Intern
ati
o
n
a
l
Jo
urn
a
l
o
f
P
u
b
lic Hea
l
th Science (IJ
P
HS)
V
o
l.4
,
No
.2
,
Jun
e
2
015
, pp
. 13
1
~
13
9
I
S
SN
: 225
2-8
8
0
6
1
31
Jo
urn
a
l
h
o
me
pa
ge
: h
ttp
://iaesjo
u
r
na
l.com/
o
n
lin
e/ind
e
x.ph
p
/
IJPHS
Sexual
Self-Sch
ema, P
e
rcepti
ons of Breast Talk, and
Physical Self-Concept
in B
r
east
Cancer Survivor
Junem
a
n
Abr
a
h
a
m,
Mir
a
nti Ayu P
u
teri
Departement of
Psy
c
holog
y
,
Bin
a
Nusantar
a University
, Indonesia
Article Info
A
B
STRAC
T
Article histo
r
y:
Received Apr 03, 2015
Rev
i
sed
May 20
, 20
15
Accepted
May 26, 2015
The qu
ality
lif
e
of breast
can
cer
survivors has been the ps
y
c
holog
y
’
s focus o
f
attention
.
However, studi
es discussing their sexuality
h
i
ghligh
t
ed from the
social ps
ycholo
g
y
perspec
tiv
e
are still not
ver
y
m
u
ch, especi
all
y
in
Indonesia.
This stud
y
aimed
to
predic
t sexual s
e
lf-schema
of
br
east cancer
survivors based on their perceptions of
the breast ta
lk and p
h
y
sic
a
l self-
concep
t. This
s
t
ud
y
us
ed a pr
edic
tive-
correlational design an
d emplo
y
ed
ps
y
c
holog
ical scales measuring instrume
nts, m
u
l
tiple l
i
ne
ar regr
ession data
analy
s
is techn
i
q
u
e as well as p
u
rpos
ive sampling method. This study
was
conducted on 1
30 women breast cancer surviv
ors (
M
ag
e
= 39.45
y
ears old;
SD
ag
e
= 3.542 y
e
ars; all b
een mar
r
ied) in
Special
Capital Region
of Jakarta -
the capital city
of Indonesia, an
d
its surroundin
g
areas (Bogor,
Tanger
a
ng
,
and Bekasi)
.
The stud
y
results
showed
that
the perception o
f
function
a
l
breast t
a
lk
and p
h
y
sic
a
l se
lf-con
c
e
pt ar
e
able
to pr
edic
t sexua
l self-
s
chem
a in
positive dire
ct
io
ns. Other percep
tions of
breast talk (m
edica
liz
ed
, gendered
,
and sexua
liz
ed b
r
east
talk)
ar
e no
t ab
le
to pr
edic
t
it.
This stud
y
ha
s im
portan
t
im
plicat
ions in
order to im
prove the life qu
ality of the survivors, namely
b
y
managing fair d
i
scourses about
breast in th
e pu
blic and k
eepin
g the proper
ph
y
s
ic
al
s
e
lf-
c
on
cept
s
i
nce
th
e
ea
rl
y s
t
ag
e of
lif
e.
Keyword:
Breast talk
Psych
o
l
og
y of
can
cer
Physical self
Sex
Self-sc
h
em
a
Copyright ©
201
5 Institut
e
o
f
Ad
vanced
Engin
eer
ing and S
c
i
e
nce.
All rights re
se
rve
d
.
Co
rresp
ond
i
ng
Autho
r
:
Jun
e
m
a
n Ab
ra
ham
,
Depa
rt
em
ent
of Psy
c
hol
ogy
,
Bin
a
Nu
san
t
ara Un
iv
ersity,
Jl
. Kem
a
ng
gi
san
Il
i
r
I
I
I
n
o
.
4
5
,
Pal
m
erah, D
K
I
Jaka
rt
a
11
4
8
0
,
In
d
onesi
a.
Em
a
il: j
u
n
e
m
a
n
@
b
i
nu
s.ac.id
1.
INTRODUCTION
Although the
r
e
is no ca
nce
r
regist
ration in Indonesia at the
national
level, it is known that accordi
ng
to the
recent
data from
12 cancer
re
gistration centers i
n
Indo
nesia in 1994,
breast can
cer is the second m
o
s
t
comm
on cancer after cervical can
cer
[1
].
Gau
t
am
a
[
2
] o
f
D
h
ar
m
a
is
Can
cer Hospital even st
ated that
breast
can
cer is th
e
n
u
m
b
e
r on
e cau
s
e of d
eat
h
o
f
wo
m
e
n
in
In
don
esia. Psych
o
l
o
g
y
has b
e
en
, still is, an
d
will
always g
i
v
e
p
i
v
o
t
al co
n
t
ri
b
u
t
io
n
s
t
o
th
e
p
r
ev
en
tion
,
tr
eatmen
t
, an
d
con
t
rol o
f
can
cer
[3
]. “Qu
a
lity of life” is
one
o
f
t
h
e
i
m
p
o
rt
a
n
t
psy
c
hol
ogi
cal
key
w
or
ds i
n
t
h
e a
p
pl
i
e
d re
searc
h
of
h
eal
t
h
psy
c
hol
o
g
y
,
i
n
cl
udi
ng
t
o
wa
r
d
s
b
r
east can
c
er su
rv
ivo
r
. By iden
tifyin
g
prob
l
e
m
s
th
at con
s
t
r
ain
t
h
e
q
u
a
lity o
f
life, as well as th
e
p
r
ed
icto
rs
of
th
at p
r
ob
lem
,
can
cer
surv
i
v
ors wou
l
d
b
e
help
ed
t
o
liv
e
her life fu
lly and
op
tim
al
ly. Qu
ality o
f
life i
s
[4
]
(p
. 1):
“
in
d
i
vidu
a
l
s’
percep
tion
o
f
their p
o
sitio
n
i
n
life in
th
e con
t
ext o
f
th
e cultu
re and
va
l
u
e systems i
n
wh
ich
th
ey live a
n
d
in
rela
ti
o
n
to
t
h
eir goa
ls, exp
ect
a
tion
s
, stand
ard
s
, a
n
d
con
cern
s
.
I
t
is a
b
r
oad
rangi
ng c
once
p
t affected in a comp
lex way
by the pe
rson’s
physic
a
l he
alth psyc
hological state, level
of
i
nde
pe
nde
n
ce soci
al
rel
a
t
i
ons
hi
ps
, pers
on
al
bel
i
e
f
s
an
d t
h
ei
r rel
a
t
i
o
nshi
p t
o
s
a
l
i
e
n
t
f
e
at
ures of
their envir
o
nment.”
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S V
o
l
.
