僵直性脊椎炎病人身體心像之相關因素

背景：僵直性脊椎炎病人較一般人遭遇更多生理及功能的損壞，為身體心像紊亂的高危險群，但在臺灣這群病人身體心像的相關因素卻很少被充分探究。目的：探討僵直性脊椎炎病人身體心像的情形及其預測因子。方法：採橫斷性相關性研究及方便取樣，收案時間為2017年1月至12月，由北臺灣某一醫學中心免疫風濕科門診招募120位僵直性脊椎炎病人。以結構性問卷及病例審查進行資料收集，研究工具包括人口學資料、跌倒史、巴斯僵直性脊椎炎疾病活動指數、脊椎炎功能指數、疼痛及身體心像等量表。結果：整體身體心像平均分數為68.16±16.14分，14.2%一年內曾跌倒，九成以上有不同程度的疼痛。多元迴歸檢測顯示脊椎炎疾病活動度分數越高（β=-.31,p= .005）；脊椎炎功能指數越高（β=-.24,p= .026）；有跌倒史者（β=-.16,p= .023），身體心像得分越低，多元迴歸模式整體解釋變異量為47.9%（F=10.95,p＜ .001）。結論／實務應用：疾病活動度、失能狀況和跌倒史與僵直性脊椎炎病人的身體心像感受有顯著相關，臨床人員應定期評估病人疾病活動狀態及身體心像變化，提升病人自我管理能力，並將預防跌倒及疼痛控制整合於照護計畫，以提升病人的身體心像及生活品質。

關鍵字

僵直性脊椎炎；身體心像；疾病活動度；疼痛；跌倒

並列摘要

Background: Patients with ankylosing spondylitis typically exhibit a greater number of physical and functional impairments than do members of the general population and are a group at high risk of body-image disturbance. However, the factors associated with body image among this population have not been adequately explored in Taiwan. Purpose: To explore the status of body image and its predictors in patients with ankylosing spondylitis. Methods: A convenience sampling-based cross-sectional and correlational study was conducted between January and December 2017. In total, 120 patients who had been diagnosed with ankylosing spondylitis were recruited from the immunology and rheumatology department of a medical center in northern Taiwan. A structured questionnaire and chart review were employed to collect research data. Instruments included demographic data, fall history, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Numeric Pain Rating Scale (NRS), and the Rheumatic Arthritis Body Image Scale. Results: The mean score for body image was 68.16 ± 16.14. Overall, 14.2% of patients had experienced a fall in the previous year, and more than 90% of participants experienced various degrees of pain. The multiple regression result revealed that patients with a higher BASDAI (β = - .31, p = .005) score, a BASFI higher (β = - .24, p = .026) score, and had a fall history (β = - .16, p = .023) had higher negative body image scores. The total variance explained in the multiple regression model was 47.9% (F = 10.95, p ＜ .001). Conclusions/Implications for Practice: Disease activity, disability, and fall history were associated with body image in patients with ankylosing spondylitis. Clinical professionals should regularly assess the disease activity and body image of patients and promote their self-management abilities. Furthermore, fall prevention and pain control should be integrated into care plans to improve patients' body image.

並列關鍵字

ankylosing spondylitis ； body image ； disease activity ； pain ； fall

參考文獻

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僵直性脊椎炎病人身體心像之相關因素

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