北區某醫學校院學生身體意象對減重意圖之影響及其相關因素之探 討
The influence of body image on weight reduction attempts after adjustment for related factors in a medical school in northern Taiwan
中文摘要
肥胖在已開發國家與開發中國家以驚人的速度增加中，而且肥胖與許多的疾病及心理困擾有著 直接與間接的關係，已儼然成為文明病。在人們普遍注重外表與身材的生活模式下，減重幾乎 成為現代人常掛在嘴邊的時髦語。許多資料顯示，青少年和成人，不論男女，都有五成以上的 比例曾經減重或企圖減重，而在引發的因素中，身體意象所扮演的角色日益受到重視。大學是 學生發展獨立人格的重要時期，瞭解大學生，尤其是醫學校院學生對自己身體意象的滿意度與 減重意圖之間的相關性，以作為醫療介入與健康促進的評估參考，著實是一重要課題。
本研究主要目的為瞭解醫學校院學生個人背景因素、社會影響因素、身體意象與減重意圖之現況，
並進一步探討這些因素間之關係。本研究以橫斷性研究設計，調查北區某醫學校院九十一學年
度第一學期之一、四年級全體學生，以自填式問卷進行資料蒐集，共得有效樣本941 名，其中
男生416 名，女生 525 名，所得資料以 t 檢定、單因子變異數分析、卡方檢定、皮爾森積差相關、
薛費法多重組別事後比較及逐步多元迴歸分析等方式進行分析，重要結果歸納如下：
一、 研究對象之身體質量指數(BMI 值)多屬於正常範圍內，共 614 名(佔全體 65.2%)。就其自 陳之理想體重與實際體重差得知，在BMI 值正常範圍內之男生有 117 名(佔該正常組 44.3%及 全體男生28.1%)，女生有 327 名(佔該正常組 93.4％及全體女生 62.3%)，對自己體重仍不 滿意，希望能再更輕些。
二、 醫學校院男生在身體意象滿意度上顯著高於女生；不論男女，都以醫事技術學系學生的身 體意象滿意度最低；男生以藥學系對身體意象的滿意度最高，女生則是牙醫學系的身體意象滿 意度最高。就年級而言，四年級男生在身體意象滿意度上顯著高於一年級男生，女生在一、四年 級間並未達到顯著差異。
三、 醫學校院女生之減重意圖顯著高於男生；女生以醫學系減重意圖最低，藥學系的減重意圖 最高；男生則是醫務管理學系減重意圖最低，醫事技術學系減重意圖最高。就年級而言，男女 生之減重意圖在一、四年級上均無顯著差異。
四、 醫學校院男生在身體意象滿意度上與BMI 值、減重信念、父親影響、母親影響及同儕影響間 呈現負相關，即BMI 值、減重信念與受重要他人看法影響愈大者，其對身體意象的滿意度愈低。
醫學校院女生在身體意象滿意度上與BMI 值、減重信念、父親影響、母親影響、同儕影響、男朋友 影響及媒體影響間呈現負相關，即BMI 值、減重信念、受重要他人看法影響與媒體影響愈大者，
其對身體意象的滿意度愈低。
五、 醫學校院學生，不分男女，其減重意圖與BMI 值、減重信念、父親影響、母親影響、同儕影響 女朋友影響及媒體影響間都呈現正相關，即BMI 值、減重信念、受重要他人看法影響與媒體影響 愈大者，其減重意圖愈高。
六、 醫學校院學生，不分男女，其身體意象滿意度愈低，其減重意圖愈高。
七、 「同儕影響」、「BMI 值」、「性別」、「年級」及「減重信念」等五個相關因素可預測醫學校院學 生身體意象滿意度。在男生部份，可預測其身體意象之因素則為「BMI 值」、「母親影響」與「年 級」；在女生部份，可預測其身體意象之因素則為「BMI 值」、「減重信念」與「同儕影響」。由研究 結果得知，不論是整體分析或男女分試，在預測醫學校院學生身體意象滿意度上，「BMI 值」均 穩定出現，可知該因素為重要預測因子。
八、 調整個人背景因素和社會影響因素後發現，「減重信念」、「媒體影響」、「身體意象」與「母親 影響」等四個因素，可以預測醫學校院學生之減重意圖。在男生部份，可預測其減重意圖之因素 為「減重信念」、「母親影響」、「身體意象」與「媒體影響」；在女生部份則為「減重信念」、「媒體影 響」與「身體意象」。不論是整體分析或男女分試，在調整「減重信念」及「媒體影響」後，「身體意 象」仍能有效預測減重意圖。
九、 不論是具減重經驗者或有男／女朋友者，在調整個人背景因素及社會影響因素後，「身體 意象」仍能有效預測減重意圖。
本研究結果摘要如上，期望能將影響醫學校院學生減重意圖之相關因素做一完整的呈現，透過 醫學教育與醫療實踐，將完整的身體意象概念灌輸予未來的醫療人員與教育者，從而對疾病預 防與個人健康之維護做正確的宣導，也建議未來研究者可採取或輔以質性晤談，以縱貫性研究 呈現身體意象和減重意圖之另一種面貌。
關鍵字：身體意象、BMI 值、減重信念、減重意圖、重要他人影響、同儕影響、媒體影響、醫學校院 學生
英文摘要
The number of people with overweight problems has been increasing at an astonishing pace among developed and developing countries. Obesity, which is the direct and indirect cause of many diseases and psychological disturbance, has already become an illness of affluence. As people generally care about physical appearance and body shape, nowadays "weight loss" has become a fashionable term people talk about every day. Studies show that more than half of the teenagers and adults surveyed (women or men alike) had lost weight or have attempted to do so. Among weight-losing factors, a desire to improve body image is often the motivation to embark on weight reduction attempts. University years are a key stage for students to develop independent personality. Understanding the relevance between the level of satisfaction of their own body image and their attempts of weight loss — for medical school in particular--could provide helpful reference for evaluations of medical treatments and health enhancement.
