Research has confirmed that many women are dissatisfied with their bodies. Seen from a pastoral perspective, this study examines the women that are dissatisfied with their bodies. An empirical qualitative study was done to evaluate the spiritual women’s thoughts, feelings, causes and effects regarding their bodies. A comprehensive literature study was done to verify the results already found. Social science and theological literature were used to determine the ethology of bodily dissatisfaction, which confirmed that it is multifactorial. A variety of therapeutic aids were studied. Cognitive behavioural therapy appears to be the most effective for the women that are dissatisfied with their bodies. The eight cognitive behavioural steps indicated by Cash were thoroughly explored and the value thereof was confirmed. The therapeutic aids found by means of the study were furthermore researched and confirmed by the Word of God and theological literature. Every woman is an individual with an individual body image and must be approached as an individual holistic being. The six dimensions of Clinebell’s holistic-liberation growth model are important for the woman’s healing process, as well as maintaining a balanced, healthy life. The implications of the research include the six dimensions of Clinebell’s holisticliberation growth model, incorporated in a pastoral counselling method to assist the woman with her healing process. Her relationship with God and positive God-centred thinking patterns ought to be of vital importance to her. By integrating the eight steps of Cash’s cognitive behavioural therapy and the six dimensions of Clinebell’s holistic-liberation growth model, the researcher was able to develop a pragmatic diagram for the woman and therapist as a possible aid in her healing process. The researcher followed the four tasks of practical theology as theoretical framework, as explained by Osmer: · Descriptive-empirical Task – “What is going on?” · Interpretive Task – “Why is this going on?” · Normative Task – “What ought to be going on?” · Pragmatic Task – “How might we respond?” / PhD (Pastoral Studies), North-West University, Potchefstroom Campus, 2014

Bakgrund: Bröstcancer är den vanligaste cancersjukdomen bland kvinnor i Sverige. Den initiala behandlingen är huvudsakligen kirurgisk med bröstbevarande kirurgi eller mastektomi. Internationell forskning visar att kvinnor som behandlats med bröstbevarande kirurgi har bättre kroppsuppfattning och sexuell aktivitet i jämförelse med kvinnor som behandlats med mastektomi. Få studier är gjorda i Sverige rörande sexualitet och kroppsuppfattning med ett tidsperspektiv inom det första året efter ingrepp. Syfte: Studien avsåg att undersöka skillnader av kroppsuppfattning och sexualitet över tid bland kvinnor som genomgått bröstbevarande kirurgi i jämförelse med kvinnor som behandlats med mastektomi. Metod: En kvantitativ studiedesign med en longitudinell utformning användes. Undersökningsgruppen var kvinnor diagnostiserade med bröstcancer som behandlats med bröstbevarande kirurgi eller mastektomi på tre sjukhus i mellersta Sverige. Studien var en del av en interventionsstudie med inriktning på livskvalitet. Resultat: Den sexuella aktiviteten förbättrades 12 månader efter ingrepp bland kvinnor som genomgått bröstbevarande kirurgi. Kvinnor som genomgått bröstbevarande kirurgi hade bättre kroppsuppfattning vid inklusion samt 12 månader efter ingrepp i jämförelse med kvinnor som behandlats med mastektomi. Det fanns samband av bättre kroppsuppfattning vid högre ålder vid inklusion samt 12 månader efter ingrepp. Det fanns även samband av bättre sexuell aktivitet vid lägre ålder under samma tidsperiod. Slutsats: Den sexuella aktiviteten förbättras 12 månader efter behandling med bröstbevarande kirurgi. Kvinnor opererade med bröstbevarande kirurgi har bättre kroppsuppfattning strax efter ingrepp samt 12 månader efter ingrepp i jämförelse med kvinnor som genomgått mastektomi. Ålder har inverkan på kroppsuppfattning och sexuell aktivitet bland kvinnor som genomgått bröstbevarande kirurgi eller mastektomi. / Background: Breast cancer is the most common cancer disease among women in Sweden. The initial treatment is mainly surgical with breast conserving therapy or mastectomy. International research shows that women who have been treated with breast conserving therapy have a better body image and sexual activity compared to women who have been treated with mastectomy. Few studies have been done in Sweden regarding sexuality and body image with a time perspective over the first year after surgery. Objective: The study aim at investigating differences of sexuality and body image over time between women who had undergone breast conserving therapy compared to women who had been treated with mastectomy. Methods: A quantitative study design with a longitudinal design was used. The participants were women diagnosed with breast cancer who were treated with breast conserving therapy or mastectomy at three hospitals in the middle of Sweden. The study was part of an intervention study with focus on quality of life. Results: The sexual activity improved 12 months after surgery among women who had undergone breast conserving therapy. Women who had undergone breast conserving therapy had a better body image at inclusion and 12 months after surgery compared to women who had been treated with mastectomy. There were correlations of a better body image at higher age at inclusion and 12 months after surgery. There were also correlations of a better sexual activity at lower age over the same period of time. Conclusion: Sexual activity improves 12 months after treatment with breast conserving therapy. Women operated with breast conserving therapy have a better body image shortly after surgery and 12 months after surgery in comparison to women who have undergone mastectomy. Age has an impact in body image and sexual activity among women who have been treated with breast conserving therapy or mastectomy.

