Thursday, March 22, 2007

Is bigger better? Breast surgery ups self-esteem&sexuality

Women who undergo breast enlargement often see a sizable boost in self-esteem and positive feelings about their sexuality, a University of Florida nurse researcher reports.

Although plastic surgery should not be seen as a panacea for feelings of low self-worth or sexual attractiveness, it is important for health-care practitioners to understand the psychological benefits of these procedures, says Cynthia Figueroa-Haas, a clinical assistant professor at UF’s College of Nursing who conducted the study. The findings — which revealed that for many women, going bigger is better — appear in the current issue of Plastic Surgical Nursing.

“Many individuals, including health-care providers, have preconceived negative ideas about those who elect to have plastic surgery, without fully understanding the benefits that may occur from these procedures,” said Figueroa-Haas, who conducted the study for her doctoral thesis at Barry University in Miami Shores before joining the UF faculty. “This study provides the impetus for future studies related to self-esteem, human sexuality and cosmetic surgery.”

In 2005, 2.1 million cosmetic surgical procedures were performed, according to the American Society for Aesthetic Plastic Surgery. That figure is expected to grow. Consider that the number of breast augmentation procedures alone increased a staggering 476 percent since 2000, according to the American Society of Plastic Surgeons. More than 2 million women in the United States have breast implants, and this year more than 360,000 American women will undergo breast augmentation.

Figueroa-Haas studied 84 women who were 21 to 57 years old, assessing their perceptions of self-esteem and sexuality before and after cosmetic breast augmentation. Study participants had been previously scheduled for breast augmentation and were undergoing the procedure solely for cosmetic purposes. Eligible candidates were mailed a consent form, a demographic questionnaire and pre-tests asking them to rate their self-esteem and sexuality. They were then mailed a similar post-test two to three months after the surgery.

Improvements in the women’s self-esteem and sexual satisfaction were directly correlated with having undergone breast augmentation. Figueroa-Haas used two widely accepted scientific scales to measure self-esteem and sexuality, the Rosenberg Self-Esteem Scale and the Female Sexual Function Index, which assesses domains of sexual function, such as sexual arousal, satisfaction, experience and attitudes.

The participants’ average self-esteem score increased from 20.7 to 24.9 on the 30-point Rosenberg scale, and their average female sexual function score increased from 27.2 to 31.4 on the 36-point index. Of note, after the procedure, there were substantial increases in ratings of sexual desire (a 78.6 percent increase from initial scores), arousal (81 percent increase) and satisfaction (57 percent increase). Figueroa-Haas did point out that a small number of participants showed no change in their levels of self-esteem or sexuality after surgery.

With a heightened interest in men’s sexuality issues in recent years, the research sheds light on women’s sexuality, and how plastic surgery can improve and enhance this important area of life, Figueroa-Haas said.

“So much attention is directed to men’s sexuality issues; we have all seen countless commercials on drugs and therapy devoted to improving men’s sexuality. Unfortunately, very little is discussed regarding women’s sexuality issues,” Figueroa-Haas said. “I strongly believe that my research shows that interventions such as cosmetic plastic surgery can address these sorts of issues for some women. For example, those women who may have breast changes due to nursing or from the inevitable natural aging process. These women may not feel as attractive, which could ultimately negatively impact their levels of self-esteem and sexuality.”

Figueroa-Haas warned that women should not view plastic surgery as a cure-all for any self-esteem and sexuality woes. In fact, ethical plastic surgeons should screen for this type of behavior and rule out potential patients who may have more serious psychological issues, she said.

“There may be patients who will never be satisfied with their bodies no matter how much surgery they receive or feel that their life will completely change after plastic surgery,” Figueroa-Haas said. “These are not ideal candidates for surgery and should seek further counseling to address their underlying psychological issues. But for women who seek improvements in certain physical areas, plastic surgery can be a very positive experience.”

Further research should be conducted to assess significant psychosocial issues that may arise after plastic surgery, said Figueroa-Haas, adding that her study helps call attention to the need for health-care providers to be able to predict outcomes in this specialized population.

“Since plastic surgery is increasing dramatically, my intention for researching this topic was to evaluate nurses’ attitudes toward cosmetic surgery patients and make recommendations for increasing awareness of the factors surrounding these patients,” Figueroa-Haas said. “Nurses should display compassion and understand an individual’s reason for seeking cosmetic surgery instead of dismissing or stereotyping these patients. This study shows that there are genuine psychological improvements that follow plastic surgery, and these issues must be understood and respected.”

