| 研究生: |
王思欣 Wang, Sih-Shin |
|---|---|
| 論文名稱: |
美感、健康與身體經驗:持續減重者進入肥胖門診前後之比較 Aesthetic, Health, and Body Experience:A Comparative Study of Weight Control Patients before and after Obesity Clinics |
| 指導教授: |
許甘霖
Hsu, Kan-Lin |
| 學位類別: |
碩士 Master |
| 系所名稱: |
醫學院 - 公共衛生學系 Department of Public Health |
| 論文出版年: | 2006 |
| 畢業學年度: | 94 |
| 語文別: | 中文 |
| 論文頁數: | 69 |
| 中文關鍵詞: | 醫病關係 、身體意象 、身體經驗 、肥胖 、醫療化 、現金交易關係 |
| 外文關鍵詞: | body slimming, weight control, body image, medicalization, obesity, cash nexus, the physician-patient relationship |
| 相關次數: | 點閱:114 下載:4 |
| 分享至: |
| 查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
研究背景:
瘦身現象存在已久,台灣在八O~九O年代主導瘦身風潮的各種瘦身美容方式,關心的主要是美感問題,而不是健康問題;近年來興起的醫學減重,將「肥胖」置於疾病的範疇,同時減重也成了一種醫療行為。這對習以美感觀點來看待肥胖與減重問題的人們而言,是個全新的事件,因為它有獨特的知識論述、社會關係及實作技術,可能使肥胖與減重對減重者有了大為不同的意涵。
研究目的:
本研究試圖透過非醫療與醫療場域此兩種體重控制場域的比較,探討具有非醫療場域之持續減重經驗者,進入減重門診這個醫療場域後,在自我認同、身體經驗、身體意象等面向上的差異,探討醫學減重的獨特性及社會意涵,從而與「肥胖醫療化」的相關爭議對話。
研究方法:
本研究自成功大學附設醫院家醫科體重控制門診建立的個人資料問卷中,挑選出擁有非醫療場域經驗的持續減重者,進行個別深度訪談及焦點團體討論,紀錄這些持續減重者在不同減重場域的經驗,再透過對這些經驗的分析與詮釋,比較兩個場域在幾個重要面向上的特點及差異。
研究結果:
1)身體經驗是持續減重者據以判斷不同體重控制場域之知識體系(包括肥胖歸因、減重原理,以及減重成敗歸因),從而產生認知與行為改變的主要依據。
2)兩種場域最顯著的差異在於其主導的社會關係,而醫療場域透過醫療團隊(擴大的醫病關係)提供的正面支持態度,是持續減重者在比較兩個場域時感受最明顯的差別,也是造成不同身體意識之最主要的原因。
3)不同的體重控制場域形塑了持續減重者不同的身體意識(包括身體意象、身體經驗及自我認同)。非醫療場域通常強化負面的身體意識,而醫療場域則強調如何做好減重而非憎恨自己。但即使如此,醫療場域並無法除去肥胖的污名化。
Background: Body slimming has been prevalent in Taiwan for more than two decades, and its major concern is the aesthetic of body figure rather than anything else. However, the emerging obesity medicine redefines overweight as health risk and chronic disease and also weight reduction as medical practice. Regarding its unique discourse and practice, the emerging medical model of overweight and weight reduction seems to be a new event to those people who have consider fatness and body slimming in aesthetic, non-medical terms, and may bring to them perception and experience.
Objectives: This study aims to explore the difference and implications of the weight control patients’ before and after identity, body experience, and body image before and after their visit of obesity clinic, and drawing upon findings, aims to contribute to the debate concerning medicalization of overweight.
Materials and Methods: This study purposively selects patients with weight reduction experience for more than three methods as subjects from the Patient Questionnaires of Weight control Clinic NCKU Hospital. The author records the experiences of these patients from in-depth interview and focus group discussion with them. By way of content analysis, the author then compares their before/after experiences on several aspects.
