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

Body Image Adaptation and Social Support in Male Buccal Cancer Patient with Postoperative.

10.6834/CSMU.2009.00109

林芸如

口腔癌 ； 身體心像 ； 身體心像因應 ； 社會支持 ； Buccal cancer ； Body image ； Body image adaptation ； Social support

中山醫學大學護理學系學位論文

2009年

碩士

廖玟君

繁體中文

口腔癌患者因疾病及治療帶來的外觀改變，對患者心理上於身體心像的調適會形成極大的衝擊，且發病年齡多集中在中壯年期的男性，本研究即探討男性口腔癌個案術後身體心像因應及社會支持之相關性，研究目的主要針對：一、了解男性口腔癌術後不同時期患者其基本屬性、健康行為、疾病情況的分布情形以及身體心像狀況、身體心像因應和社會支持的情形；二、了解身體心像的影響因子為何，採用橫斷式研究法，以立意取樣，於南部某區域教學醫院的耳鼻喉科門診，選取罹患口腔癌且經手術治療過後的男性患者，並排除合併其他非口腔癌重大傷病者及合併其他慢性疾病造成外觀改變者。由研究者以問卷訪談個案，問卷包括：個案基本資料、身體心像量表、社會支持量表及身體心像因應量表，研究其間共收集了112位男性口腔癌術後患者。研究結果顯示個案基本屬性中：平均年齡為52.88歲、大多數個案為已婚(70.5%)、經濟上必須靠自己取得(56.2%)；健康行為中：大部分的個案得知罹患口腔癌後戒除菸(73.2%)、酒(70.5%)及嚼食檳榔(78.6%)的習慣；疾病治療方面：病灶以發生在面頰處最多(31.2%)其次是舌頭(19.6%)、且大部分個案接受過放射線療法(62.5%)。Pearson Correlation統計結果顯示在所有個案中，身體心像與身體心像因應中的外觀修飾(r=.575 ,p < .05)、逃避(r=.434 ,p < .05)及正向理性接受呈正相關(r=.481 ,p < .05)。身體心像重建的過程中，其主要預測身體心像的之因素為身體心像因應中的外觀修飾(t=5.574，p<0.01)及逃避(t=2.895，p<0.01)，總解釋變異量為38.1%。建議未來口腔癌術後的患者的照護上，應多加觀察個案所呈現出來的外觀修飾及逃避態度，及深入了解個案的需求，以其能幫助個案早日發展合宜的身體心像。

The changes of appearance in buccal cancer patient due to disease itself or after remedy always has big impact on patients’ body image. This study explored the adaptation process of body image for appearance changes in buccal cancer patients after surgery and examined the relationship among adaptation, social support, and body image. The purposes of this study were to: 1.explore the distribution of essential attribute, healthy behavior, disease condition, body image, body image adaptation, and social support in buccal cancer patients after operation; and 2. examine if the adaptation of body image and social support will affect patients’ body image. The study usee a cross-sectional design and recruit post-operative buccal cancer patients from a regional teaching hospital at southern Taiwan. Subjects who have appearance changes caused by other non-buccal cancer disease were excluded. Structured questionnaires including the “Body Image Coping Strategies Inventory,” the “Social Support Scale” and the “Body Image Scale” were used to interview patients. One hundred and twelve male buccal cancer patients with a mean age of 52.88 years completed this study. The majority of them were married (70.5%), economy supported by self (56.2%), and with cheek (31.2%) or tongue (19.6%) cancer. There were 62.5% of them received radiotherapy. Regarding the healthy behaviors, the majority of patients gave up smoking (73.2%), liquor (70.5%), and betel chewing (78.6%) after noticed oral cancer. The result of Pearson correlation showed that body image were positively associated with coping strategies of appearance fixing (r=.575 , p < .05), avoidance (r=.434 , p < .05), and positive rational acceptance (r=.481, p < .05). Coping strategies of appearance fixing (t=5.574，p<0.01) and avoidance (t=2.895，p<0.01) but not social support can predict the reconstruction of body image. The total explained variance is 38.1%. Based on these findings, we suggest that nurses should observe patients’ performance for fitting their appearance or avoiding manners of withdraw from situation or interacting with others to assess their status of body image changes and their needs. It can help developing comfortable body image in buccal cancer patients after surgery.

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