險，因為透過進一抽取訴說方式及其內涵的話 ， 能看出列管個案多數僅是在單純訴說自己的感受或抱怨，接線員也因難以介入。本研究結果也可呼應過去認為經常來電者並非同質性團體的文獻， 透過本研究對於安心專線經常來電者的區分，去說明需再對經常來電者做分類 ， 同時也藉提供安心專線目前對於經常來電者進行列管和非列管的區分是合理的佐證。
The Anxin Hotline has gradually become a trusted psychological consultation hotline for the people of Taiwan, playing a significant role in suicide prevention. The Anxin Hotline mainly provides crisis intervention, suicide prevention, and referral resources, and is a one-time service. However, there is a group of callers who, despite not being in crisis or at risk of suicide, continue to call frequently, which causes line congestion and affects other callers with urgent needs. Previous research has also indicated that this can lead to fatigue, resentment, or a sense of manipulation among hotline operators. Frequent callers might overly rely on the suicide prevention hotlineinstead of attempting to solve problems on their own.
The supervisors of the Anxin Hotline assess the suicide risk of these callers. If they are found to have no suicide risk or emotional distress, but their frequent calls affect other callers, or if the calls are of a harassing or sexually coercive nature, they are categorized as surveilled cases. Their calls are then routed to a dedicated line to reduce congestion. However, there has been no research specifically focusing on this group of surveilled cases, and previous studies on whether frequent callers havesuicide risk are divided. Some believe that frequent callers have at least the same level of suicide risk as other callers, while others think that most frequent callers areseeking social support and are not at risk of suicide.
The Anxin Hotline distinguishes between surveilled and non-surveilled frequent callers, and the calls from surveilled cases are restricted to a single line. This method lacks empirical evidence. If these surveilled cases have suicide risk, it contradicts the purpose of the Anxin Hotline. Additionally, this group of surveilled cases is notwithout a history of suicide attempts. Literature indicates that those with a history of suicide attempts still have potential suicide risk. Therefore, what are the differences in the content of calls between surveilled and non-surveilled frequent callers? What makes some frequent callers categorized as surveilled cases while others are not restricted? This study aims to provide empirical data, particularly regarding suicide risk, as a reference for distinguishing frequent callers at the Anxin Hotline.This study also considers the factors related to hotline operators, examining whether operators' awareness of a caller being a surveilled case affects their responses and the caller's way of expressing themselves.
This study defines frequent callers as those who made over 100 calls to the Anxin Hotline in 2022, including both surveilled and non-surveilled cases. To eliminate the influence of a history of suicide attempts, frequent callers with such a history were first identified. Ten surveilled cases were then selected, and ten non-surveilled cases with matching demographic and clinical variables were chosen through case matching. For each caller, the most recent call exceeding 15 minutes in 2022 was analyzed. Content analysis was used to examine differences in the content of the calls, the ways issues were expressed, the hotline operators' responses to the two groups, and the callers' reactions to the operators' responses.
The results of the content analysis indicate that there is no significant difference in the superficial content of the calls between surveilled and non-surveilled cases, meaning both groups might mention suicide or emotional distress. However, further exploration of the ways issues were expressed reveals that surveilled cases have difficulty articulating their distress concretely, often using vague or superficial terms, and frequently changing topics or calling just to complain. In contrast, non-surveilledcases can more clearly articulate their problems and understand their distress and needs, making it easier for them to engage in cooperative problem-solving discussions with the hotline operators to reduce emotional distress or suicidal thoughts.
This study suggests that while both surveilled and non-surveilled cases might discuss suicide-related issues, it does not necessarily indicate that they all have suicide risk. Surveilled cases are often merely expressing their feelings or complaints, making it difficult for operators to intervene. The results support the notion that frequent callers are not a homogeneous group and that distinguishing between surveilled and non-surveilled cases among frequent callers is justified. This provides evidence for the current classification method used by the Anxin Hotline. |
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| Description: | 碩士
國立政治大學
心理學系
109752019 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0109752019 |
| Data Type: | thesis |
| Appears in Collections: | [心理學系] 學位論文
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