4, No
. 2,
J
u
ne 2
0
1
5
:
13
1 – 1
3
9
13
2
Co
n
c
ern
i
n
g
to th
e qu
ality o
f
life, Ratn
a stated
th
at th
e
can
cer
situ
ation
m
a
y d
i
stu
r
b e
m
o
tio
n
a
l
rel
a
t
i
on
bet
w
e
e
n c
o
u
p
l
e
s t
h
r
o
u
g
h
t
h
e
deci
si
on
o
f
no
l
o
ng
er
havi
ng
se
xu
al
i
n
t
e
rco
u
r
se,
wi
t
h
t
h
e
ass
u
m
p
ti
o
n
that sexual activity can lea
d
t
o
fatigue
and
make the ca
nc
er m
o
re se
vere
[
5
]
.
Si
l
e
n
ce a
n
d
ab
sence
rel
a
t
i
ng t
o
sexu
al life in
th
is con
t
ex
t are
situ
atio
n
s
reg
a
rd
ed
b
y
m
a
ny people as “
r
eas
onable”, although we als
o
rec
o
gnize
th
at th
ese th
ing
s
h
a
v
e
an
imp
act on
th
e
quality o
f
lif
e. Th
e d
e
crease i
n
sexu
al life quality can
in
d
e
ed
b
e
an
objective
phys
ical effect
of t
h
era
p
y a
n
d m
e
dications
(e
.g. because of
thei
r
im
pact
on the horm
onal sy
ste
m
),
but
al
so ca
n be
t
h
e resul
t
of
s
o
cial decisions
tak
e
n
b
y
th
e co
up
le on
th
e basis o
f
perce
p
t
i
ons
(f
or e
x
am
pl
e, t
h
e
percei
ved se
x
u
al
at
t
r
act
i
on,
and
percei
ve
d sex
u
al
cap
acity). Mean
wh
ile, in
f
act, pleasure
and sexual
sat
i
s
fact
i
on an
d or
gasm
as
wel
l
are not
i
m
possi
bl
e t
h
i
ngs t
o
ha
ppe
n
whe
n
cance
r s
u
r
v
i
v
or
s expe
r
i
ence
ch
ang
e
s in
t
h
eir sex
u
a
lity [6
].
Sexu
ality re
m
a
in
s as an
i
m
p
o
r
tan
t
d
i
m
e
n
s
io
n o
f
th
e qu
ality
o
f
life after a wo
m
a
n
h
a
s b
e
en
d
i
agno
sed
with
b
r
east cancer [7
]. Th
e
p
o
ssib
ilities o
f
sex
u
a
l life i
n
b
r
east can
cer surviv
ors
b
eco
m
e
critical to
in
v
e
st
ig
ate
because, acc
ording t
o
Ratna
,
sexual nee
d
s
that are
not
we
ll
m
a
naged by
cance
r s
u
rvi
v
ors
and their partners
will lead
to
poten
tial sex
u
a
l
d
y
sfu
n
c
tion
n
o
t o
n
l
y in
can
c
er p
a
tien
t
s
bu
t also
on
th
eir p
a
rtn
e
rs, as
well as th
e
p
o
t
en
tial o
f
infid
e
lity [5
]. Th
is is th
e m
a
in
urg
e
n
c
y
of th
e n
e
ed
for th
is study.
In t
h
ei
r
revi
e
w
of
n
u
m
b
ers e
m
pi
ri
cal
research fi
ndi
ng
s pe
r
t
ai
ni
ng t
o
t
h
e s
e
xual
psy
c
h
o
l
o
gy
o
f
b
r
east
can
cer surv
ivors,
Em
i
l
ee, Ussh
er, an
d
Perz fo
und
th
at t
h
eir sexu
ality can
b
e
su
mm
ariz
ed
as a resu
lt
o
f
th
e
d
y
n
a
m
i
c
in
teractio
n
b
e
tween
th
e
m
a
terial as
p
ect (th
e
po
ssi
b
ility o
f
sex
u
a
l
d
y
sfun
ction
)
,
in
trap
sych
ic asp
ects
(em
o
tional and body im
age changes
due to physical
changes
)
, a
nd s
o
ci
o-c
u
ltural as
pects
(sexual
rene
g
o
t
i
a
t
i
on wi
t
h
part
ners
, and
di
sc
ur
si
ve con
s
t
r
uct
i
o
n o
f
b
r
east
s
) [
8
]
.
Thi
s
prese
n
t
st
udy
foc
u
se
d
o
n
t
h
e
soci
al
ps
y
c
hol
o
g
i
cal
as
pect
s o
f
t
h
e
se
xual
l
i
f
e
of
w
o
m
e
n breast
can
cer su
rv
i
v
ors.
W
ilm
o
t
h
fo
und
th
rou
g
h
h
i
s qu
alitativ
e
e
m
p
i
rical research
that altered
sexu
al-self is an
in
teg
r
al asp
ect
of th
e ch
ang
e
in
t
h
e i
d
en
tity of a breas
t can
cer su
rv
ivo
r
[7
].
Un
lik
e th
e
ex
p
e
rien
ce of
p
e
ri-
m
e
nopa
use
,
this alteration is com
p
rehende
d
m
o
re infl
ue
ntial by the wom
e
n because
it starts earlier, runs
faster an
d
is life-threaten
i
n
g
as well. Giv
i
ng
m
ean
in
g
to
t
h
e n
e
w sex
u
a
l
id
en
tity o
b
t
ai
n
e
d
after
u
n
d
e
rgo
i
ng
d
i
agn
o
sis and
th
erap
y is p
a
rt
o
f
th
e self-g
ro
wt
h
of th
e su
rv
ivo
r
s. Still in
relatio
n
to
t
h
e self d
i
m
e
n
s
io
n
s
,
Markopoulos
et al. found t
h
at the ty
pes o
f
sur
g
e
r
y
(
b
rea
s
t
-
co
nser
vi
n
g
vs.
m
a
stecto
m
y with
d
e
layed
breast
reco
nst
r
uct
i
o
n
vs.
m
odified
radical m
a
stec
tomy) are va
riables
t
h
at
m
oderat
e
t
h
e
psy
c
hol
ogi
cal
i
m
pact
o
f
breast ca
ncer
diagnosis on s
e
lf-esteem
[9]. Based on th
es
e
tw
o
s
t
u
d
i
e
s
[
8
],
[9
],
th
e
au
tho
r
ar
gu
ed
th
a
t
s
e
lf
d
i
m
e
n
s
io
n
s
are th
e m
o
st funda
m
e
n
t
al en
tity an
d th
at m
o
st w
i
d
e
ly affected
b
y
a can
cer
d
i
agn
o
sis b
ecau
s
e the
self is “the
subject
of e
xpe
rience”
[1
0] (p . 24). Howeve
r, diffe
r
ent
from
the existing pre
v
i
ous
studies, thi
s
stu
d
y
sp
ecifically p
a
id
atten
tio
n
t
o
sexu
al se
lf-sc
h
em
a of the survivors. Se
lf-sc
h
em
a is a
m
e
ntal structure that
p
e
op
le
u
s
e t
o
o
r
g
a
n
i
ze kno
wled
g
e
abo
u
t
t
h
e
m
selv
es [1
1
]
. Sexu
al self-sch
em
a is “co
gnitiv
e g
e
n
e
ralizatio
n
s
abo
u
t
t
h
e se
xu
al
aspect
s
of
o
n
esel
f
...
a
n
d
t
h
ey
g
u
i
d
e
se
xu
al
beha
vi
or”
[
1
2]
(
p
.
