女性失智症者的身體心像與尊嚴照護：護理與社會學的雙重視角

Body Image and Dignity Care for Women with Dementia: Nursing and Sociological Perspectives

國內研究中，針對女性失智症者的身體心像、其自我認同與尊嚴照護之間的關聯，仍缺乏系統性研究。阿茲海默氏症為最常見的失智症類型，呈現明顯性別差異，約三分之二個案為女性，而身體心像的變化被認為是影響女性失智症者尊嚴的因素之一；由於社會文化對女性外貌的期待較高，許多女性在罹病前已建立穩固的身體心像認同，隨著病程進展，身體變化及社會標籤可能導致自我價值感下降與負面自我評價，進而影響其尊嚴與心理福祉。當各專業僅從自身立場介入時，照護容易片段化，唯有透過跨專業整合與合作，從個案出發重新設計照護模式，才能落實以人為中心的全人照護，本文結合護理學與社會學的雙重視角，剖析女性失智症者身體心像的變化歷程及其對尊嚴照護的影響，並建議未來失智症照護應納入身體心像的敏感性評估，透過跨專業合作與尊嚴導向的長期策略，促進整體性照護，以提升女性失智症者的心理福祉與生活品質。

To the best of our knowledge, no systematic research has been conducted yet on the relationship between body image, self-identity, and dignity in care among women with dementia in Taiwan. A marked gender disparity exists among patients with Alzheimer's disease, the most prevalent form of dementia, with approximately two-thirds of patients being women. Body image alterations are considered major dignity-affecting factors in female patients with dementia. Due to societal and cultural expectations around the physical appearance of women, several women have developed a stable sense of body image and identity prior to the dementia onset. With the progression of dementia, physical changes and social stigma could lead to diminished self-worth and negative self-evaluation, thereby adversely affecting dignity and psychological well-being. When professionals intervene solely from their own disciplinary perspectives, care often becomes fragmented. Person-centered holistic care could be practiced only through interdisciplinary integration and collaboration with patient-centered design of care models. This study combines nursing and sociological perspectives to analyze body image evolution in women with dementia and its implications in dignity in care. We recommend that future dementia care should incorporate body image sensitivity assessments and implement long-term dignity-centered care strategies through interdisciplinary collaboration, aiming at improving the psychological well-being and quality of life of women with dementia.