癌症病患身體心像及其相關因素之探討
Body image and Its Correlates in Cancer Pations
中文摘要 論文摘要
論文名稱：癌症病患身體心像及其相關因素之探討 研究所名稱：台北醫學大學護理學研究所
研究生姓名：鄧盡妹
畢業時間：九十二年度第二學期
指導教授：賴裕和 台北醫學大學護理學研究所教授
癌症病患因疾病本身、化學治療、放射線治療或手術治療，而使身體某部份改變、
外型改變或有疤痕、皮膚變化，而造成身體心像改變，在國內外文獻中，對癌症 病患身體心像如何？是否受人口學特性、疾病與治療特質、病患活動功能狀況、
社會支持及病患症狀嚴重度之影響？過去之研究探討相當有限，所以引發筆者想 做這方面之探討。
本研究目的為探討癌症病患之身體心像及其相關因素，採橫斷式描述性相關性研 究，以立意取樣方式來選取樣本，於 92 年 12 月至 93 年 6 月，共收案 101 位個 案，研究對象為台北某醫學中心癌症住院病患，經診斷為乳癌、大腸直腸癌、婦 癌、肝膽癌及頭頸部癌之病患，採結構式問卷訪談，問卷包括病人基本資料、身 體心像量表、社會支持量表、Karnofsky 功能量表、症狀嚴重度數字量表。結果 顯示，病患年齡分布在 25 歲至 80 歲間，平均年齡為 55.55 歲，以女性、已婚、
有宗教信仰者居多，教育程度以高中程度較多，疾病診斷方面以大腸直腸癌、且 以第三期居多，有器官切除之病患較多，大部份病人自覺病情嚴重且接受化學治 療者居多，參加支持團體方面大部份病人均未正式加入團體。病患活動功能評 估，分佈在 50-60 分之間。身體心像方面，總分為 30 分，研究結果平均值為 13.03 分 。而癌症病患之身體心像與年齡呈顯著負相關，表示年齡越低，越在意自己 之身體心像，但與性別、身高、體重、宗教信仰、職業、教育程度、婚姻狀況等 變項未達顯著差異；與診斷別有顯著相關，即大腸直腸癌病患比頭頸部癌患者具 有較負向之身體心像，與目前治療方式有顯著相關，即其他治療病患之身體心像 比化學治療加放射治療之患者較負向，但與診斷年數、器官切除與否、器官切除 程度、癌症分期、手術方式、自覺病情嚴重度及自覺體重情形等變項未達顯著差 異；至於癌症病患之身體心像與活動功能狀況及社會支持均未達顯著差異；且對 整體症狀嚴重度亦未達顯著差異；但對於個別症狀之口乾、口腔炎、吞嚥困難、
張口困難呈顯著負相關，表示口乾、口腔炎、張口困難、吞嚥困難等症狀越嚴重，
反而身體心像得分越低；另外與焦躁不安、腹瀉、外表改變、麻木感、體重減少、
腹水呈顯著正相關，表示焦躁不安、腹瀉、外表改變、麻木感、體重減少、腹水 等症狀越嚴重，則身體心像越負向。
本研究結果，可提供護理人員照顧癌症病患之依據，兼顧身、心、靈之照護，以
提高病患之生活品質。
關鍵詞：癌症病患、身體心像、病患活動功能、社會支持、症狀嚴重度。
英文摘要 Abstract
Title of Thesis: Body Image and Its Correlates in Cancer Patients Institution: Graduate Institute of Nursing, Taipei Medical University Author: Jin-Mei Deng
Thesis directed by: Yeur-Hur Lai, Ph.D., Professor
The purpose of this study was to examine the extent of body image and its correlates in hospitalized cancer patients. A total of 101 cancer patients diagnosed with breast cancer, colorectal cancer, gynecological cancer, hepatobiliary cancer, and head and neck cancers were recruited from a medical center in northern Taiwan. Patients were interviewed cross-sectionally to obtain demographic data and to complete
questionnaires assessing body image, performance status, social support and symptom severity. The majority of the study sample was female and had a mean age of 55.5 years. The mean score for body image was 13.03 (theoretical scores range from 0 to 30, with higher scores representing a more negative body image). The results showed that younger patients had a more negative body image than older patients, and patients with colorectal cancer had a significantly more negative body image than patients with head and neck cancers. Furthermore, negative correlations were found between body image and the severity of certain physical symptoms: dry mouth, stomatitis, dysphagia, and difficulty opening the mouth. Positive correlations were found between body image and the severity of anxiety, diarrhea, appearance change, numbness, weight loss and ascites. For the latter symptoms, the more severe the symptom, the more negative the body image. Patients receiving aggressive supportive treatments had a more negative body image. However, body image was not
significantly correlated with any of the other variables studied.
These results suggest that cancer patients generally had a moderate level of body image, which correlated with the severity of several selected diseases and
demographic variables. Thus, health care providers should make more efforts to assess and to pay attention to cancer patients’ body image problems. Consideration of this aspect of patients’ cancer experience would provide them more comprehensive cancer care and enhance the quality of their care.
Key Words : cancer, body image, performance status, social support, symptom severity.
