乳癌術後婦女之身體心像與憂鬱傾向之探討

To Explore Body Image and Depressed Tendency of Post-mastectomy Women with Breast Cancer

10.6692/KJN.202004_37(1).0001

陳紀伃(Chi-Yu Chen)；黃惠滿(Hui-Man Huang)；林婉如(Wan-Ju Lin)；陳咨淇(Tzu-Chi Chen)

身體心像 ； 憂鬱傾向 ； 乳癌術後婦女 ； Body image ； depressed tendency ； post-mastectomy women

高雄護理雜誌

37卷1期（2020 / 04 / 01）

1 - 12

繁體中文

背景：乳癌是女性最常見的癌症。乳癌婦女在接受手術後可能因其身體結構改變而影響心理適應，值得護理人員關注。目的：探討（1）乳房切除術後之乳癌婦女的身體心像與憂鬱傾向；（2）影響乳癌術後婦女身體心像與憂鬱傾向的因素；（3）乳癌術後婦女憂鬱傾向的預測因子。方法：採橫斷式量性研究設計，以方便取樣方式選取南臺灣某區域教學醫院90位接受乳癌手術後滿一個月之門診及住院婦女。使用「身體心像量表」、「流行病學研究中心憂鬱量表」和「個人基本屬性問卷表」測量身體心像、憂鬱傾向、以及人口統計和疾病相關資料；以多元迴歸確定與憂鬱傾向有關的重要因素。結果：乳癌術後婦女：（1）50%出現負向的身體心像感受，43.3%有憂鬱傾向；（2）不同經濟狀況的婦女在「私密的身體心像」、「憂鬱傾向」上有顯著差異；（3）罹病年限2-5年較罹病年限低於2年者在「社會的身體心像」上有顯著負向感受；（4）「完整的身體心像」、「私密的身體心像」、「社會的身體心像」三層面身體心像及整體身體心像愈負向時其憂鬱傾向也愈嚴重；（5）身體心像、經濟狀況為憂鬱傾向的預測因子，可解釋總變異量17.9%，而身體心像為顯著預測因子。結論：乳癌術後婦女的身體心像及經濟狀況會影響其憂鬱傾向。護理人員應及早協助乳癌術後婦女適應其身體心像的改變並關心其經濟狀況受疾病影響的狀況以降低憂鬱情緒。

Background: Breast cancer is the most common cancer in women. Post-surgical breast cancer patients often experience changes in their psychological adaption due to changes in their body structures, thus warranting increased care and attention from nursing personnel. Purpose: This study aimed at exploring body image, depression tendencies and related factors among post-mastectomy women with breast cancer; additionally, examining the predictive factors of depression tendencies. Methods: Cross-sectional quantitative study design was adopted. A convenience sample was used to recruit 90 outpatient and inpatient women with breast cancer surgery a month after surgery from a district teaching hospital in Southern Taiwan. Data were collected using a ＂Body Image Scale＂, ＂the Center for Epidemiologic Studies-Depression scale (CES-D)＂, and ＂Basic Information Questionnaire＂; and determining important factors related to depression tendencies with multiple regression. Results: (1) Fifty percent of the post-mastectomy women developed negative body image perception and 43.3% had depression tendencies. (2) Women with different economic status had significant differences on ＂private body level of body image＂ and ＂depression tendencies＂. (3) Patients with 2-5 years of disease progression had significantly more negative perception on ＂social body＂ level body image than patients with less than 2 years of disease progression. (4) The depression tendency correlated positively with ＂total body image＂ and the following three body image levels: ＂complete body＂, ＂private body＂ and ＂social body＂. (5) Body image and economic status were two predictors for depression tendencies. The total variance explained was 17.9%; and body image was the significant predictor. Conclusions: The results confirm that post-mastectomy women's body images and economic status can affect their depression tendency. Nursing personnel should assist post-mastectomy women in adapting to changes in their body image, be concerned about their economic conditions affected by the disease, and offer aid to reduce depression.

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