Bakgrund: Att få en stomi kan innebära flera olika förändringar i en människas liv. Individens självbild kan förändras efter operationen, till följd av det nya kroppsliga utseendet och dess funktioner. Ett tillfredsställande sexliv är starkt korrelerat till psykosocialt- och fysiskt välbefinnande. Syfte: Syftet med detta arbete var att beskriva patienters upplevelser samt eventuella förändringar som kan uppstå kring deras sexualitet efter att ha erhållit en stomi. Metod: Litteraturstudien är baserad på originalartiklar som beskriver personers upplevelser av att leva med en stomi. Resultat: Resultatet visar att både män och kvinnor uppfattar flera olika omställningar i och med den förändrade kroppsliga funktionen och det nya utseendet. Stomin medförde konsekvenser hos deltagarna som ofta påverkade identitets- och kroppsuppfattningen negativt, och deltagare hade därför svårt att acceptera sin stomi och dess utseende. Sexlivet kunde påverkas i och med att stomin medförde rädsla och osäkerhet för andra människors reaktioner, då själva stomin ansågs vara oattraktiv. Även oförändrat sexliv förekom. Slutsats: Att personal kan bemöta frågor gällande sexualitet och intimitet är viktigt efter en stomioperation, och måste anpassas efter varje enskild individs behov. Detta ändamål kräver utökade studier för personal som kommer i kontakt med patienter som erhållit stomi. / Background: An ostomy comes with several changes in a person’s daily life. One’s self image may change due to the bodily changes, both esthetical and functional. A satisfying sex life is strongly correlated to psychosocial- and physical well being. Purpose: The aim of this study was to obtain an understanding of people’s experiences and possible changes in their sexuality after an ostomy formation. Method: This literary review is based on original qualitative articles studying people’s experiences following the life-altering changes an ostomy means. Findings: The results showed that both men and women felt that getting the ostomy involved adapting to it in many ways, due to their bodily modification. Consequences of the ostomy often affected the participant’s identity- and body image negatively, which often made it hard for the participants to accept their ostomy and its appearance. The sex life was often affected, as the ostomy, considered unattractive, induced fear and insecurity with the participant as to how other people would react to it. Some participants experienced a non- changed sex life. Conclusions: It’s important that questions regarding sexuality and intimacy following an ostomy formation can be answered appropriately, and must be adapted to the specific needs of the individual. This requires further studies, enabling professionals in contact with ostomy patients to better manage such situations.

