乳癌術後婦女身體意象衡鑑量表之研發

Constructing the Body Image Scale of the Postmastectomy Breast Cancer Women

林耀盛(Yaw-Sheng Lin) ； 胡至家(Chih-Chia Hu)

《臨床心理學刊》 5卷2期 (2011/12) Pp. 37-46

https://doi.org/10.6550/ACP.201112_5(2).0003

摘要

目的：乳癌術後婦女面對乳房切除造成心理衝擊和身體意象的完形性變化，是多重失落的臨床現象。研發乳癌術後婦女「生理-心理」互動關係衡鑑指標，以身體意象為評估核心，並建立和憂鬱情緒的連結，是重要議題。方法：依文獻回顧、參考相關衡鑑工具和分析訪談資料，自行編製「乳癌術後婦女身體意象量表」，並進行預試、項目分析和相關檢驗，建構完整量表，同時建立基本信度和效度。結果：本研究有效樣本共214名，平均年齡為48.92歲（±7.19歲），乳癌期數第Ⅰ期與第Ⅱ期初期的病患為大多數，約佔57.95％。經統計分析，顯示「乳癌術後婦女身體意象量表」具備良好的內部一致性信度（.93）。區辨效度方面，術後乳房「未重建組」和「重建組」身體意象得分，與「流行病學中心憂鬱量表」（CES-D）的相關分別為.50（p＝.000）和.598（p＝.000），無論術後是否進行重建，都得以透過身體意象的切截分數，區辨出臨床上情緒憂鬱的個案。身體意象量表的因素分析，呈現四個因素（命名為整全、性化、私密與社會），解釋變異量達52.40％。結論：身體意象由因素分析結果，呈現多重身體觀點，更不可忽視情緒狀態。本研究顯示「重建組」的身體意象切截分數達72.60分者，是憂鬱的高危險族群；「未重建組」切截分數則為58.35分。未來可以透過身體意象的評估，探究情緒心理，以協助患者重新建立「生理—心理」合適狀態的身心關係。

關鍵字

身體意象 ； 乳癌 ； 衡鑑

並列摘要

Object: The study was aimed to construct the body image scale adapted for postmastectomy breast cancer women. Through the assessment, we could understand the multiple losses phenomena from the body image change in Gestalt view. Exploring the psycho-physical interactive relationship from the body to depressive reactions to the breast operation was the important issue for the chronic illness sufferers. Method: Literature reviews, referring to the other assessment tools and depth interviews to four subjects were adopted and revised to construct the scale. Then, the twice pilot study, and the item analysis were conducted to construct the self-report scale form. The reliability and validity were analyzed. Results: Total 214 samples were recruited with mean ages 48.92 (±7.19) years old, and their illness onset at earlier stages (first and second stage) at large. The internal consistency coefficient of the scale was high, it was manifested that basic reliability was in good form. Also, the scale was constructed with fine discriminate validity through the CES-D index. Factor analysis to the scale was showed four main structures, namely, the whole body, intimate body, sexual body and social body. Conclusion: The body images were multiple views for the survivor. The index of psycho-physical link from the body image to the breast cancer patients' emotion state was well-built. To evaluate the survivor's body image might be the first step to do the psychological assessment, especially to the depressive mood. It is the embodiment clinical practice of the holistic health model.

並列關鍵字

body image ； breast cancer ； assessment