子宮肌瘤婦女於子宮全切除後初期的身體意像

The Perception ofBody Image in the Early Post-Total Hysterectomy Period ofWomen with Uterine Myomas

本研究採田野研究法（field method） ，研究者採觀察者即參與者（observer-as-participant）的方式收集資料，研究對象以立意取樣決定，共進取七位子宮肌瘤接受子宮全切除的婦女，研究者於研究對象選定後，以主護護理師的身份，提供研究對象住院期間每日所需的護理照護及進行資料收集，並於研究對拿出院後，安排每週一次家訪或電訪，至手術後一個月的時間，以便進一步了解其想法、感受。研究者將研究對象所表現出來的自發性語言及非語言行為寫成敘述體（narrative）的行為過程紀錄，再以內容分析法（content analysis）將其中有關語言部分，加以有系統的整理、分析、歸類。研究資料經整理、分析及歸類後發現，身體意像是動態的、不斷地在調整與修正，無法用時間清楚的劃分，但可看出時序性的變化，經由研究結果顯示，子宮肌瘤婦女接受子宮全切除後的身體意像，歸類成三大類：（一）知覺到手術後腹部的變化、（二）重新建立身體意像、（三）女性身體的象徵意義。本研究結果有助於臨床護理人員站在病人的立場，更深入了解子宮肌瘤婦女於接受子宮全切除後對其身體的感受與看法，並提供婦科護理人員做參考，藉以評估此類病人的需求，期望所提供的護理是病人所期待的護理。This study utilized the field method. For information collection, the 'observer as participant' method was used. A total of seven subjects who received total hysterectomies for uterine myomas were selected by purposive sampling. During the subjects' hospitalization, the researcher served as a primary care nurse to provide the subjects, nursing care and at the same time as an information collector. After the patients' discharge, home or telephone interviews once a week were arranged to further understand their thoughts and existential situation in relation to their womanhood after the hysterectomies. This was done until one month after the operation. The subjects' verbal responses and non-verbal behaviors were documented as narrative process-recordings. Those related to the verbal portion were further arranged, analyzed and categorized. This study concludes that in women who had total hysterectomies for uterine myomas, the perception of one's body image after operation is a dynamic one with continuous adjustment and amendment. We could not delimit the specific time period clearly but the changes in relation to time sequence is noticeable. The results of this study also reveal that the perception of one's body image in this group of subjects after operation can be categorized in three main themes: (1). perceiving sensational change of one's abdomen in early post-operative period (2). rebuilding the perception of one's body image (3). Awareness of the significance of women's bodies. The result of this study may assist the clinical nursing staff to relate to the perspective of this particular group of patients and therefore to have a deeper understanding of their feelings and views; it may provide the gynecology nursing staff a reference for assessment of these patients' needs and hopefully enable the nursing staff to provide the nursing care which the patients expect.