1
0
7
9
)
.
It
i
s
i
m
port
a
nt
t
o
kn
o
w
the se
xual sel
f-sc
h
em
a because this
sche
me is a centr
al ele
m
ent of sexual life
that can
pre
d
ict sexua
l
satisfactio
n
o
r
also
sexu
al prob
lem
s
/d
ifficu
lties, an
d
fu
rth
e
r it h
a
s a relatio
n
a
l i
m
p
act o
n
sexu
al p
a
rt
n
e
r
[13
]
.
To
t
h
e sam
e
stressor attack
ing
a
p
e
rson’s sex
u
a
lity su
ch
as breast can
cer,
o
n
e
can
p
e
rform
a v
a
riety o
f
sexu
al
responses (active
vs
. p
a
ssiv
e
) d
e
p
e
nd
s on
h
e
r
sexu
al
self-sch
em
a
(p
o
s
itiv
e
vs
. ne
gat
i
v
e).
As m
e
n
tio
n
e
d
b
y
Em
i
l
ee et al
., th
e so
cial aspect p
l
ay
s a ro
le in
th
e sexu
ality o
f
b
r
east cancer p
a
tien
t
s
[8].
One
of the social as
pect
s raise
d
in th
is research is the d
i
sco
u
rse
a
b
out
w
o
m
a
n’s b
r
east
,
whi
c
h i
s
ab
out
issu
es d
i
scu
ssed
b
y
th
e pub
lic ab
ou
t th
e brea
st, or “breast talk”. Thes
e thin
gs are the s
o
cial constructions that
indicate the cre
a
tion of m
eaning
by
the publi
c
, whic
h accommodate the soci
o-historical-cultural context [14].
Th
e n
a
rrati
o
n
in
th
e so
cial-co
m
m
u
n
ity
lev
e
l g
r
eatly a
ffects th
e in
d
i
v
i
du
al’s life; it is
n
o
ex
cep
tion
for th
e
cancer s
u
rvi
v
o
r
. Gi
dd
ens
[1
5]
sug
g
est
e
d t
h
at
an u
n
d
erst
a
ndi
ng
of t
h
e a
g
ent
i
c dim
e
nsi
on
o
f
a pe
rso
n
s
h
ou
l
d
be
i
n
t
e
grat
e
d
wi
t
h
t
h
e co
nsi
d
e
r
at
i
on
of
her s
o
ci
al
act
i
on. H
u
m
a
ns i
n
dee
d
ha
v
e
a refl
exi
v
e a
c
t
i
on t
h
at
af
fec
t
s t
h
e
co
mm
u
n
ity, b
u
t
sh
e is also
the reprodu
ctio
n
o
f
h
e
r so
cial
life [15
]
. In
relatio
n
t
o
breast can
cer, Lang
ellier and
Su
lliv
an d
e
fin
e
d
breast talk
as o
n
e
’s “r
eferences to
breasts an
d
t
h
e sp
ecificity
o
f
th
e
b
r
east as th
e site o
f
th
ei
r
cancer
, inclu
d
ing
phy
sical
m
a
nifestatio
ns ..
.., as well
as statem
ents about fem
i
ninity, bo
dy
im
age, an
d
sexuality ....
[c
onsisting
of] breast as m
e
dicalized body pa
rts; breasts as
functional to
breastfee
ding a
n
d the
bo
dy
’s
m
o
t
i
l
ity
;
breast
s
a
s
ge
nde
re
d t
o
si
g
n
al
w
o
m
e
n’s
fem
i
ni
ni
t
y
an
d
b
ody
i
m
age;
an
d
br
east
s
a
s
sexu
alized
”
[16
]
(p
. 78
, 79). Thu
s
, th
e so
ciety in
th
e
contex
t of Lang
ellier and
Su
llivan
’s research
i
s
th
e
b
r
east can
cer
su
rv
ivor co
mm
u
n
ities. Th
omas-MacLean
rev
ealed
th
e
sig
n
i
fican
ce of k
nowledg
e ab
ou
t th
e
p
h
e
no
m
e
n
o
l
o
g
ical d
i
m
e
n
s
io
n o
f
th
e stru
cture and
con
t
en
t
o
f
illn
ess stories o
f
breast can
cer su
rv
ivors th
at
were inv
e
stig
ated
in
a stud
y [17
]
. Th
is
k
i
nd
of inv
e
stig
at
io
n
m
a
y facili
t
a
te can
cer
su
rv
ivo
r
s t
o
und
er
stand
them
selves and thei
r diseas
es, and it ca
n ease t
h
e c
o
m
m
uni
cat
i
on an
d rel
a
t
i
o
ns
hi
ps
wi
t
h
hea
l
t
h
car
e
p
r
actitio
n
e
rs.
B
a
sed o
n
t
h
e
abo
v
e
descri
pt
i
on, t
h
i
s
st
udy
hy
pot
hesi
zed
(H
1,
H2
, H
3
,
H4
) t
h
at
t
h
e p
e
rcept
i
o
ns
o
f
med
i
calized
b
r
east talk
, fu
n
c
t
i
o
n
a
l breast tal
k
, g
e
nd
ered
breast talk
, an
d
sex
u
a
lized
b
r
east talk
co
n
s
ecutiv
ely
are ab
le to
pred
ict sexu
al self-sch
em
a from
the
breast ca
nce
r
s
u
rvivor.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Sexu
al
Sel
f
-
Sc
hem
a
,
Perce
p
t
i
ons
of
Bre
a
st
T
a
l
k
,
an
d
Physi
c
al
Sel
f
-
C
o
n
cep
t
i
n
.
...
(
J
u
n
em
an
A
b
ra
h
a
m)
)
13
3
In
add
itio
n
to
b
r
east talk
, ano
t
h
e
r v
a
riab
le t
h
at is sup
p
o
s
ed
to
p
r
ed
ict sex
u
a
l self-sch
ema is p
h
y
sical
sel
f-c
once
p
t
.