Results: (1)Body experience constitutes the basis for weight control patients to judge different knowledge system and to influence their change in attitude and behaviors concerned with overweight and weight reduction. (2)The most significant difference of the two settings is their respective characteristic social relationship. Social support in and through the physician-patient relationship, among others, is the most sighificant difference perceived by the patients, which matters especially for patients’ attitude towards their body. (3)Different settings shape weight control patients different attitude towards the body, including body image, identity, and body experience. Non-medical settings offer reinforce the patients negative attitude towards their body whereas the medical setting focus more on how to make weight control work rather than hate oneself. However, experiences in obesity clinic do not help patients to discharge stigmatization of overweight.
American Academy of Pediatrics. Committee on Public Education (2001) Children, adolescents, and television. Pediatrics, 107,423-426.
Booth, Wayne C., et al. (2003) The Craft of Research. Chicago: The University of Chicago Press.
Braziel, Jana Evans (1997) Body out of Bounds:Sex and Fat Chics, deterrirorializing the Fat Female Body. Berkeley:University of California Press. 231-256.
Brown, Phil (2000) Naming and Framing:The Social Construction of Diagnosis and Illness. Perspective in Medical Sociology, 74-103.
Clarke, Adele E., et al (2003) Biomedicalization: technoscientific transformations of health, illness, and U.S. biomedicine. American sociological review, 68, 2. Apr
Cockerham, William C., et al (1997) Dictionary of Medical Sociology
Conrad, Peter and Alison Angel (2001) Homosexuality and remedicalization. Society, July/August.
Jacqueline, A.P., Thomas R. S., and Elizabeth J. (2000) Psychosocial differences associated with body weight among female adolescents: The importance of body image. Journal of Adolescent Health, 26,330-337.
Leinhard, M. L. and Barry, N.J. (1998) Body image and obesity:effects of gender and weight on perceptual measures of body image. Addictive Behaviors, 23, 31-34.
Levine, S. B.(1992) Intrapsychic and Interpersonal Aspects of Impotence: Psychogenic Erectile Dysfunction. Erectile Disorders: Assessment and Treatment. New York: Guilford Press, 198-225.
Miles, A. (1981) The Mentally Ill in Contemporary Society. Martin Robertson, Oxford.
Neumark-Sztainer Dianne(1998) Adolescents engaging in unhealthy weight control behaviors:Are they at risk for other Health-Compromising Behaviors? American Journal of Public Health, 88(6), 952-955.
Nye, Robert A. (2003) The evolution of the concept of medicalization in the late twentieth century. Journal of Histroy of the Behavioral Sciemces, 39(2), 115-129 Spring.
Rahmqvist, Mikael (2002) Doctors’ advice to overweight patients concerning healthy lifestyles. Journal of Nutrition, 46(1), 40-44.
Ross, C.E. (1994) Overweight and depression. Journal of Health and Social Behavior, 35, 63-78.
Slade P (1988) Body image in anorexia nervosa. British Journal of Psychiatry,153:20–22.
Willems, S., et al (2005) Social-economic status of the patient and doctor-patient communication:does it make a difference? Patient Education and Counseling, 56139-146.
Zola, I. K.,(1972) Medicine as an institution of social control. The Sociological Review, 20(4), 487-504.
