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| Title: | 消失的病人：中國大陸網路媒體的妥瑞症新聞框架建構
Disappearing Touretters: A News Framing Analysis of Online News Media in Mainland China |
| Authors: | 溫馨
Wen, Xin |
| Contributors: | 徐美苓
Hsu, Mei-Ling
溫馨
Wen, Xin |
| Keywords: | 妥瑞症
網路媒體
框架分析
健康傳播
Tourette syndrome
Online media
Framing analysis
Health communication |
| Date: | 2025 |
| Issue Date: | 2025-09-01 14:25:02 (UTC+8) |
| Abstract: | 妥瑞症已成為兒童、青少年群體中較常見的疾病，然其在中國大陸文化語境下仍被視為罕見疾病，民眾的認知程度普遍不高。妥瑞氏症具有不致命、不傳染且不會造成即時性傷害之特徵，在過去多年間被排除於主流醫學關注之外。加之患者出於病恥感而發展出的「自我管理」方式，使得症狀更加隱匿難辨，妥瑞症患者也日漸淪為「消失的病人」。
本研究以中國大陸網路媒體為研究場域，透過van Gorp質量兼具的新聞框架分析取徑，耙梳2018至2022年間共420則妥瑞氏症報導的框架類型與再現樣貌，並從更深層的社會情境脈絡剖析其框架化過程。
在質化的框架歸納階段，主要依據框架裝置與推理裝置對框架進行解構，並進一步探討社會文化脈絡與框架化之間的關聯性。本研究共萃取出「健康醫療框架」（包含「疾病科普子框架」、「風險警示子框架」與「中西醫結合療法子框架」）、「生活問題框架」、「患者抗病框架」和「社會支持框架」四類新聞框架。研究發現，妥瑞症患者通常被曲解為頑皮搗蛋、不服管教、自暴自棄的「壞孩子」，其蘊含的深層文化現象指向中國傳統文化對於個體個性與行為的制約，此現象模糊了「個性」與「患病」的邊界，導致患者生病的事實受到壓抑，構成另一層次的「消失」。
在量化演繹階段，本研究發現中國大陸網路媒體更傾向以「健康醫療框架」建構妥瑞症。其中「疾病科普子框架」的報導量最多，可見網路媒體主要發揮了疾病知識普及的功能，應有助提升民眾的健康素養。從妥瑞氏症報導的時間趨勢看，2021年報導數量增勢最明顯，或與社群媒體的推動及醫療領域的重要進展有關，妥瑞症新聞多集中於秋、春過敏季節與暑假期間。一如中國大陸的主流醫療體系，妥瑞症新聞以西醫取向為主，但中醫取向論述仍具重要性，後者強調了中醫治療具有填補西醫不足之優越性，此論述背後亦承載著對弘揚中國傳統文化與文化自信之追求。在報導屬性上，妥瑞氏症新聞並未仰賴健康醫療媒體之報導，已成為社會主流新聞廣泛關注的疾病議題。在立場取向上，新聞論述趨於中性，並未呈現明顯的污名化或正面化傾向，此情形或與近年來全球範圍內推行的去污名化運動影響有關。
在消息來源部分，「學者專家」的佔比高達九成以上，體現出妥瑞症新聞對於專業權威觀點的高度倚重，新聞資訊的呈現方式以學者專家的視角為主，缺乏從患者本人或家屬視角出發之論述，造成與妥瑞症直接相關的患者本人及其家屬的聲音不被彰顯，亦構成患者話語的「消失」。
研究亦發現，不同醫學取向與不同屬性之報導使用的新聞框架均存在顯著差異。以健康知識科普為核心的「健康醫療框架」更偏好「西醫取向」報導。而注重政績宣傳的「社會支持框架」則偏好「中西醫結合或未特定指明」取向之報導；「非健康醫療類報導」具有更多元的傳播內容，因而更加偏好「患者抗病框架」與「社會支持框架」。不同框架在消息來源引述與立場取向上亦呈現出差異。「健康醫療框架」與「生活問題框架」在消息來源上高度仰賴「學者專家」意見做背書。「患者抗病框架」則較重視「患者親友」與「患者本人」的經歷訴說及情感表達，此框架亦更為偏好「正面化」的立場取向。本研究最後提出新聞實務與未來研究進路建議。
Tourette Syndrome (TS) has become a relatively common condition among children and adolescents. However, within the sociocultural context of mainland China, it is still regarded as a rare disease, with low public awareness. Characterized by being non-fatal, non-infectious, and not causing immediate harm, TS has been excluded from mainstream medical attention for years. Additionally, patients' development of "self-management" strategies due to stigma makes their symptoms more concealed and indistinct, gradually rendering TS patients "disappearing patients."