B
r
east
cancer
sur
v
i
v
ors
wh
o u
nde
rgo tre
a
tm
ent for the
i
r cancer can
expe
rience
pe
rsistent
effects
, t
h
at
i
s
t
h
e effect
s
of
t
r
eatm
e
nt
(radi
at
i
on a
nd/
or
ho
rm
one t
h
er
api
e
s an
d/
o
r
c
h
em
ot
herapy
a
nd/
o
r
t
a
rget
ed
t
h
era
p
i
e
s and/
or
su
rg
ery
)
i
n
t
h
e c
h
r
o
ni
cal
pat
i
e
nt
’s
bo
dy
, ei
t
h
e
r
w
h
i
c
h
has
bee
n
e
xpe
ri
ence
d si
n
ce t
h
e
im
pl
em
ent
a
t
i
o
n o
f
t
h
e t
r
eat
m
e
nt
o
r
ha
s bee
n
j
u
st
e
xpe
ri
en
ced i
n
se
ve
ral
m
ont
hs or
y
ears aft
e
r
t
h
e t
r
e
a
tm
ent
had
been c
o
m
p
l
e
t
e
d [1
8]
,[
19]
.
Persi
s
t
e
nt
effe
ct
s can affect
t
h
e per
s
o
n
’
s
sel
f-c
once
p
t
,
es
pe
ci
al
l
y
phy
si
cal
sel
f
-
conce
p
t. Pa
rk, Zlateva, and Bank [20] stated that
canc
e
r can c
h
ange
self-conce
pt. Self-c
once
p
t
has a
h
i
erarch
ical stru
cture th
at represen
ts th
e com
b
in
ativ
e
effects o
f
o
n
e’s p
e
rcep
tion
s
of h
e
r ab
ility, stren
g
th
, and
ap
p
e
ar
an
ce [21
]
. Th
e stud
y
o
f
B
r
ag
ado
et
al. f
oun
d th
at
in
ch
ildr
e
n
,
che
m
o
t
h
e
r
a
p
y
wo
r
s
en
s t
h
eir
physical
sel
f-c
once
p
t
[
2
2]
. Es
naol
a,
I
n
fant
e,
an
d Z
u
l
e
i
k
a f
o
u
n
d
t
h
at
phy
si
cal
sel
f
-c
once
p
t
i
s
m
a
de u
p
o
f
c
o
m
pon
ent
s
o
f
ability (e.g., “I can run and e
x
ercise for a l
o
ng tim
e
w
ithout getting tire
d
”), strength
(e.g., “I am
str
o
ng”
)
,
attractiv
en
ess
(e.g
., “I
feel secu
re
abou
t my p
h
y
sical
appearan
ce”), and con
d
ition
(e
.g.,
“In
g
e
n
e
ral, I
feel
phy
si
cal
l
y
wel
l
”
). It
i
s
est
i
m
a
t
e
d t
h
at
t
h
e p
e
rsi
s
t
e
nt
ef
fect
causes a d
ecr
ease i
n
t
h
ese c
o
m
pone
nt
s [
2
3
]
. Thi
s
decrease
can
make sexual s
e
lf-sc
h
em
a of
the breast ca
n
cer s
u
r
v
i
v
or
b
ecom
e
s
m
o
re negat
i
v
e
.
B
a
se
d
on
t
h
e
d
e
scri
p
tio
ns, th
is stu
d
y
h
y
p
o
th
esized
(H5) th
at p
h
y
sical self-con
cep
t
is ab
le to
p
r
ed
ict sex
u
a
l self-sch
ema of
the breast ca
nc
er s
u
rvivor.
B
y
i
n
t
e
grat
i
n
g
al
l
of t
h
e pr
e
v
i
o
us hy
pot
hes
e
s, fr
om
t
h
e fi
rst
(H
1) t
o
t
h
e
fi
ft
h (
H
5), t
h
e
n
t
h
e aut
h
o
r
h
ypo
th
esized
,
“Th
e
re is a th
eo
retical
m
o
d
e
l th
at can
b
e
use
d
to explain a variety of a breast cancer’s s
e
xual
self-sc
h
em
a.” (H6).
2.
R
E
SEARC
H M
ETHOD
2.
1.
Pa
rticipa
n
ts and Desig
n
Particip
an
ts
of
th
is stud
y were 13
0
fem
a
le b
r
east
cancer survivors
(m
ean of ag
e
= 39
.4
5
y
ears of ol
d;
st
anda
rd
devi
a
t
i
on of a
g
e = 3.
54
2 y
ears) r
ecrui
t
e
d wi
t
h
pu
r
posi
v
e sam
p
l
i
ng t
ech
ni
q
u
e
. Part
i
c
i
p
ant
s
of t
h
e
measu
r
em
en
t in
stru
m
e
n
t
trial were 70
surv
i
v
o
r
s ou
tsid
e of t
h
e
field
research
p
a
rticip
an
ts.
Th
is research
d
e
sign
is q
u
antitativ
e, p
r
ed
ictiv
e-co
rrelation
a
l d
e
sign
,
with
d
a
ta an
alysis tech
n
i
qu
es
in
vo
lv
ing
a m
u
ltip
le lin
ear reg
r
ession
an
al
ysis. Th
e
p
r
ed
icto
r
v
a
riab
les o
f
t
h
is research
are t
h
e p
e
rcep
tio
ns
to
ward
breast talk
(m
ed
icaliz
ed
b
r
east talk,
fun
c
tion
a
l br
ea
st talk, ge
ndered
breast ta
lk,
and sexualized brea
st
talk
) an
d ph
ysical self-co
n
c
ept. Th
e criterion v
a
riab
le
is se
xual self-schem
a of
the
breast
cancer survivor.
2.
2.
Instruments and
Pr
ocedure
Part
i
c
i
p
ant
s
w
e
re
gi
ve
n a
q
u
e
s
t
i
o
n
n
ai
re c
o
ns
i
s
t
i
ng
of
a
num
ber
o
f
t
h
e scal
e
s
m
easuri
n
g
p
r
edi
c
t
o
r
an
d
criterio
n
v
a
riab
les in
Ind
o
n
e
sian
. Criteria of scale reliab
ility an
d
ite
m
v
a
lid
ities o
f
th
e
measu
r
ing
in
st
ru
m
e
n
t
are an internal
consistency index (Cronba
ch’s
Alpha) t
h
at
i
s
great
e
r
t
h
a
n
or
eq
ual
to 0.6, a
n
d the
corrected
ite
m
-
to
tal co
rrelatio
n
s
th
at are
greater t
h
an
or equal to 0.25.
M
easurem
ent
i
n
st
r
u
m
e
nt
of sexual
sel
f
-sc
h
e
m
a wa
s adapte
d from
Sexual
Self-sc
h
em
a
Scale [12].