The purpose of this study is to understand current condition of medical students’
individual background factors, social factors, body image and weight reduction attempts, as well as to explore their correlations. The cross-sectional research questionnaire surveyed 941 medical students (416 male and 525 female) at freshman and senior classes of a medical school in northern Taiwan. For data
analysis, t-test, single-variable variance analysis, Scheffe’s multiple comparisons method, chi-square test, Pearson’s product-moment correlation, and multiple regression analysis were used. The findings of the research are as follows:
1. For 614 medical students, about 65.2% of all subjects have normal BMI. Among them, there are 117, which equals to 44.3% of male students with normal BMI, and 327 female--or 93.4% of the female group, are dissatisfied with their weight and want to lose more.
2. Male medical students are obviously more satisfied with their own body image than females. Generally, the students at the School of Medical Technology are the least satisfied with body image; from gender perspective, female students at the School of Dentistry and male students of School of Pharmacy give highest score to their body image, respectively. Among male students, senior students have better body image than freshman; the difference between female students at
freshman/senior classes is not significant.
3. Female students have significantly higher weight reduction attempts than males. Among females, those at the School of Medicine have lowest attempts to lose weight, and the ones at the School of Pharmacy have highest attempts to lose weight. For males, students at the School of Health Care Administration have lowest attempts to lose weight, and those at the School of Medical Technology have greatest attempts to reduce weight. There is no significant difference on the weight reduction attempts between freshman and senior classes.
4. For male students, there is a negative correlation between BMI, weight
reduction belief, parental influence, peer pressure, and body image satisfaction.
That means, the greater the BMI, weight reduction belief, and influence of important others, the lower the body image satisfaction they perceive.
As to female students, there is a negative correlation between BMI, weight reduction belief, parental influence, peer pressure, boy friend influence, media coverage influence, and body image satisfaction. It demonstrates that the greater the BMI, weight reduction belief, influence of important others and media, the lower the body image satisfaction they express.
5. Among medical students, either male or female, there is a positive correlation between BMI, weight reduction belief, parental influence, peer pressure, boy/girl friend influence, media coverage influence, and weight reduction attempts.
Therefore, the greater the BMI, weight reduction belief, influence of important others and media, the greater the weight reduction attempts they possess.
6. Among medical students, either male or female, there is a negative correlation between body image satisfaction and weight reduction attempts. That means, the lower the body image satisfaction, the greater the weight reduction attempts they
have.
7. Five related factors including “peer pressure”, “BMI”, “gender”, “class year”, and “weight reduction belief” can be used to predict medical students’ body image. Gender-wise speaking, “BMI”, “mother’s influence” and “class year” can be used to predict male students’ body image; “BMI”, “weight reduction belief”
and “peer pressure” can predict female students’ body image. Either group analysis or gender-based analysis shows that “BMI” is the most appeared indicator of predictability.
8. After adjusting for individual background and social factors, the research points out four factors─“weight reduction belief”, “media coverage influence”, “body image” and “mother’s influence” can be used to predict students’ weight reduction attempts. As to male students, “weight reduction belief”, “mother’s influence”, “body image” and “media coverage influence” are best indicators.
However, for the female group, “weight reduction belief”, “media coverage influence” and “body image” cannot be ignored. Either group analysis or gender- based analysis shows that after adjusting for “weight reduction belief” and “media coverage influence” factors, “body image” can still be used for effectively
predicting students’ weight reduction attempts.
9. No matter medical students have or don’t have weight loss experience, or they have boy/girl friend or not, after adjusting for individual background and social factors, “body image” can still be used for effectively predicting students’ weight reduction attempts.
It is expected that this research will be able to present all factors affecting
medical students’ weight reduction attempts, and to provide prospective medical workers and educators with a complete picture of the concept of body image.
Hence preventive and individual health care can be properly promoted. It is also suggested that future researchers may use or integrate in-depth interviews into a longitudinal research to reflect different aspects of body image and weight
reduction attempts.
Key Words:
body image; BMI; weight reduction belief; weight reduction attempts; influence of important others; peer pressure; media coverage influence; medical student