This study takes mainland China's online media as the research field, employing van Gorp's integrated qualitative-quantitative news framing approach to examine the frame types and representational patterns in 420 TS-related reports from 2018 to 2022, while analyzing the framing process within deeper sociocultural contexts.
In the qualitative frame induction stage, frames were deconstructed based on frame devices and reasoning devices, with further exploration of the relationship between sociocultural contexts and framing. Four news frames were extracted: the "healthcare frame" (including sub-frames of "disease popularization," "risk warning," and "integrated Chinese and Western medicine treatment"), "life situation problem frame," "patient resistance frame," and "social support frame." The study found that TS patients are often misinterpreted as "bad kids" who are mischievous, disobedient, or self-abandoned. This reflects an underlying cultural phenomenon: traditional Chinese culture's constraints on individual personality and behavior blur the boundary between "personality" and "illness," suppressing the fact of patients' illness and constituting another form of "disappearance."
In the quantitative deduction stage, mainland China's online media were found to prefer constructing TS through the "healthcare frame," with the "disease popularization sub-frame" having the largest number of reports. This indicates that online media primarily function in popularizing disease knowledge, which should help improve public health literacy. Regarding the temporal trend, TS reports increased most significantly in 2021, possibly related to social media promotion and key advancements in the medical field. Reports were also concentrated in autumn and spring allergy seasons and summer vacations. Consistent with mainland China's mainstream medical system, TS news was predominantly Western medicine-oriented, but traditional Chinese medicine (TCM) perspectives remained significant. TCM discourse emphasized its superiority in compensating for Western medicine's shortcomings, carrying the pursuit of promoting traditional Chinese culture and cultural confidence. In terms of report attributes, TS news did not rely on healthcare-specific media but has become a disease issue widely concerned by mainstream social news. In terms of stance, news discourse tended to be neutral, without obvious stigmatization or positive bias, possibly influenced by global anti-stigma movements in recent years.
Regarding sources, "scholars and experts" accounted for over 90%, reflecting TS news' heavy reliance on professional authoritative viewpoints. Information was primarily presented from experts' perspectives, lacking discourse from patients or their families, resulting in the underrepresentation of the voices of patients and their families—constituting the "disappearance" of patients' discourse.
The study also found significant differences in news frames used across different medical orientations and report attributes. The "healthcare frame," centered on health knowledge popularization, preferred "Western medicine-oriented" reports. The "social support frame," focusing on performance propaganda, favored reports with "integrated Chinese and Western medicine or unspecific designation" orientations. "Non-healthcare reports," with more diverse content, preferred the "patient resistance frame" and "social support frame."
Furthermore, frames differed in source citation and stance. The "healthcare frame" and "life problem frame" heavily relied on "scholars and experts" for endorsement. The "patient resistance frame" attached more importance to the experiential narratives and emotional expressions of "patients' relatives and friends" and "patients themselves," and also preferred a "positive" stance. Finally, the study put forward suggestions for journalistic practices and future research directions. |
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| Description: | 碩士
國立政治大學
傳播學院傳播碩士學位學程
108464067 |
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| Data Type: | thesis |
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