Th
e title of th
e scale is “
De
sc
ribe Y
o
urself
”.
Th
e i
n
stru
ctio
n in
th
is scale is
as fo
llo
ws [12
]
(p
.
11
00
):
“
Belo
w is a
listin
g
o
f
ad
jectives. Fo
r ea
ch
wo
rd, con
s
i
d
er wh
eth
e
r
o
r
no
t th
e term d
e
scrib
e
s yo
u.
Eac
h
a
d
j
ect
i
ve i
s
t
o
be rat
e
d
on
a sc
al
e ra
ngi
ng f
r
om
0
= n
o
t
at
al
l
de
scri
pt
i
ve of
me
t
o
6 = very
muc
h
descri
pt
i
ve of
me
. C
h
oo
se a
nu
m
b
er of
each
ad
jective to
in
d
i
ca
te how a
ccu
ra
tely th
e ad
jective
descri
be
s yo
u.
There
are
n
o
r
i
ght
or w
r
on
g
answ
e
r
s
. Pl
e
a
s
e
be t
h
o
u
ght
f
u
l
a
nd
h
one
st
. Q
u
est
i
o
n: t
o
wh
a
t
exten
t does th
e term
_
___
_ d
e
scrib
e
m
e
?
”
Th
is scale con
s
ists of three fact
ors,
wh
ich
o
r
ig
i
n
ally co
n
s
isted
o
f
26 ite
m
s
. Th
e fi
rst factor is
Passionate-romantic. The second
factor is Ope
n
. T
h
e third factor is
Em
bar
r
asse
d-c
o
ns
ervat
i
v
e
.
Sexu
al
sel
f
-
sch
e
m
a
is calcu
lated
b
y
p
e
rform
i
n
g
th
e calcu
latio
n as
fo
ll
ows:
F
a
ct
or
1 +
Fact
or 2
-
Fa
ct
or 3
. Sam
p
le ite
m
s
of Fact
or 1 a
r
e (1
) l
ovi
ng
, (
2
)
st
im
ul
at
i
ng, (3
) aro
u
sa
bl
e, (
4
)
rom
a
ntic, (5)
passio
n
ate, (
6
)
warm
, (7) re
ve
aling
.
Sam
p
l
e
i
t
e
m
s
of
Fact
o
r
2 are
(1
)
u
n
i
n
hi
bi
t
e
d,
(2
)
o
p
en
-m
inde
d,
(
3
)
f
r
an
k
,
(
4
)
ex
peri
e
n
c
e
d,
(5
)
br
oa
d-
m
i
nded
,
(6
) st
rai
g
ht
f
o
r
w
ar
d, a
n
d (
7
)
out
s
p
oke
n.
Sa
m
p
l
e
i
t
e
m
s
of Fact
or
3 are
(
1
) caut
i
o
us,
(
2
)
t
i
m
i
d, (
3
)
pr
u
d
e
nt
, (
4
)
conservative, a
n
d
(5) ine
xpe
ri
enced.
Valid
ity an
d
reliab
ility
test
o
f
t
h
e in
stru
men
t
g
a
v
e
th
e
fo
llo
wi
n
g
resu
lts: On
Fact
o
r
1, Cronb
ach’s
Alph
a = 0
.
75
1, co
rrected
ite
m-to
tal co
rr
el
at
i
ons
ran
g
e
d
fr
o
m
0.32
0 t
o
0.
7
0
9
,
wi
t
h
4 i
t
e
m
s
abo
r
t
e
d.
O
n
Fact
or
2, C
r
on
bac
h
’s
Al
p
h
a = 0.
79
5,
correct
e
d
i
t
e
m
-
t
o
t
a
l
cor
r
el
at
i
ons
0.
28
3 u
p
t
o
0.
6
5
7
,
wi
t
h
o
u
t
any
i
t
e
m
s
t
h
at
need
t
o
be ab
o
r
t
e
d.
On Fact
or
3, C
r
o
n
b
ach
’s Al
p
h
a = 0.
6
0
8
,
co
r
r
ect
ed i
t
e
m
-
t
o
tal
correl
a
t
i
o
ns
ran
g
e
d
fr
om
0.28
0 t
o
0.
49
2,
wi
t
h
3
i
t
e
m
s
abo
r
t
e
d.
T
hus
, t
h
e
num
bers
of
val
i
d
i
t
e
m
s
are
1
9
i
t
e
m
s
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
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06
IJP
H
S V
o
l
.
4, No
. 2,
J
u
ne 2
0
1
5
:
13
1 – 1
3
9
13
4
Measu
r
em
en
t in
stru
m
e
n
t
o
f
percep
tion
s
o
f
breast
talk
was
ad
ap
ted
fro
m
t
h
e resu
lts of Lan
g
e
llier and
Su
lliv
an’s qu
al
itativ
e research [1
6
]
. Th
e th
emes o
f
b
r
east talk
g
e
n
e
rated
fro
m
a d
e
p
t
h
n
a
rration
were d
e
riv
e
d
in
to
statem
en
t
ite
m
s
, with
th
e respon
se scale fro
m
St
rongl
y
Di
sa
gree
(s
co
re o
f
1
)
to
St
ro
ngl
y A
g
ree
(sco
r
e
o
f
6). Exam
ples
of Medicalized Breast Talk perception ite
m
s
are “
W
om
en’s breast
s
are s
p
e
c
i
f
i
c
bo
dy
or
ga
ns i
n
whic
h the e
x
istence ca
n be m
odi
fied
by operation, etc.”
,
“Th
e
cu
lt
u
r
al m
e
an
ing
of th
e
breast is less i
m
p
o
r
tan
t
th
an
t
h
e m
ean
in
g
o
f
t
h
e health
.” Sam
p
le it
e
m
s o
f
Gende
r
ed B
r
east Tal
k
pe
rce
p
tion
a
r
e “The im
age
of a
wom
a
n de
pen
d
s o
n
he
r b
r
ea
st
s”, “
W
i
t
h
out
breast
,
t
h
e
r
e i
s
no i
n
t
i
m
acy
and l
ove i
n
a
wom
a
n”, “The
breas
t
vi
sual
a
ppea
r
a
n
ce ca
n n
o
t
be
repl
ace
d
by
ot
her t
h
i
n
gs s
u
c
h
as a
pr
ost
h
es
i
s
(an a
r
t
i
f
i
c
i
a
l
breast
)
”, “T
he
breast
m
a
kes a
wom
a
n
feel
s t
o
be
want
e
d
.”
