[[alternative]]An changing of body image and coping behavior of oral cancer patients after operation in thehospital---in middle age and elder

[[abstract]]本研究目的主要是瞭解口腔癌患者手術後如何面對身體心像改變及採取之因應行為。研究採橫斷性設計，於2009年4月1日至 7月31日，以立意取樣於北部二家醫學中心，選取85位首次接受口腔癌手術後之個案，採結構式問卷進行資料收集。研究工具包括：基本資料表、身體心像及因應行為量表，採用Spss 17.0統計軟體。 研究結果顯示，年齡分佈介於40－79歲之間，平均年齡為55.60±9.12歲，大多數有抽菸、嚼食檳榔及喝酒習慣。年齡越輕越在乎自己的身體心像改變；癌症分期越後期、手術切除的部位越大、身體活動功能越差，則身體心像就越負面。在問題為取向的因應行為方面，年齡越大、無職業、教育程度國中以下者呈現問題因應頻率較高。情緒為取向的因應行為方面，癌症分期越後期、手術方式越大則病患使用情緒因應的頻率越高。以多層次回歸探討影響口腔癌患者手術後因應行為的重要預測因子，結果最能預測口腔癌患者手術後問題因應行為的變項為「職業-工、商」；而最能預測口腔癌患者手術後情緒因應行為的變項為「身體心像」。 根據研究結果，建議政府加強對民眾宣導口腔自我檢查的重要性及瞭解口腔癌的訊號。由研究發現口腔癌分期及手術方式對患者身體心像具有相當程度的影響，此階段病患需要情緒及心理方面的支持。本研究結果提供醫療照顧者，依個別癌症分期及手術方式給予疾病解釋及支持。建議未來的研究者提供教育介入，了解醫療專業團隊，識別個案的情緒及身體心像改變後個案的適應。[[abstract]]The purpose of this study was explored how the participants with oral cancer had faced the change of their body image and how they copied their behaviors after the first operation. It was cross - sectional design with purposive sampling, from April 1st 2009 to July 31st 2009. The data had collected from two Medical Centers in Northern Taiwan, and there were 85 participants who were treated with first wide area operation of oral cancer. The questionnaire included: demographics, the body image, and the coping behaviors. The data was analyzed by SPSS 17.0.The result showed the age range, mean and SD of participants was 40-79, 55.60, and ± 9.12 years, respectively. Most of them had been smoking, drinking and chewing betel nuts. The younger participants were concerned the change of body image compared the older. Participants, who had the poor cancer staging, a wide range of operation, and the poor physical function, have lower scale of body image. The participants, with older, the less education years, and non-occupation, had showed the more frequency in the problem-oriented coping behavior. The participants with poor cancer staging, and a wide range of operation, had showed frequently emotional-oriented coping behavior. We use the multilevel regression explores the predictive factor; in the problem-oriented coping behavior, the predictor factor was participants who working in the industrial and commercial; in the emotional-oriented coping behavior, the predict factors was participants who had the less score of body image.According to these results, it is recommended that the Government need strengthen oral self-examination and teaching the early sign of oral cancer. This study also explored the stage of oral cancer and the way of operation impacted the body image. Therefore, they need emotional and psychological supports from nurse caregivers. The results of this study provided medical caregivers explain and emotion support according to the stage of oral cancer and the way of operation. Suggestion the future researchers, need set up education intervention, understand the coping behavior of cases by intervention which are identified the changing of body image and emotional support from medical professional team