乳腺癌患者术后体象水平及影响因素

Body image and influencing factors of patients after breast cancer resection

目的了解乳腺癌患者术后的体象水平并对其影响因素进行分析。方法采用方便取样法在2010年2—6月选取北京市2所三级甲等医院的60例乳腺癌术后患者，采用患者一般资料调查表、乳腺癌体象评定量表（BIBCQ）和社会支持评定量表（SSRS）进行问卷调查，并对其影响因素进行分析。结果本组患者的BIBCQ总分为（112．18±30．03）分，各维度得分前3位从高到低排序为：躯体羞耻维度（31．53±7．84）分、疾病易感维度（27．23±8．36）分、功能受限维度（17．88±6．99）分。乳腺癌术后患者社会支持总分为（42．45±5．67）分，得分从高到低排序分别为：主观支持（42．45±5．67）分、客观支持（24．90±3．21）分及对支持的利用度（10．10±2．80）分。对乳腺癌患者术后体象水平与一般资料行单因素分析，结果表明，文化程度及手术方式为乳腺癌患者术后体象水平的主要影响因素，差异有统计学意义（F分别为8．469，6．034；P〈0．05）。乳腺癌体象量表总分与社会支持总分及其3个维度得分的相关分析结果表明：社会支持总分与体象量表总分呈负相关，差异有统计学意义（r=-0．333，P〈0．01），客观支持维度分数与体象量表总分呈负相关（r=-0．341，P〈0．01）；多元线性回归结果显示，年龄、文化程度、社会支持水平以及手术方式是乳腺癌患者术后体象水平的主要影响因素。结论影响乳腺癌患者术后体象水平的因素是多方面的，应根据这些影响因素对患者进行有针对性的护理于预，以提高患者的体象水平。

Objective To understand the body image and its influencing factors of patients underwent breast cancer resection. Methods With the design of descriptive correlational study and the method of convenience sampling, 60 patients after breast cancer resection from Grade Ⅲ-A Hospitals in Beijing city were chosen to investigate with self-made general questionnaire, the Body Image after Breast Cancer Questionnaire （BIBCQ） and Social Support Rating Scale （SSRS）. The data was analyzed by SPSS 17.0. Results Total score of BIBCQ was （ 112.18 ±30.03）. Highest three factors were shame of the body, susceptibility of the diseases, limitation of the function （31.53±7.84,27.23 ± 8.36, 17.88± 6.99, respectively）. The score of social support of patients was （42.45 ±5.67）. The top three factors in this category were subjective support, objective support and the usage of the support （42.45±5.67, 24.90 ± 3.21, and 10.10 ±2.80, respectively）. Single factor analysis showed that the major influencing factor for the body image of patients underwent breast cancer resection was the education level and the operation mode （ F = 8. 469 and 6. 034, respectively; P 〈 0. 05 ）. Total score of the social support and objective support was found negatively correlated with the BIBCQ score（ r = - 0.333 and 0. 341, respectively ;P 〈 0. 01 ）. Multiple linear regression analysis revealed that age, educational level, social support level and the operation mode were the main influencing factors. Conclusions Pertinent nursing should be given for young and high educational background patients. Nurses should strengthen the patients＇ social support and give them information support for surgical management.