Monday, March 19, 2007

Postnatal sexual problems

Postnatal health and sexual problems persist at 12 months, but races experience different levels

Nearly one in three women still experience painful sexual intercourse a year after their baby is born and more than half have at least one sex-related health problem, according to research in the March issue of Journal of Clinical Nursing.

482 women who had attended maternity units in Birmingham, UK, took part in a self-administered questionnaire at least a year after their most recent birth.

"87 per cent complained of at least one health problem" says Midwife Amanda Williams, who is currently on secondment to the city's Perinatal Institute.

"Asian women, who made up 15 per cent of the survey, were more likely to complain of health problems than white women, as were women who were older and had larger babies and longer labours."

Key findings include:

The three most common problems reported were sex-related health issues (55 per cent) followed by stress urinary incontinence (54 per cent) and urge urinary incontinence (37 per cent).
Painful intercourse was reported by 19 per cent of women who had had caesareans, 34 per cent who had had a normal birth and 36 per cent of women who had an instrument-assisted birth, such as forceps.

Sex-related health problems were highest among instrument-assisted births (77 per cent) and lowest among caesarean births (51 per cent), with 64 per cent of women having normal births reporting at least one problem related to sex.

Women who had an instrument-assisted delivery also took two weeks longer than woman who had had caesareans and normal births to resume sexual intercourse (ten weeks versus eight) with figures ranging from one week to 52.
Forceps deliveries were also associated with higher levels of stress, urge, and continual incontinence.

Having an epidural did not lead to an overall increase in health problems and this study does not support previous research that identified increased stress incontinence and frequent urinating as risk factors.

Asian women reported greater health problems than white women. Perineal pain was more than two times higher (62 per cent versus 28 per cent) and they experienced much higher levels of continual urinary incontinence (35 per cent versus 20 per cent).

However, Afro-Caribbean women displayed similar levels of ill health to white women.

The women surveyed were aged 16 or over and from all ethnic groups. They had had their babies at least 12 months before the survey began and all had a live baby with no congenital abnormalities at the time of the survey.

"Our research has raised a number of issues" says Amanda Williams. "For example, it has highlighted concerns about the long-term health effects resulting from forceps deliveries and the variations in ill health between white and Asian women. Both these areas could benefit from further research.

"It's also important to point out that while women who had had caesareans reported fewer problems with the health issues covered by this study, this delivery method is associated with other problems that have a negative effect on women's quality of life, like adhesions and wound infections.

"We believe that our study points to the need for health professionals to provide ongoing support for women who have given birth, focusing on issues such as perineal problems and sensitive health problems.

"This, coupled with greater public awareness of these issues, will hopefully make it easier for women to get help for both short-term and long-term health problems."

Thursday, March 8, 2007

Not as happy as you thought you’d be?

Study shows that disappointment has more impact than unexpected enjoyment

Wonder why half of all marriages end in divorce? According to a new study from the Journal of Consumer Research, we are more likely to pay attention to disappointment than to the ways in which our experiences exceed our expectations.

"Affective misforecasting" is the difference between the way we think we’ll feel and the way we actually do. Vanessa Patrick (University of Georgia), Debbie MacInnis, and C. Whan Park (both, University of Southern California) find that we only pay attention to this difference when something fails to meet our expectations – for example, when married life, which we thought would be so wonderful, starts to lose its sheen.

"This research shows that when we feel better than we anticipated we would, we take it for granted, and it does not influence how we evaluate the product or service," write the researchers. "However, when we feel worse than we thought we would, we sit up and pay attention."

The researchers present the result of two interesting studies. In the first, they told participants that they were about to see a movie and provided them with reviews of the movie. About half received positive reviews (e.g., "Hilarious!" or "Pretty Wild!"), while the others received negative reviews (e.g., "Very boring!" or "Pretty Horrible!!"). They then watched a black-and-white film clip that had been previously tested to generate a neutral response.

Participants who anticipated watching a boring, horrible movie did not pay attention to the ways in which the movie was better than expected. However, those who had read the glowing reviews paid particular attention to the differences between their anticipated and actual feelings and rated the movie much lower.