復原期燒傷病患之身體心像、自尊與社交焦慮

Body image, self-esteem and social anxiety among burn patient's in recovery stage

周彥慈

燒傷病患 ； 身體心像 ； 自尊 ； 社交焦慮 ； Burn patient ； Body image ； Self-esteem ； Social anxiety

中山醫學大學護理學系學位論文

2017年

碩士

蔡麗雅;李淑杏

繁體中文

燒傷是種常見創傷且各年齡層均可能發生，復原期燒傷病患生理面臨疼痛、感染、疤痕攣縮、肢體活動受限、排汗困難且對熱敏感以及外觀改變等問題，生理變化會對心理與社交產生衝擊和壓力，導致身體心像紊亂、低自尊及社交焦慮，影響求學、就業、社交活動與人際關係。本研究旨在探討復原期燒傷病患之身體心像、自尊與社交焦慮，及其影響因子，以橫斷式研究設計，於中部三間醫院進行收案，採立意取樣法與問卷調查方式收集資料，研究工具包含：身體心像量表、自尊量表與社交焦慮量表。研究共收案87位，結果顯示身體心像總分19.91分(SD=8.78)，平均1.99分，略偏負向；自尊量表總分28.48分(SD=5.77)，平均2.85分，傾向正向；社交焦慮量表總分149.43分(SD=17.14)，平均2.58分，偏焦慮。身體心像量表中以『婚姻』、『宗教信仰』、『燒傷後工作情形』、『燒傷深度』、『燒傷總面積』、『關節活動受限情形』、『燒傷意外至今總天數』等變項與身體心像具顯著差異；自尊量表中以『婚姻』、『宗教信仰』、『燒傷深度』、『關節活動受限情形』、『燒傷意外至今總天數』等變項與自尊具顯著差異；社交焦慮量表中以『婚姻』、『宗教信仰』、『燒傷深度』、『燒傷面積』、『關節活動受限情形』、『燒傷意外至今總天數』等變項與社交焦慮具顯著差異。復原期燒傷病患之身體心像與自尊呈現顯著中度正相關性，身體心像與社交焦慮呈現高度負相關性，顯示身體心像越負向，自尊評價越差，社交焦慮程度也越高；而自尊與社交焦慮呈現顯著高度負相關，顯示自尊越差，社交焦慮程度也越高。社交焦慮之迴歸分析中，可解釋變異量為68.9%，達統計上顯著差異，社交焦慮預測因子包含：『女性』、『自尊』、『身體心像』及『燒傷意外至今總天數』，建議未來照護復原期燒傷病患，應協助強化其優點與自信，增強自尊，協助因應身體心像調適，尤其關注女性與燒傷意外歷經天數較多之族群，協助社交調適，減少社交焦慮。

Burn injury is an usual trauma wound, and it could be happened in all ages. The burn patients in recovery will face physiological problems such as pain, infection, and scar contraction, limited range of movement, impaired sweating function, impaired heat sensitivity, and appearance change. The physiological change will have significant impact on patient's psychological and social status. It will cause body-image disturbance, low self-esteem and social-anxiety, which will affect patient's study, work, social activity and relationships. The research is going to study body-image, self-esteem and social anxiety of burn patients under recovery period, this was a cross-sectional, purpose designed study. Data were collected by using a structured, self-reported questionnaires includes: body-image scale, self-esteem scale and social anxiety scale. A total of 87 burn patients at three hospitals in Taichung completed participated in this study. The results of this study indicated that the total of body-image scale was 19.91(SD=8.78), average of 1.99, showing a negative body-image; of self-esteem was 28.48(SD= 5.77), average of 2.85 showing a positive self-esteem; of social anxiety scale was 149.43(SD= 17.14), average of 2.58, more lean to anxiety. In body-image scale, marriage, religious belief, work performance after burn injury, degree of burn, burn surface area, limitation of range of motion in joint, and total hospitalization day showed a significant difference. In self-esteem scale, marriage, religious belief, degree of burn, limitation of range of motion in joint, and total hospitalization day showed a significant difference. In social anxiety scale, marriage, religious belief, degree of burn, burn surface area, limitation of range of motion in joint, and total hospitalization day showed a significant difference. There was a significant moderate positive correlation of body image with self-esteem among burn patient during recovery stage, and there was a high negative correlation of body image with social anxiety, which mean showed that the body image was more negative, the self-esteem was poorer, and more social anxiety. In the social anxiety regression analysis, the variance was 68.9% and the F value was 15.085, which was statistically significant. The predictors of social anxiety included: "gender _ female", "self-esteem score", and "Body image score "and "days elapsed since burn". It is recommended that future care patients among burn in recovery stage, should help strengthen their advantages and self-confidence, strengthen self-esteem and assist in adapting to body image, much concern should be given to female and those who have stayed in hospital for quite a period of time, in respect to social adjustment and reducing social anxiety.

1. 方素瓔 (2010)•乳癌婦女術後的物化身體、身體心像與伴侶互動對其心理健康之影響
   連結：
2. 王紹穎 (2007)•自我感、復原力與創傷後症狀之關聯性研究:以燒傷病人為例 (碩士論
   連結：
3. 王楚君 (2003)•乳房手術患者術後兩週內之症狀困擾、身體心像、生活品質之探討 (碩
   連結：
4. 余文君 (2014)•出院燒傷病人生活品質及其相關因素之探討-以某復健機構服務之病
   連結：
5. 吳佳儀、李明濱、吳其炘 (2015)•燒傷之身心問題與全人照護•臺灣醫界，58(8)，9-14。
   連結：
6. 李雅文、易麗珍、陳雅玲、黃靜宜 (2005)•燒傷病患出院後壓力感受、壓力處理自我
   連結：
7. 李德芬、林欣潔、吳佳玟、吳嘉純、林美珍 (2004)•燒燙傷病患的疼痛處置•疼痛醫
   連結：
8. 李歡芳 (2003)•老人自尊與懷舊療法•護理雜誌，50(4)，98-102。 doi:10.6224/jn.50.4.98
   連結：
9. 周煌智 (2016)•重大災難後燒傷病人的心理重建•護理雜誌，63(1)， 36-41。doi:10.6224/jn.63.1.36
   連結：
10. 林芸如 (2009)•男性口腔癌個案術後身體心像因應及社會支持相關性探討 (碩士論
    連結：
11. 林郁勳、林秀華、史麗萍、楊永健 (2016)•大面積燒傷治療•護理雜誌，63(1)，12-
    連結：
12. 崔宛玉、林寬佳、黃惠璣 (2013)•口腔癌手術病人於住院期間身體心像改變及其因應
    連結：
13. 張秀如、余玉眉 (2007)•身體觀點－體現與身體心像•護理雜誌， 54(3)，77-81。
    連結：
14. 中文參考文獻
15. (博士論文)•國立成功大學，台南市。
16. 文)•國立臺灣大學，台北市。
17. 士論文)•國立臺北醫學大學，台北市。
18. 人為例 (碩士論文)•國立臺灣大學，台北市。
19. 效能及其相關因素探討•實證護理，1(4)， 273-282。doi:10.6225/jebn.1.4.273
20. 學雜誌，14(2)，74-85。
21. 文)•中山醫學大學，台中市。
22. 16。doi:10.6224/jn.63.1.12
23. 林靜蘭 (2013)•焦慮性疾患之護理•於黃宣宣總校閱，新編精神科護理學(二版，602-
24. 631頁)•台北：永大。
25. 行為探討•護理暨健康照護研究，9(2)， 127-138。doi:10.6225/jnhr.09.2.127
26. doi:10.6224/jn.54.3.77
27. 張