臺灣大學生之性別、性取向、身體意象與健康相關生活品質之關係

Abstract

目標：欲了解臺灣大學生之身體意象與其生理、心理、社會關係及環境四範疇之健康相關生活品質是否有所關聯，並比較前述關係是否因性別及性取向而有所差異。 方法：採橫斷性設計，於臺灣知名電子佈告欄進行問卷調查，共回收1,058份有效問卷。測量工具使用多向度身體自我關係問卷 (Multidimensional Body Self-Relations Questionnaire, MBSRQ) 中之外表整體評估 (Appearance Evaluation, AE) 及對體重過重的關注程度量表 (Overweight Preoccupation, OP) 測量身體意象，與臺灣簡明版世界衛生組織生活品質問卷 (The World Health Organization Quality of Life-BREF, WHOQOL-BREF) 測量健康相關生活品質，並利用描述性統計、皮爾森積差相關、多變項線性迴歸進行資料分析。 結果：身體意象中，女大學生較男大學生關注自身體重之變化 (p <0.001)，在外表整體評估上則無性別差異；健康相關生活品質方面，女大學生於社會關係之健康相關生活品質分數較男大學生高 (p <0.001)，於其他範疇之生活品質亦無性別差異；健康相關生活品質與身體意象則無性取向之差異；外表整體評估與各範疇之健康生活品質皆有顯著正相關 (範圍從0.307至0.529)，於性別與性取向之分層中亦然，而於各範疇之相關模式中，皆為顯著的相關因子；另，大學生健康相關生活品質之相關因素隨性別而異，且男大學生其生活品質之相關因素有聚集化現象，並於心理及環境範疇之生活品質測量中，有性取向之交互作用。最後，身體意象對於男學生健康生活品質之相關模式於生理、心理、社會關係及環境範疇分別有15.6%, 24.7%, 16.3%,及6.5%的改變量，女學生則有11.4%, 26.4%, 11.3%,及10.5%的改變量。 結論：大學生之身體意象與其健康相關生活品質息息相關，建議未來在大學生健康相關生活品質的研究或健康促進計畫中，納入身體意象的議題，與考慮性別及性取向之差異，並追蹤大學生身體意象之變化，以增進大學生健康相關之生活品質。

Objective: To examine the relationships between body image and physical health, psychological, social relationships, and environment domains of health-related quality of life (HRQOL), and to explore if these relationships varied by gender and sexual orientation among college students in Taiwan. Methods: Data from 1,058 participants were collected, using a cross-sectional survey administered via a popular bulletin board system commonly frequented by college students in Taiwan. Appearance evaluation (AE) and overweight preoccupation (OP) scales from the Multidimensional Body Self-Relations Questionnaire (MBSRQ) were used to measure body image, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) was used to measure HRQOL. Descriptive statistics, Pearson’s correlation, and multiple linear regression analyses were used to examine the relationships. Results: Female college students paid more attention to body weight changes (p<0.001) than their male counterparts, but AE scores did not differ by gender. Females had significantly higher scores in the social relationships domain (β=12.94) of HRQOL than males (β=12.23), but there were no gender differences in other three domains. Body image and HRQOL did not differ significantly by sexual orientation. Significant positive correlation was found between AE and all four domain scores, with the correlation coefficients ranging from 0.307 to 0.529 in the total sample, and the correlation was also significant when stratified by gender and sexual orientation. AE was significantly associated with all four domain scores in both gender-specific models. We also found that factors affecting male students’ HRQOL seem to aggregate, and among male students, sexual orientation interaction effects were found with BMI in psychological domain and with cigarette use in environment domain. Finally, model fit statistics showed that R2 changed significantly when AE and OP were entered into the models, indicating 15.6%, 24.7%, 16.3%, and 6.5% increases in the variance explained in the physical health, psychological, social relationships, and environment domain scores, respectively, in the male-specific model, and 11.4%, 26.4%, 11.3%, and 10.5%, respectively, in the female-specific model. Conclusions: Body image is an important factor when assessing HRQOL among college students. Differences by gender and sexual orientation should also be taken into consideration when developing interventions to promote healthy body image and improve HRQOL.