The display of the male body has recently become a common phenomenon in Western culture. The objectification of men is a new theoretical concept that originates from the more familiar concept of the perceived objectification, observation and evaluation of the female body (Fredrickson & Roberts, 1997). McKinley (as cited in Soban, 2006) terms this concept Objectified Body Consciousness (OBC). Past studies confirm that the concept of OBC may also be successfully applied to males (Grieve & Helmick, 2008; Tiggemann & Kuring, 2004), especially in relation to current cultural expectations for the male body (Grieve & Helmick, 2008; Soban, 2006). At an extreme level internalisation of the mesomorphic body shape as body ideal may lead to a Drive for Muscularity (DM; Grieve, 2007). Grieve and Helmick (2008) indicate that males who score high on objectification measures show higher incidences of DM. According to the socio–environmental theories of Grieve (2007) and McCabe and Ricciardelli (2004) males experience significant social pressures to achieve the muscular ideal. There is a scarcity of literature concerning body–image concerns and the muscular ideal within the South African male undergraduate population. This research was therefore exploratory in nature and aimed to determine whether undergraduate men with high levels of OBC differ significantly in DM from undergraduate men with low levels of OBC. In addition, the study investigated the existence of a correlation between OBC and DM and whether undergraduate men differ in DM in accordance with exposure to certain socio–environmental factors. The quantitative study employed a survey design (Mouton, 2001) and used the Objectified Body Consciousness Scale (OBCS; McKinley & Hyde, 1996) and the Drive for Muscularity Scale (DMS; McCreary & Sasse, 2000). A convenience sample of 278 undergraduate males (mean age = 19 years) was selected based on availability and readiness to partake in the study (Field, 2005). Participants were all males aged between 18 and 20 and residing on the North–West University Potchefstroom Campus. Results indicate that undergraduate men with either elevated or low levels of OBC do not differ in terms of their DM. No correlation exists between OBC and DM. A group of undergraduate men who read fitness and health–related magazines, participate in sport, exercise regularly and have used steroids and supplements in the past year was identified. This group presented with high incidences of Muscle Development Behaviour suggesting that they may be at risk of internalising an attitude of increasing muscularity that may result in DM. / Thesis (M.A. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2011.

The display of the male body has recently become a common phenomenon in Western culture. The objectification of men is a new theoretical concept that originates from the more familiar concept of the perceived objectification, observation and evaluation of the female body (Fredrickson & Roberts, 1997). McKinley (as cited in Soban, 2006) terms this concept Objectified Body Consciousness (OBC). Past studies confirm that the concept of OBC may also be successfully applied to males (Grieve & Helmick, 2008; Tiggemann & Kuring, 2004), especially in relation to current cultural expectations for the male body (Grieve & Helmick, 2008; Soban, 2006). At an extreme level internalisation of the mesomorphic body shape as body ideal may lead to a Drive for Muscularity (DM; Grieve, 2007). Grieve and Helmick (2008) indicate that males who score high on objectification measures show higher incidences of DM. According to the socio–environmental theories of Grieve (2007) and McCabe and Ricciardelli (2004) males experience significant social pressures to achieve the muscular ideal. There is a scarcity of literature concerning body–image concerns and the muscular ideal within the South African male undergraduate population. This research was therefore exploratory in nature and aimed to determine whether undergraduate men with high levels of OBC differ significantly in DM from undergraduate men with low levels of OBC. In addition, the study investigated the existence of a correlation between OBC and DM and whether undergraduate men differ in DM in accordance with exposure to certain socio–environmental factors. The quantitative study employed a survey design (Mouton, 2001) and used the Objectified Body Consciousness Scale (OBCS; McKinley & Hyde, 1996) and the Drive for Muscularity Scale (DMS; McCreary & Sasse, 2000). A convenience sample of 278 undergraduate males (mean age = 19 years) was selected based on availability and readiness to partake in the study (Field, 2005). Participants were all males aged between 18 and 20 and residing on the North–West University Potchefstroom Campus. Results indicate that undergraduate men with either elevated or low levels of OBC do not differ in terms of their DM. No correlation exists between OBC and DM. A group of undergraduate men who read fitness and health–related magazines, participate in sport, exercise regularly and have used steroids and supplements in the past year was identified. This group presented with high incidences of Muscle Development Behaviour suggesting that they may be at risk of internalising an attitude of increasing muscularity that may result in DM. / Thesis (M.A. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2011.

