復健期重度燒傷病患疤痕與身體心像及生活品質之關係

Body Image and Quality of Life in patients with burned scar during rehabilitation

復健期是指傷口大多已癒合準備出院返家之燒傷病患，因疤痕影響外觀，同時感到尷尬、沮喪、煩惱或憤怒，而這種負面情緒嚴重影響燒傷病患出院後的生活品質。本研究目的主要探討重度燒傷病患在復健期燒傷疤痕影響身體心像及生活品質的程度。以橫斷式研究、自填問卷收集出院後三年內經醫師診斷重度燒傷70位個案資料。研究結果得知，復健期的重度燒傷病患（1）性別、燒傷深度、手術次數、燒傷部位、疤痕部位會影響復健期重度燒傷病患的生活品質；且（2）在生活品質中皮膚面向（28.17±14.66）影響最大，其中以對熱的敏感度分數最低；（3）疤痕與身體心像、生活品質之間顯著負相關，疤痕主觀感受與正常皮膚愈不同者，其生活品質愈低（r = - 0.47, p <.001）；（4）身體心像與生活品質顯著負相關，其身體心像分數越高者，生活品質愈低（r = - 0.45, p< .001）；（5）性別、燒傷深度、手術次數、疤痕可作為預測生活品質的重要因子。根據研究結果瞭解復健期的重度燒傷病患對疤痕的感受仍高於正常膚色的病人，並影響身體心像與生活品質，因此照護重度燒傷病人如何預防疤痕的形成是一大重要的任務。

Many burn patients are left with scars that can be visually unappealing, affecting their self-esteem and causing varied reactions from others. This often leads to feelings of embarrassment, depression, annoyance, or anger among patients. The recurrence of these negative emotions can diminish the overall quality of life. We investigated the condition of scars, body image, and the overall quality of life experienced by individuals undergoing rehabilitation after suffering severe burns. This cross-sectional study employed a purposive sampling method. Data were collected by self-response questionnaires from 70 participants. The study revealed the following key findings: 1. The more distinct the difference in skin appearance, the lower the quality of life (correlation coefficient, r = -.47, p <.001); 2. Among the factors examined in quality of life, skin appearance had the most significant impact (mean score: 28.17±14.66), while sensitivity to heat received the lowest score; 3. A deteriorating body image correlated with a reduced quality of life (correlation coefficient, r = - .45, p < .001); 4. Gender, burn depth, number of operations, and the extent of scarring demonstrated significant associations with quality of life; 5. Gender, burn depth, number of operations, and the extent of scarring were identified as significant predictors of quality of life in this study. The study highlights that individuals undergoing rehabilitation after suffering severe burns often perceive their scars differently, which subsequently impacts their body image and overall quality of life.