Sam
p
l
e
i
t
e
m
s
of S
e
xual
i
z
e
d
B
r
ea
st
Tal
k
perce
p
t
i
on a
r
e “T
he
breast
sho
w
s a
w
o
m
a
n’s
sex
u
al
desi
re”, “
I
can
reac
h
or
gasm
onl
y
t
h
r
o
u
g
h
t
h
e se
nsat
i
o
n i
n
m
y
breast
s
”
,
“T
he
brea
s
t
di
m
e
nsi
on i
s
n
o
t
o
n
l
y
p
h
y
s
i
cal
, b
u
t
al
so ae
st
het
i
c
, m
e
nt
al, an
d em
ot
i
ona
l
.
” Exam
pl
es of
Fu
nct
i
o
nal
B
r
east
Talk pe
rception ite
m
s
are “Breast accomm
o
d
ates powe
r
to
support
daily activities”, “Breast
m
a
kes women be
active and inc
r
ease their fre
e
dom
of m
o
ve
m
e
nt”, an
d “
B
reast
has t
h
e
fu
nct
i
o
n a
nd
m
eani
ng t
h
at
m
a
kes
wom
e
n p
r
ou
d.
”
Valid
ity an
d
reliab
ility
test o
f
th
e in
stru
m
e
n
t
g
a
v
e
t
h
e fo
llowing
resu
lts: On
Med
i
calized
Breast Talk
perce
p
t
i
o
n, C
r
on
bac
h
’s
Al
ph
a = 0
.
6
4
7
, c
o
r
r
ect
ed i
t
e
m
-
t
o
t
a
l
cor
r
el
at
i
ons
ra
nge
d
fr
om
0.
29
7 t
o
0.
52
3
.
T
h
e
num
ber
of
t
h
e
val
i
d
i
t
e
m
s
i
s
4
of t
h
e
10
i
t
e
m
s
prop
ose
d
.
On
Ge
n
d
ere
d
B
r
east
Tal
k
pe
rcept
i
o
n,
C
r
on
bac
h
’
s
Al
p
h
a = 0.
77
9,
correct
e
d
i
t
e
m
-
t
o
t
a
l
cor
r
el
at
i
ons
ran
g
e
d
fr
o
m
0.29
0 t
o
0.
6
2
4
.
The
num
ber of t
h
e
val
i
d
i
t
e
m
s
i
s
7
of
9
i
t
e
m
s
prop
ose
d
.
O
n
Se
xual
i
zed
B
r
eas
t
Tal
k
perce
p
t
i
o
n
,
C
r
o
nbac
h
’s
Al
p
h
a
=
0.
69
2
,
co
rre
ct
ed i
t
e
m
-
t
o
t
a
l
cor
r
el
at
i
ons
ra
nge
d fr
om
0.4
7
2
t
o
0.
6
1
7
.
The n
u
m
b
er
o
f
t
h
e val
i
d
i
t
e
m
s
i
s
3 of 7 i
t
e
m
s
pro
p
o
s
e
d
. O
n
Fu
nct
i
onal
B
r
e
a
st
Tal
k
perce
p
t
i
o
n
,
C
r
on
bac
h
’s
Al
p
h
a
= 0.6
,
co
rrected
ite
m
-
to
tal co
rrel
a
tio
n
s
rang
ed
fro
m
0
.
2
7
7
t
o
0.459. Th
e nu
m
b
er
o
f
v
a
lid
item
s
is 1
9
ite
m
s
. Th
e
n
u
m
b
e
r
is a v
a
lid
po
in
t 4
o
f
8
item
s
p
r
op
o
s
ed.
Th
us, t
h
e
num
bers
o
f
val
i
d
i
t
em
s of
Perce
p
t
i
ons
o
f
B
r
ea
st
Tal
k
are
1
8
i
t
e
m
s
.
M
easurem
ent
i
n
st
rum
e
nt
of phy
si
cal
sel
f-c
once
p
t
was a
d
apt
e
d fr
om
the Phy
s
i
cal
Sel
f-at
t
r
i
b
ut
e
Quest
i
on
nai
r
e
[2
4]
. T
h
e a
u
t
h
or
use
d
t
h
e
fi
rs
t
part
of
t
h
e
questio
nn
aire. In
stru
ction
s
for t
h
is to
o
l
are as fo
llo
ws
[2
4]
(
p
.
6
4
1
):
“This questionnaire has
to do
w
ith
your attitudes about
s
o
me of
y
our
activities and
abilities. For
t
h
e f
i
rst
ni
ne i
t
ems
bel
o
w
,
y
o
u s
h
o
u
l
d
rat
e
y
our
sel
f
rel
a
t
i
ve t
o
ot
her
peo
p
l
e
yo
ur a
g
e
a
n
d
gen
d
er
by
usi
n
g t
h
e f
o
l
l
ow
i
n
g sc
al
e:
Bot
t
o
m
5%
(s
core
o
f
1
─
aut
h
or’s
note: the scoring syst
e
m
was
not
men
tio
n
e
d to
p
a
rticip
an
ts in th
is in
stru
ction
)
, L
o
wer
10%
(score
o
f
2
)
, L
o
wer
20%
(sc
o
re o
f
3
)
,
Low
e
r 30%
(sc
o
re of
4
)
, L
o
w
e
r 50%
(sco
re of 5)
, U
p
per
50%
(sco
re of 6
)
, Up
per 30%
(sco
re of 7)
,
Up
per
2
0
%
(sc
o
re
o
f
8)
, Up
per
10
%
(sc
o
re
of
9
)
, To
p 5
%
(sco
re o
f
10
)
.
A
n
e
x
am
p
l
e o
f
th
e
wa
y the
sca
l
e wo
rks is a
s
fo
llo
ws: if on
e o
f
t
h
e tra
its th
a
t
fo
llo
ws w
a
s ‘h
eigh
t’, a
wo
ma
n who
is ju
st b
e
lo
w
aver
age i
n
hei
ght
w
oul
d c
h
o
o
se
‘l
ow
er
5
0
%
’ w
h
ereas
a
w
o
m
a
n w
h
o i
s
t
a
l
l
e
r t
h
an
8
0
%
(
but
no
t
t
a
l
l
e
r t
h
a
n
9
0
%
)
of
her f
e
m
a
l
e
cou
n
t
e
r
part
s
w
o
ul
d c
h
oose
‘u
p
p
er
20%
’.
