憂鬱傾向和親密關係對乳癌術後婦女身體意象影響之相關探討

The Effect of Depressed Tendency and Intimate Relationship on the Body Image of Women with Postmastectomy Breast Cancer

林耀盛(Yaw-Sheng Lin) ； 胡至家(Chih-Chia Hu) ； 張娟鳳(Chuan-Feng Chang)

《高雄行為科學學刊》 1卷1期 (2009/01) Pp. 25-39

https://doi.org/10.29854/TJKBS.200901.0002

摘要

目的：本文嘗試探討乳癌術後婦女患者的憂鬱傾向、親密關係和身體意象之相關影響，進而揭示其心理生活的經驗因子。方法：研究共蒐集88位罹患乳癌第Ⅰ期和第Ⅱ期間，且進行乳房切除手術的患者資料。受試者年齡介於41.05至52.59歲（M=46.82；SD=5.77）；其手術後時間介於16.03至43.45個月（M=29.74；SD=13.71）；接受乳房重建手術47人，而未接受乳房重建41人。研究測量工具為「身體意象量表」、「成人早期婚姻親密關係量表」和「流行病學研究中心憂鬱量表」。結果：經邏輯迴歸分析發現，高憂鬱傾向、低性慾的親密和低社會的親密，為乳癌術後婦女身體意象差的顯著預測變項。路徑分析顯示，不論是透過直接或是間接方式，「憂鬱傾向」對乳癌術後婦女身體意象，具重要影響力。結論：1.本研究落實「生物心理社會」健康模式，顯示憂鬱傾向評估和社會關係建立的重要性。2.身體意象是從「自然化」到「社會化」的轉化概念。由此顯示，慢性病不僅是個人事故，更是社會事件。

關鍵字

乳癌 ； 身體意象 ； 憂鬱傾向 ； 親密關係

並列摘要

Objective: The paper is to explore the states of the postmastectomy breast cancer women's body image, depressive disposition and intimacy relationship. And, the psychological life factors affected the illness experiences are further discussed. Method: Eighty-eight subjects with age between 52.59 and 41.05 years old (M=46.82, SD=5.77) in a certain hospital center in southern Taiwan were evaluated through the Body Image Scale(BIS), the Center of Epidemiology Study-Depression Scale(CES-D)- Chinese edition, and Marital Intimacy Inventory (MII). Results: By the logistic regression analysis, the variables of the high depressive disposition, low sexual intimacy and low social intimacy are the most important variables to predict poor body image in postmastectomy breast cancer women. The path analysis indicates that whether through directly or indirectly effects, the depressive disposition variable made important impacts on postmastectomy breast cancer women's body image. Conclusion: The study puts the bio-social-psychological model of health into practice. We point out the importance to assess the depressive disposition in the clinical caring and to help the patients to reconstruct the social relationships. The concept of body image is articulated from the natural entity to the socialization, and the chronic illness as a social event is elaborated.

並列關鍵字

breast cancer ； body image ； depressive disposition ； intimacy relationship