Bakgrund: Vanligaste behandlingsformen för bröstcancer är kirurgi, där ibland hela bröstet tas bort (mastektomi). Ibland görs bröstrekonstruktion efter mastektomi. Tidigare studier visar att mastektomi kan ha negativ inverkan på kvinnors livskvalitet och kroppsuppfattning. Syfte: Syftet var att undersöka hur kvinnor som genomgått mastektomi skattar sin livskvalitet och kroppsuppfattning, samt om samband kan ses mellan dessa. Syftet var även att beskriva om det finns skillnader i livskvalitet och kroppsuppfattning mellan kvinnor som genomgått mastektomi med eller utan bröstrekonstruktion. Metod: En kvantitativ tvärsnittsstudie använts. Enkäter skickades till samtliga (975) kvinnor som inom en treårsperiod genomgått mastektomi i Uppsala, Gävle eller Falun. Livskvalitet och kroppsuppfattning mättes med de standardiserade frågeformulären Life Satisfaction Questionnaire och Body Image Scale. Enkätdatan sammanställdes i statistikprogrammet SPSS och analyserades med deskriptiv statistik, Spearmans rangkorrelation och Mann-Witney U-test. Resultat: Medianvärdet för kvinnornas livskvalitet var 76,5 på en skala 0 till 100, högre värde representerar mer positiv livskvalitet. Medianvärdet för kroppsuppfattning var 7 på en skala 0 till 30, lägre värde representerar mer positiv kroppsuppfattning. Ett moderat samband påvisades mellan skattningen av livskvalitet och kroppsuppfattning. Ju högre livskvalitet desto bättre kroppsuppfattning. Ingen signifikant skillnad kunde påvisas i livskvalitet eller kroppsuppfattning mellan kvinnor som genomgått och inte genomgått rekonstruktion.   Slutsats: Livkvalitet och kroppsuppfattning skattades högt och det fanns ett samband mellan bättre livskvalitet och mer positiv kroppsuppfattning. Rekonstruktion kunde inte visas spela någon avgörande roll i hur kvinnorna skattade sin livskvalitet och kroppsuppfattning. Mer forskning behövs för att identifiera eventuella andra faktorer som kan påverka detta. / Background: The most common treatment for breast cancer is surgery, sometimes the entire breast is removed (mastectomy) and sometimes reconstruction is done. Mastectomy can have negative impact on women´s quality of life and body image.   Objective: The aim was to explore how women that underwent mastectomy rate their quality of life and body image, and if a correlation exists between these. The aim was also to explore if differences exists in quality of life and body image, between women who underwent reconstruction after their mastectomy or not.   Methods: A quantitative cross-sectional study was used, surveys were sent out to 975 women in Uppsala, Gävle and Falun. The Life Satisfaction Questionnaire and Body Image Scale were used to measure quality of life and body image. Data were analyzed with descriptive statistics, Spearman’s rank correlation and Mann-Whitney U-test.   Results: Median value for women’s quality of life was 76.5 on a 0-100 scale, the higher value the higher quality of life. Median value for women’s body image was 7 on a 0-30 scale, the lower value showed more positive body image. A moderate correlation was found between quality of life and body image. No significant differences existed in quality of life and body image between women that underwent reconstruction or not.   Conclusions: Quality of life and body image were rated high and a correlation between better quality of life and body image was demonstrated. Reconstruction did not seem to have a crucial role in how the women rated their quality of life and body image, more studies are necessary to identify if there is other factors that affect this more.

Building on theoretical frameworks that conceptualize the body as a material and symbolic entity, this thesis examines how women use their bodies to mediate the conditions of their social and cultural environment. Canadian women who occupy social locations marked by their involvement in one of three socially and economically marginalized service occupations (hairdressing, sex trade and restaurant work) were interviewed using a body-mapping methodology. The purpose was to reveal how quotidian experiences such as feeling inadequate, incompetent, lonely, disenfranchised or dissatisfied are embodied as physical pain and illness. The research shows that women give meanings to these experiences by acting on and reflecting cultural beliefs about health, work, the body and the flexibility and potential for recreating the self. In particular, the Canadian women in the study are influenced by discursive ideas that they have the option (and indeed the personal responsibility) to `transform,' `change,' `control,' and `reshape' themselves.