”
Sam
p
le ite
ms are (1) Relative to
o
t
h
e
rs y
o
ur ag
e an
d g
e
nder
,
r
a
te you
r ph
ysical str
e
ng
t
h
,
w
ith
t
h
ose
i
n
t
h
e “t
op
5
%” bei
n
g t
h
e
st
ro
ngest
;
(
2
) R
e
l
a
t
i
v
e t
o
ot
her
s
y
o
u
r
age an
d ge
n
d
e
r, rat
e
y
o
u
r
phy
si
cal
endurance
, wit
h
those i
n
the
“top
5%”
being those
with
t
h
e m
o
st
endu
ra
nce;
(
3
)
R
e
l
a
t
i
v
e t
o
ot
hers y
o
ur a
g
e
an
d
g
e
nd
er, rate yo
u
r
ph
ysical attractiv
en
ess, with
tho
s
e in
th
e “to
p
5%” b
e
ing
th
e m
o
st a
ttractiv
e; (4)
Relativ
e to
o
t
her
s
you
r ag
e an
d g
e
nd
er
, r
a
t
e
yo
ur
sp
or
t c
o
m
p
etence, wi
th those in the
“top 5%”
bei
n
g the
m
o
st co
m
p
eten
t in
sp
orts; an
d (5
) Relativ
e to
o
t
h
e
rs y
o
ur ag
e and
g
e
nd
er, rate y
o
ur
ph
ysical flex
ib
ility, wi
t
h
those
in t
h
e “top
5%”
being t
h
e m
o
st flexible
.
Valid
ity an
d reliab
ility tes
t
o
f
th
e instru
m
e
n
t
g
a
v
e
th
e fo
llowing
resu
lts: C
r
onb
ach’s
Alph
a =
0
.
85
2,
cor
r
ect
ed i
t
e
m
-
t
o
t
a
l
cor
r
el
at
i
o
ns
0.
60
1
u
p
t
o
0.
71
8.
T
h
e
nu
m
b
ers of
val
i
d
i
t
e
m
s
are 5 i
t
e
m
s
.
Th
is stud
y
was carried
o
u
t
b
y
th
e au
tho
r’s in
itiativ
e and
o
n
t
h
e ag
ree
m
en
t o
f
t
h
e
Psych
o
l
og
y
Dep
a
rtm
e
n
t
Head
,
Facu
lty
o
f
Hu
m
a
n
ities,
Bin
a
Nu
san
t
ara Un
i
v
ersity,
i
n
t
h
e form
o
f
a le
tter o
f
assig
n
m
en
t to
d
o
research
, as well as th
e k
n
o
wledg
e
of th
e Research
Co
ord
i
n
a
tor of th
e Dep
a
rtm
e
n
t
.
W
h
en
fillin
g
in
th
e
q
u
e
stio
nn
aire, th
e p
a
rticip
an
ts were provid
e
d
with
in
form
ed consent, and t
h
ey were inform
ed of the
co
nsequ
e
n
ces
(su
c
h
as fatigu
e
) at th
e time of fillin
g,
an
d th
at th
ey
are en
titled
to resign
at an
y
ti
m
e
th
ro
ugh
ou
t th
e
p
h
a
ses
o
f
th
e st
u
d
y
.
3.
R
E
SU
LTS AN
D ANA
LY
SIS
Descri
p
tio
n o
f
th
e p
a
rticip
an
ts were
as fo
llo
ws
: In
term
s o
f
th
e
pr
of
ession
, 48
hou
sew
i
v
e
s, 35
entre
p
re
neurs, 34 private
sect
or
em
ployees, and 13
civ
il serv
an
ts. Th
e
p
a
rticip
an
t’s
domici
l
es were Jak
a
rta
(1
1
1
), Ta
n
g
era
ng
(1
4)
, B
o
go
r
(4)
,
an
d B
e
ka
si
(1)
.
The et
h
n
i
c
com
posi
t
i
on o
f
t
h
e pa
rt
i
c
i
p
ant
s
were Ja
v
a
(7
9)
,
C
h
i
n
ese
(
3
3
)
,
Su
nda
nese
(
1
3
)
, Pa
da
ng
(
3
)
,
B
a
t
a
k (
1
)
,
a
n
d
B
e
t
a
wi
(
1
).
T
h
e c
o
m
posi
t
i
on
of t
h
e e
duca
t
i
ona
l
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Sexu
al
Sel
f
-
Sc
hem
a
,
Perce
p
t
i
ons
of
Bre
a
st
T
a
l
k
,
an
d
Physi
c
al
Sel
f
-
C
o
n
cep
t
i
n
.
...
(
J
u
n
em
an
A
b
ra
h
a
m)
)
13
5
lev
e
l o
f
p
a
rticip
an
ts were Bach
elor Stratu
m 1
(10
2
),
an
d
Seni
o
r
Hi
g
h
S
c
ho
ol
(2
8
)
. Th
e ent
i
r
e part
i
c
i
p
ant
s
were m
a
rried.
The pa
rticipant co
m
position
of breast canc
e
r stages we
re
Stage 2 (86),
Stage 3 (37),
Stage 1
(5
), a
nd
St
age
4 (
2
)
.
A
t
o
t
a
l
of
7
2
pa
rt
i
c
i
p
ant
s
ha
d
un
de
r
g
o
n
e s
u
r
g
e
r
y
,
and
5
8
pa
rt
i
c
i
p
ant
s
ha
d n
o
t
/
d
i
d
not
expe
ri
ence s
u
r
g
ery
.
A t
o
t
a
l
of
89 pa
rt
i
c
i
p
ant
s
had u
n
d
er
go
n
e
radi
at
i
on t
h
e
r
apy
,
4
0
part
i
c
i
p
ant
s
ha
d u
n
d
e
r
g
o
n
e
mastecto
m
y, a
n
d 1 pa
rticipant expe
rience
d
horm
one t
h
era
py.
Mu
ltip
le lin
ear reg
r
ession
an
alysis sh
o
w
ed
th
e resu
lts o
f
F
(
5
, 129
)
= 5.46
9,
p
= 0
.
00
0,
R-s
q
uare
=
0.
18
1.
T
h
i
s
i
n
d
i
cat
ed t
h
at
t
h
e
fi
ve
pre
d
i
c
t
o
rs
pr
o
pose
d
i
n
the research h
y
po
th
eses were ab
le sim
u
ltan
e
o
u
s
ly to
pre
d
i
c
t
sex
u
al
sel
f-sc
h
em
a wi
t
h
a c
ont
ri
b
u
t
i
o
n
of
1
8
.
1
%;
H
6
i
s
s
u
pp
o
r
t
e
d
by
em
pi
ri
cal
dat
a
.
In a m
o
re
det
a
i
l
e
d,
phy
si
cal
s
e
l
f-co
n
ce
pt
(
Be
ta
= 0.268
,
p
< 0.
0
1
) a
n
d pe
r
cept
i
o
n
o
f
f
u
nc
t
i
onal
b
r
east
talk
(
Beta
=
0.
26
9,
p
<
0
.