Camryn Manheim著,熊名瑤、蘇培英譯,(2002),《醒醒吧,我就是胖!》
<Wake UP, I Am Fat!>台北:高談文化。
Kathy Davis著(1995),張君玫譯(1997),《重塑女體》<Reshaping the Female Body: The Dilemma of Cosmetic Surgery>台北:巨流。
Mimi Nichter著(2000),王紹婷譯(2001),《少女Weight的煩惱》(Fat Talk-What Girls And Their Parents Say About Dieting)。台北:新新聞。
Richard Klein著,張明貴、蔡珮君譯,(XXX)《後現代瘦身主義》(Eat Fat)、台北:時報出版。
Rorbert Pool著,王紹婷譯(2003),《為何減肥這樣難?》(Fat: Fighting the Obesity Epidemic)。台北:貓頭鷹出版社。
Shawna Vogel著,魏淑鈴、王紹婷譯(2001),《脂肪迷思》(The Skinny on Fat)。台北:新新聞。
中時新聞資料庫,1991-2000。
尤嫣嫣(2001)<由身體意象觀點談體重控制計畫>,《學校衛生》,第38期,頁56-69。
余玉眉等(1975)<身體心象>,《護理雜誌》,第22期,頁29-46。
吳至行(2003)<成人肥胖治療之概論>,《肥胖臨床診斷與治療》,頁95-111。
吳珮琪(2002)《解讀少女雜誌廣告中的美貌迷思》。中山大學碩士論文。
吳嘉苓(2001)<空間、規訓與生產政治>,《台大社會學刊》,第29期,頁1-58。
吳嘉苓、黃于玲(2002)<順從、偷渡、發聲與出走:「病患」的行動分析>,《台灣社會學》,頁 73-117。
杜玉蓉(2003)《誰在訴說女人的身體?─以瘦身類資訊式廣告為例》。政治大學碩士
論文。
林文源(1998)《To be or not to be?長期洗腎病患的生活、身體經驗》。清華大學碩士
論文。
林宜親、林薇(2001)<青少年體型意識與節制飲食行為之研究>,《中華衛誌》,頁
33-41。
林盈秀(2003)《減肥的身體的我-歷史與性別的觀點》。清華大學碩士論文。
胡幼慧 主編(1996)《研究法系列-質性研究。理論、方法及本土女性研究實例》。巨流。
范麗娟(2004)<重視身體意象之社會建構對於服務肥胖少年之實務意涵>,《壆校衛生》,第44期,頁99-106。
唐妍蕙(2003)《社會壓力對身體意象與飲食障礙問題影響之探討》。成功大學碩士論
文。
陳淑芬(1999)《她們的美麗與哀愁─女性雜誌的美貌建構與讀者使用之研究》。政
治大學碩士論文。
高木蘭(1996)《減重女性的身體形象構成與實踐》。高雄醫學大學碩士論文。
張尹凡(2001)<臺灣地區20至49歲成年民眾體重認知與減重行為之研究>,《台灣家庭醫學雜誌》,第11卷4期,頁180-186。
許甘霖、王思欣 (2006) <肥胖與體重控制>,《台灣醫療四百年》,台北:經典。
郭清輝(2003)<肥胖與糖尿病>,《肥胖臨床診斷與治療》,頁37-46。
陳楷模編著 (2001)《減重醫學》,台北:宏心文化。
陳聖暉(1999)《淡水有線電視購物頻道之塑身廣告文本公式研究》。輔仁大學論士論
文。
楊偉勛(2003) <肥胖的成因>,《肥胖臨床診斷與治療》,頁 29-36。
劉伯恩 (2001)《劉伯恩雞尾酒減肥法》,台北:高富出版社。
潘文涵(2003)<肥胖的定義與肥胖流行病學>,《肥胖臨床診斷與治療》,頁1-17。
蕭芳惠、林薇(1998)<台北市高中女生的體型意識及飲食異常傾向之研究>,《衛生教育學報》,第11期,頁107-127。
聶西平(1998)《瘦身廣告之內容分析》。台灣大學碩士論文。
肥胖門診主治醫師訪談 2004(ID001-1)
肥胖門診主治醫師訪談 2005(ID001-3)
肥胖門診主治醫師訪談 2005(ID003-5)
肥胖門診病患訪談 2004(IP001-1)
肥胖門診病患訪談 2004(IP002-2)
肥胖門診病患訪談 2005(IP003-3)
肥胖門診病患訪談 2005(IP004-4)
肥胖門診病患訪談 2006(IP005-5)
肥胖門診病患訪談 2006(IP006-6)
肥胖門診病患訪談 2006(IP007-7)
肥胖門診病患訪談 2006(IP008-8)
肥胖門診病患訪談 2006(IP009-9)
肥胖門診病患訪談 2006(IP0010-10)
肥胖門診病患訪談 2006(IP0011-11)
肥胖門診病患訪談 2006(IP0012-12)
肥胖門診病患訪談 2006(IP0010-13)
肥胖門診病患訪談 2006(IP0011-14)
肥胖門診病患訪談 2006(IP0012-15)
肥胖門診病患訪談 2006(IP0012-16)