Bakgrund: Bröstcancer är den främsta cancerformen hos kvinnor världen över. Kirurgi är den viktigaste behandlingen vid bröstcancer och innebär att antingen delar av bröstet eller hela bröstet avlägsnas. Till följd av kirurgin kan kvinnorna antingen välja att rekonstruera sitt bröst eller använda en protes. Många kvinnor beskriver en förändrad kroppsuppfattning efter bröstoperationerna. Syfte: Syftet med studien var att belysa kvinnors upplevelser av sin kroppsuppfattning och dess inverkan på vardagen efter bröstoperation till följd av bröstcancer. Metod: Tolv kvalitativa artiklar valdes ut, sammanställdes och analyserades enligt kvalitativ innehållsanalys. Sökningen av artiklarna genomfördes i CINAHL, PubMed och PsycINFO. Även manuell sökning genomfördes. Resultat: Att genomgå lumpektomi eller mastektomi visade sig ha en inverkan på kvinnornas identitet och feminitet. Det resulterade också i en upplevelse av asymmetri. Kvinnorna hade svårigheter att bemöta operationsområdet och sörjde sina tidigare kroppar. De copingstrategier som kvinnorna använde sig av för att hantera kroppsuppfattningen var anpassning av klädval, protesanvändning eller bröstrekonstruktion. Kroppsuppfattningen som kvinnorna erhöll efter operationen inverkade på deras sexualitet. Deras partner och andra sociala faktorer inverkade också på den kroppsuppfattning kvinnorna erhöll efter bröstoperationerna. Konklusion: Resultatet visar på att upplevelsen av kroppsuppfattningen efter bröstoperation är komplex. Det är därför viktigt att sjuksköterskan har ett personcentrerat förhållningssätt i bemötandet av den bröstopererade kvinnan. / Background: Breast cancer is the leading cancer among women worldwide. Surgery is the main treatment for breast cancer and leads to that part of the breast or the whole breast being removed. Following the surgery women can choose either to reconstruct their breast or use prosthesis. Many women describe an altered body image after the breast surgeries. Aim: The aim with the study was to illustrate women’s experience of their body image and its impact on everyday life after breast surgery due to breast cancer. Method: Twelve qualitative articles were included and were compiled and analyzed with qualitative content analysis. The article search was performed in CINAHL, PubMed and PsycINFO. Articles were also searched manually. Results: To undergo lumpectomy or mastectomy was found to have an impact on the identity and the femininity. It also resulted in an experience of asymmetry. The women had difficulties to face the surgical site and mourned their former bodies. The coping strategies that the women used to deal with their body image were to adapt their clothing choices, use prosthesis or undergo breast reconstruction. The body image the women received after the surgery had an impact on the women’s sexuality. Their partners and other social factors influenced the body image that the women received after the breast surgeries. Conclusion: The results show that the perception of body image after breast surgery is complex. That is why it is important that the nurse have an person-centered approach in the treatment of the breast operated woman.

