Three studies were conducted to develop and validate a theoretically derived multidimensional inventory of females' sexual self-conceptions (sexual subjectivity). Study 1 revealed five factors on the Female Sexual Subjectivity Inventory (FSSI): sexual body-esteem, three factors of conceptions and expectations of sexual desire and pleasure (self, partner, and self-efficacy), and sexual self-reflection. A shorter revised version of the FSSI was tested in Study 2. In Study 3, a confirmatory factor analysis indicated a good fit to the data. The FSSI had a sound factorial structure and high reliability. Significant associations between the five scales in the FSSI and sexual self-awareness, safe sex self-efficacy, and sexual anxiety provided evidence of validity. Some FSSI scales were also associated with self-silencing in close relationships, resistance to sexual double standards, and self-esteem. Sexual subjectivity is a complex intraindividual phenomenon that includes cognitive and emotional components, some of which can be assessed with the FSSI scales.

The female sexual subjectivity inventory: development and validation of a multidimensional inventory for late adolescents and emerging adults.

Aim. To review the literature on studies of sexuality after hysterectomy and to identify barriers to nursing assessment of this aspect of human functioning.

Methods. Articles published between 1970 and 2002 on female sexuality, hysterectomy, and nursing assessment of sexuality were located using MEDLINE, CINAHL, Psychlit and Sociofile databases. Study findings were reviewed in relation to the effect of hysterectomy on sexuality, as well as women's perspectives on hysterectomy. Barriers to nursing assessment of sexual functioning are described with suggestions for inclusion of this topic in practice.

Conclusions. There are very few nursing studies on the topic, which may reflect the lack of inclusion of sexual assessment and education in clinical practice. Reasons for this are discussed, and instruments used in sex research are described. There are a number of gaps in the knowledge base on to this topic. Future research in this area is needed to provide direction for nurses in this aspect of clinical practice.

Sexuality after hysterectomy: a review of the literature and discussion of nurses' role

Over 74,000 women in the United States are diagnosed annually with endometrial or cervical cancers and experience significant treatment-related difficulties with body image, sexuality, and sexual functioning. The aims of the research were to examine relationships among body image, sexuality, and sexual functioning, and to understand women’s views of these concepts. A novel theoretical framework encompassing these three concepts and contextual variables guided the research. A non-experimental cross-sectional pilot study was conducted with pre-menopausal women in an academic medical center who had stages I–III cervical or endometrial cancer, were 3–36 months post-treatment, and had no mental health comorbidities. Participants completed the Body Image Scale, Female Sexual Function Index, Female Sexuality Questionnaire, a demographic questionnaire, and open-ended questions; the researchers collected clinical data from the medical record. Twenty women participated, and most reported issues with body image, sexuality, and sexual functioning. Significant relationships were found between body image and sexuality (p = 0.0244) and sexuality and sexual functioning (p < 0.0003). Stages II–III disease were significantly (p = 0.0371) associated with worse body image. Women reported issues with body image, sexuality, sexual functioning, psychosocial areas, reproduction, and communication with healthcare providers and personal caregivers. This study is one of the first to simultaneously examine relationships among body image, sexuality, and sexual functioning. Despite design and sample limitations, findings demonstrate a need for longitudinal studies using larger samples to further examine relationships among these concepts and selected contextual variables, explore communication issues, and refine the theoretical framework.

Body Image, Sexuality, and Sexual Functioning in Cervical and Endometrial Cancer: Interrelationships and Women’s Experiences

Background: For breast cancer survivors, sexual problems are one of the most common and distressing sequelae of cancer and its treatment. However, sexual problems are often undiagnosed and untreated. One potentially important, but understudied, risk factor for poor sexual adjustment after breast cancer is body image concern. For example, physical changes in appearance as a result of cancer treatment may alter how women perceive themselves and their bodies which may in turn increase risk for sexual problems. Therefore, the current study was designed to evaluate whether body image predicted sexual dysfunction and sexual dissatisfaction following breast cancer. In addition, mediation analyses evaluated body image as a mediator of the relationship between number of cancer-related changes in appearance and sexual dissatisfaction and sexual dysfunction. Mediation analyses also examined body image concerns during sexual activity as a mediator of the relationship between body image concerns and sexual dissatisfaction and dysfunction. Â Â Methods: A sample of 219 U.S. breast cancer survivors was recruited via breast cancer websites, blogs, and social media websites to complete an online self-report survey about body image and sexual functioning after diagnosis and treatment for breast cancer. Â Â Results: Participants' mean age was 47.3 years with an average time since diagnosis of 4.4 years. Women were predominantly European American, married, and diagnosed with Stage I or II breast cancer. On average, women in this sample experienced 6.1 (SD = 2.2) changes in their physical appearance due to cancer treatment, such as hair loss, breast disfigurement and changes to their skin. Sexual problems were common with 69% (n = 72) of sexually active survivors (n = 104) meeting criteria for sexual dysfunction. High levels of body image concerns were also reported. In regression analyses, medical treatment variables, general distress, and body image variables predicted sexual dissatisfaction, whereas only medical treatment variables and general distress predicted sexual dysfunction. Results from mediation analyses indicated that body image mediated the relationship between having a greater number of cancer-related changes in appearance and lower levels of post-treatment sexual dissatisfaction. Two of the body image variables also significantly mediated the relationship between experiencing a greater number of changes in appearance and post-treatment sexual dysfunction. Finally, higher levels of body image concern during sexual activity mediated the relationship between body image and sexual dysfunction as well as sexual dissatisfaction.Â Â Conclusion: Overall, results suggest that body image concerns and sexual problems are prevalent and distressing for a majority of women diagnosed and treated for breast cancer. Many women also experience multiple changes in their physical appearance. In addition, body image concerns may be amplified in a sexual context due to the increased exposure of one's body during sexual…

Body image and sexual functioning in breast cancer survivors

Body Image Related to Sexual Health: Development of the Concept.

The purpose of this study was to develop and validate a measure of female sexuality, the Female Sexuality Questionnaire (FSQ). A survey design was employed for the study. The sample included 262 adult women ages 18 to 81 (M = 32). Five hundred questionnaires were distributed to a diverse female population representing multiple geographic areas in the U.S. and Canada. Participants were healthy (as per self-report), sexually active and engaged in an intimate relationship. The majority of the sample was premenopausal. Item stems for the FSQ were developed based on the literature and the domain-referenced approach for item generation. A pool of 70 items generated to represent 6 theoretical domains of female sexuality: Reproduction, Beliefs, Intimacy, Body Image, Physical Responsiveness, and Satisfaction were subjected to systematic review by a panel of experts. A 5-point self-report response scale was appended to the 54 items surviving judges' reviews (criterion validity index of 91.3 for the pool of retained items). Data screening and item analysis was performed and yielded 13 items which were removed prior to principal factor analysis (PFA) resulting in a sample of 218 subjects and 41 items. The PFA with quartrimax rotation resulted in a 5-factor solution. Four of the five were consistent with the hypothesized domains of Satisfaction, Physical Responsiveness, Beliefs, and Body Image. The fifth factor suggested an association with Intimacy, and was renamed Relationships. The hypothesized domain of Reproduction was not supported. Twelve items failed to load on any of the factors. Recommendations for alternations of the final version of the FSQ are based upon the empirical results of the item analysis and PFA.

The Female Sexuality Questionnaire: instrument development.

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The Female Sexuality Questionnaire: instrument development.