心臟移植患者接受運動訓練過程身體心像變化之探討
Body Image Change During Exercise Training Among Heart Transplant Patients
中文摘要
本研究旨在瞭解心臟移植患者於運動訓練過程中身體心像之變化。研究目的主 要探討運動訓練過程身體心像滿意度及身體心像關注層面之變化、身體心像滿意 度與身體心像關注層面的相關性、以及基本屬性對身體心像滿意度、身體心像關 注層面的影響。
研究方法以質性研究法為主，量性研究法為輔，採立意取樣，針對心臟移植患 者給予連續十週的運動訓練，於訓練的第一週、第五週及第十週，分別與研究對 象進行深度訪談與量表測量，量表採用Body Cathexis Scale。資料分析採用內容 分析法、百分比、平均值、標準差、Friedman test、McNemar test、Mann-Whitney Utest、Kruskal-Wallis test 及 Spearman correlation。收案時間自民國 86 年 12 月至 87 年 5 月止，共收集十位個案。研究結果顯示運動訓練前之身體心像滿意度平 均值為2.47，運動訓練中之身體心像滿意度平均值為 3.17，而運動訓練後之身 體心像滿意度平均值為3.25，統計上有顯著差異（p<0.01），並經 McNemar test 後顯示運動訓練中與運動訓練後對身體心像感到滿意的人數有顯著性增加
（p<0.05）。研究對象之身體心像關注層面於運動訓練過程均以身體功能層面關 注最多，行為表現之負向評價行為減少，正向評價行為增加。在所有的行為單元 中，運動訓練前以「生理功能\負向評價行為」關注最多，運動訓練中與運動訓練 後則以「生理功能\與自己比較之行為」關注最多。身體心像的三個層面
及行為表現，在運動訓練過程均無顯著差異（p>0.05）；而運動訓練前、中、後 各期之身體心像層面和行為表現之變化，則具有顯著差異（p<0.05）。身體心像 滿意度與關注層面的相關性為運動訓練前及運動訓練中之身體心像關注層面與 身體心像滿意度均無顯著相關（p>0.05）；運動訓練後之比較行為與身體心像 滿意度呈顯著正相關（rs=0.648，p<0.05）。基本屬性與身體心像滿意度無顯著 相關（p>0.05）。針對研究對象的基本屬性與身體心像關注層面作相關性分析，
以Mann-Whitney U test、Kruskal-Wallis test 及 Spearman correlation 檢定基本屬性 對身體心像關注層面的影響，結果發現運動訓練過程中教育程度與確認行為達 顯著正相關（rs＝0.681，p<0.05），顯示教育程度愈高者，其確認行為的出現 率亦較高。此外，教育程度與比較行為達顯著負相關（rs =-0.681，p<0.05），即 教育程度低者，其比較行為的出現率較教育程度高者為多。再者，宗教信仰則是 分別與身體功能層面、身體感覺層面達顯著差異（p<0.01）。其中有宗教信仰者 對身體功能層面關注較高，而無宗教信仰者則是對
身體感覺層面的關注較多。由上述結果顯示運動訓練可有效增進心臟移植患者身 體心像之滿意度，並朝向正向之發展。本研究結果有助於瞭解心臟移植患者之身 體心像變化，以提供身體心像護理措施之參考，並進而提昇心臟移植患者之照
護品質。
英文摘要
The purpose of this study was to examine the body image change of heart transplant patients during exercise training. Both qualitative and quantitative methods were used in this study. Subjects who met the selection criteria were selected by purposive sampling . The exercise
training program was three times per week for 10 weeks. Data was collected by means of interview and the Body Cathexis Scale. Data was analyzed by content analysis、Friedman test、McNemar test、Mann-Whitney U test、
Kruskal-Wallis test and Spearman correlation.
A total of ten valid cases were selected. The results of this study
showed that the mean score of body image satisfaction was 2.47 before exercise training, 3.17 after 5 weeks, and 3.25 after 10 weeks of training.
The scores at the fifth and the tenth weeks of exercise training were higher than those before training. By content analysis quantifying the qualitative data, these patients showed three types of behaviors：
orienting behavior、comparative behavior、appraisal behavior. The most frequent behavior was the appraisal behavior before training, and the comparative behavior was the most frequent behavior after 5 weeks and 10 weeks of training. The body image focused on three dimensions：body structure、body sensation and body function. The most frequent dimension of body image was the body function during exercise training.
A significant correlation between body image satisfaction and three dimensions of body image was not observed before and at the 5th week of exercise training. However, the comparative behavior was correlated with body image satisfaction after 10 weeks of training(rs=0.648, p<0.05).
The influence of demographic variables on body image satisfaction was not found. Educational level was significantly related to the orienting
behavior(rs =0.681, p<0.05), and comparative behavior(rs =-0.681, p<0.05).
Base on the results of the study, it was concluded that satisfaction
of body image was increased and a positive view of body image was enhanced during exercise training. The findings of this study will help nurses
understand body image change of heart transplant patients, provide suitable nursing intervention , and promote the quality of care.
