探討乳癌生存者身體心像、社會支持與復原力的關係

背景：本計畫為探討乳癌生存者復原力之主要預測因子之研究。隨著乳癌早期篩檢的推廣及治療方式的進步，使得乳癌患者的存活率大幅提升，但卻也造成乳癌生存者生理、心理、社會及靈性等層面的問題，更影響日後的復原力及生活品質，而過去探討乳癌生存者復原力的研究相當有限。目的：本研究將分析乳癌生存者復原力的重要預測因子。方法：為橫斷性、描述性及預測性研究，選取南部某一醫學中心及兩所區域教學醫院200位乳癌生存者，請個案自填結構性問卷[基本資料、身體心像關係量表、社會支持量表及復原力量表] 或以問卷訪談方式進行資料收集，以探討身體心像、社會支持及復原力之現況、相關性及復原力的重要預測因子。獨立樣本t檢定及單因子變異數分析(one-way ANOVA)、皮爾森積差相關(Pearson's correlation)、斯皮爾曼等級相關(Spearman's correlation) 及逐步複迴歸進行資料分析。研究結果：結果發現身體心像關係量表平均得分為80.97±13.50；社會支持量中家人支持方面平均得分為51.93±13.24、醫療人員支持方面平均得分為51.35±16.45；復原力量表平均得分為71.91±10.36。總收入、身體心像、家人社會支持、醫療人員社會支持與復原力呈顯著相關。分析結果身體心像解釋變異量最大，其對復原力單獨解釋變異量為13%；有接受放射線治療，解釋變異量為6.6%；再來是醫療人員支持，解釋變異量為3.6 %；其次是總收入，解釋變異量為2.7%；三者總解釋變異量為26%。標準化方程式為復原力＝-.343x身體心像- .240x放射線治療+.172x醫療人員支持+.169x總收入。表示身體心像越差、有接受放射線治療、醫療人員支持較低者及收入低者，其乳癌生存者的復原力越差。結論：相關結論可提供臨床參考。表示身體心像越好、收入較高者、無接受放射線治療及醫療人員支持較高者，其乳癌生存者的復原力越好。

關鍵字

乳癌生存者；身體心像；社會支持；復原力

並列摘要

Background: With the popularization of the early screening of and advances in treatment approaches for breast cancer, the survival rate of breast cancer patients has increased significantly. However, physiological, psychological, social, and spiritual problems in breast cancer survivors affect the future resilience and quality of life of patients. Studies on the resilience of breast cancer survivors are quite limited. Purpose: To analyze the current status of body image, social support, and resilience, as well as the main predictors of resilience. Methods: A cross-sectional, correlational, predictive study was conducted. Purposive sampling was used to select 200 breast cancer survivors. These cancer survivors were recuited in a medical center and two regional teaching hospitals in southern Taiwan. Subjects were asked to complete a structured questionnaire, or a questionnaire-based interview was conducted with them. Independent t test, One-Way ANOVA, Pearson’s correlation, Spearman's correlation, stepwise multiple regression analysis were used to analyzed the data. Results: The results showed that the average score on the body image relationship scale was 80.97±13.50. In terms of social support, the average family support score was 51.93±13.25, and the average medical staff support score was 51.34±16.45. The average resilience score was 71.91±10.36. Total income, body image, social support from family members, and social support from medical staff were significantly correlated with resilience. Body image explained the largest proportion of variance in resilience (13%), total income, having received radiation therapy, and medical staff support explained 6.6%, 3.6%, and 2.7% of the variance in resilience, respectively. The total variance explained by the four variables was 26%. The standardized equation was resilience =-.343x body image - .240x radiation therapy +.172x medical staff support +.169x total income. Conclusion: The findings of this study can provide a clinical reference, suggesting that better body image, higher income, not having received radiation therapy, and support from the medical staff are linked with greater resilience in breast cancer survivors.