Bakgrund: Bröstcancer är den mest förekommande cancersjukdomen bland kvinnor världen över. Den vanligaste behandlingen mot sjukdomen är kirurgi, vilken innefattar mastektomi där hela bröstvävnaden tas bort eller lumpektomi där endast en del av bröstvävnaden avlägsnas. Det kirurgiska ingreppet kan medföra negativa konsekvenser för kvinnorna ur ett fysiskt, emotionellt och socialt perspektiv. Det kan även påverka kvinnors kroppsuppfattning samt hur kvinnorna ser på sig själva.  Syfte: Att belysa kvinnors kroppsuppfattning efter kirurgisk behandling där hela eller delar av bröstet tas bort till följd av bröstcancer.  Metod: En litteraturöversikt innehållande 12 kvalitativa artiklar som belyser kvinnors kroppsuppfattning efter genomförd kirurgisk behandling. Samtliga inkluderade artiklar kvalitetsgranskades, söktes igenom efter likheter samt skillnader och sammanställdes sedan iform av subkategorier och huvudkategorier i resultatet.  Resultat: Åtta olika subkategorier framkom: känsel, attack mot kroppsuppfattningen, identitet och feminitet, attraktion, minskad kvinnlighet, yttre fasad, normer och ideal och rädsla. Dessa föll in under de tre huvudkategorierna: kvinnans kroppsuppfattning i relation till jaget, till andra och den sociala omgivningen. Slutsats: Kvinnorna upplevde en negativt förändrad kroppsuppfattning sompåverkade identiteten samt feminiteten. Utöver kirurgins inverkan på kvinnan själv påvisades även att kvinnans relationer till närstående samt den sociala omgivningen hade påverkats till följd av den upplevda förändrade kroppen. Klinisk relevans: Denna litteraturöversikt kan leda till en ökad medvetenhet och förståelse av kvinnors kroppsuppfattning efter kirurgisk behandling hos sjuksköterskor. Detta kan i sin tur leda till att kvinnorna upplever bättre stöd och omvårdnad efter genomförd kirurgi efter bröstcancer. / Background: Breast cancer is the most occurring cancer form among women worldwide. The most common treatment of breast cancer is surgical treatment, which involves mastectomy where the whole breast tissue is removed or lumpectomy where only a part of the breast tissue is removed. The surgical operation can imply negative consequences for the woman in a physical, emotional and social perspective. It can also affect women´s body image as well as how they look upon themselves. Aim: To describe women’s body image after surgical treatment following breast cancer. Method: A literature review of 12 qualitative articles that illustrate woman’s body image after completed surgical treatment. All articles where assessed regarding quality and was profoundly searched through for similarities and differences, which compiled into subcategories and main categories presented in the results. Result: Eight different subcategories were found: feeling, an attack against the body image, identity and femininity, attraction, decreased femininity, the external facade, social norms and ideals and fear. These were divided into the three main categories: the woman’s body image in relation to myself, others and the social surroundings. Conclusion: The women experienced a negative change in their body image that influenced their identity and femininity. In addition to the impact of the surgery on the woman herself, the result also showed an impact on the relationships to people those who are close to them as well as the interactions within the society. Clinical Implication: This literature review can lead to an increased awareness and understanding of women’s body image after surgical treatment amongst nurses. In turn this can further lead to women feeling better support and care after surgical treatment following breast cancer.

Syftet med denna studie var att undersöka mödrars upplevelser av hur överföring mellan mor och dotter kan se ut gällande kroppsuppfattning och utseende, samt hur överföringen kunde påverkas genom medvetna val i mödrars eget förhållningssätt till sina kroppar. Tidigare forskningsresultat visade att moderns förhållningssätt till den egna kroppen i relation till kost och motion påverkade döttrarnas ätbeteende. De teoretiska utgångspunkterna var Bowlbys teorier kring anknytning, Meads den generaliserade och signifikante andre, Bourdieus begrepp hexis samt Chodorows teorier om modersfunktionen. Fem intervjuer med mödrar, i åldern 35-45 år genomfördes. Samtliga intervjuer spelades in för att senare transkriberas. Det transkriberade materialet kodades systematiskt och tematiskt. Resultatet visade att mödrar till döttrar medvetet upplever att en överföring sker gällande tankar och känslor inför den egna kroppen. Denna medvetenhet hos modern genererade strategier för att försöka förhindra överföring av negativa känslor och tankar kring kropp och utseende till dottern. / This study aimed to explore how mothers, with daughters, experienced the transmission between the two according to opinions about their bodies and appearance. The study also explored the possibility of influencing this transmission according to how the mother decided to talk and behave with regard to their bodies and appearance. The results of previous research showed that the mother's attitude to their own bodies in relation to diet and exercise influenced their daughters' eating behaviors. The theoretical bases for the study were Bowlby’s attachment theory, Mead’s the generalized and significant other, Bourdieu’s hexis and Chodorow’s the reproduction of mothering. Five interviews were conducted with mothers of daughters, ranging in ages from 35-45. All interviews were recorded and transcribed. The transcribed material was analyzed thematically. The results showed that mothers with daughters experience a transmission of the thoughts and feelings about the body. This awareness generated strategies to prevent negative thoughts and feelings surrounding appearance and body image for daughters.