05
)
are ab
le to pred
ict sexu
al self-sch
em
a in
po
sitiv
e ways (see Tab
l
e 1); H5
an
d
H2
are sup
ported
b
y
em
p
i
rical d
a
ta. Th
is m
ean
s th
at th
e
m
o
re a wo
m
a
n
h
a
s p
o
s
itiv
e
p
h
y
sical self-co
n
cep
t, the
m
o
re p
o
s
itiv
e h
e
r sex
u
a
l self-sch
em
a. Th
e m
o
re sh
e h
a
s a p
o
s
itiv
e p
e
rcep
tio
n
o
f
fun
c
tio
n
a
l breast tal
k
, the
m
o
re p
o
s
itiv
e
h
e
r sexu
al self-sch
em
a. Howev
e
r, p
e
rcep
ti
on
s of m
e
d
i
cali
zed
breast talk (
Beta
=
0.
01
0
,
p
>
0.
05
),
ge
n
d
ere
d
breast
t
a
l
k
(
Beta
=
-
0
.034
,
p
> 0.05)
an
d
sexu
alized
b
r
east talk
(
Bet
a
=
0
.
02
0,
p
>
0.
05
) a
r
e
n
o
t
ab
le to
p
r
ed
ict sexu
al self-sch
em
a; H1
,
H3
, an
d H4
ar
e no
t su
ppo
r
t
ed
b
y
em
p
i
r
i
cal d
a
ta.
Tab
l
e
1
.
M
u
ltip
le lin
ear reg
r
essio
n
pred
ictin
g
se
xu
al self-sch
em
a in
b
r
east can
cer surv
ivo
r
(
n
=
13
0)
Variable
B S
E
B
Beta
t
p
Phy
s
ical self-
c
oncept
0.
317
0.
114
0.
268
2.
773
0.
006
M
e
dicalized br
east talk
0.
032
0.
300
0.
010
0.
107
0.
915
Gender
e
d br
east talk
-
0
.
061
0.
214
-
0
.
034
-
0
.
286
0.
775
Sexualized br
east talk
0.
076
0.
382
0.
020
0.
199
0.
842
Functional br
east talk
0.
811
0.
333
0.
269
2.
436
0.
016
Thi
s
st
udy
f
o
u
nd t
h
at
phy
s
ica
l
self-concept is a
b
le to
predic
t sexu
al self-sch
ema
of breast c
a
ncer
survi
vors in
the posi
tive way
. T
h
e e
x
istence of
pre
d
ictive correlation
c
a
n
be unde
rstood first of
all
becaus
e
sex i
t
s
el
f cove
r
s
alm
o
st
all
t
h
e phy
si
cal
di
m
e
nsi
o
ns o
f
r
o
m
a
nt
i
c
rel
a
t
i
ons
hi
ps [
24]
. T
h
e m
easuri
ng i
n
st
ru
m
e
nt
of physical se
lf-conce
pt
use
d
in
this
pres
ent study is t
h
ick
with el
ements of
knowledge a
n
d e
f
ficacy of
physical com
p
etence [25],
which is in
dee
d
necessa
ry
for doi
ng
a succes
sful
a
nd m
eaningful sexual activity.
In
add
itio
n,
wo
m
e
n
who
p
e
rceiv
e
th
em
selv
es ph
ysically
attractiv
e are
also
m
o
re com
f
o
r
tab
l
e with sexu
al
m
a
tters [2
6]
.
Don
a
g
h
u
e
foun
d
a po
sitiv
e co
rrelatio
n
b
e
tween
bod
y
satisfactio
n
an
d
sexu
al self-sch
em
a (esp
ecially
th
e
pa
ssiona
te/ro
m
an
tic
factor, i.e. t
h
e in
clinatio
n
to
p
o
sitiv
e e
m
o
tio
n
s
in
i
n
ti
m
a
te relatio
n
s
h
i
p
s
, and
th
e
op
e
n
fact
or
, i
.
e.
t
h
e
t
e
nde
ncy
o
f
a
pers
o
n
t
o
ha
ve
an
o
p
en
m
i
nd an
d e
xpe
ri
enc
e
), a
n
d ex
pl
ai
n
e
d t
h
at
s
e
x
u
al
sel
f
-
co
nfid
en
ce
(i.e. confid
en
ce t
o
p
u
rsu
e
a
quality in
ti
mate
relatio
n
s
h
i
p
)
con
n
ects with the two v
a
riab
les [2
7
]
.
Sexu
al activ
ity in
th
is
presen
t stu
d
y
is a
d
y
ad
ic activ
ity, in wh
ich
all
women
surv
i
v
ors
are m
a
rried
and
h
a
ve
d
e
fi
n
itiv
e p
a
rtn
e
rs. Alipoo
r
et al. fou
n
d
t
h
at th
e m
o
re
p
o
sitiv
e p
h
y
sical
self-co
n
c
ep
t of a wo
m
a
n
,
the lo
wer
her body dissa
tisfaction [28]. Summarize the entire find
i
ngs
, i
t
can be concl
u
de
d t
h
at
t
h
e
m
echani
s
m
of
pre
d
i
c
t
i
v
e co
rr
el
at
i
on bet
w
ee
n p
h
y
s
i
cal
sel
f-c
once
p
t
a
nd
sex
u
al
sel
f-sc
h
em
a i
s
bri
d
ge
d by
t
h
e de
gr
ee o
f
co
nf
id
en
ce and satisf
actio
n of
a breast cancer survi
v
or
wo
man
w
ith
h
e
r
bod
y.
Th
is st
u
d
y
f
oun
d th
at
func
tio
n
al bre
a
s
t
tal
k
is c
a
p
a
ble t
o
pre
d
ict se
xu
al self
-schem
a
o
f
a fe
mal
e
breas
t
c
a
ncer
survi
vor
, in
the positive
way, while
othe
r breas
t
talks
,
namel
y me
dicaliz
ed, sexualiz
ed,
and
gendere
d breas
t
talk ar
e unable to pr
edict it
. Percep
tio
ns abo
u
t
breast talk
are di
ffe
rent
f
r
om
ph
y
s
i
cal
sel
f-c
once
p
t
f
o
r p
h
y
s
i
cal
sel
f
-
c
once
p
t
i
s
a
b
o
u
t
t
h
ei
r
bo
dy
i
n
a
wh
ol
e o
r
g
l
obal
l
y
, w
h
i
l
e
t
h
e di
sc
ussi
on
on t
h
e
b
r
east talk sp
ecifies in
o
n
e
p
a
rt of
th
e ph
ysical self, i.e. breast.
In
ord
e
r to
d
i
scu
ss th
is issu
e, first o
f
all, it i
s
necessary to
expose in a
dva
n
ce th
e breast fun
c
tion
s
in
th
e so
ciety cog
n
ition
.
Th
e co
gn
itio
n
of society is critic
a
l
to
k
now becau
s
e th
e can
c
er exp
e
rien
ce an
d, in
part
i
c
ul
a
r
,
ho
w a s
u
r
v
i
v
or
creat
es t
h
e
m
eani
ng
of
t
h
e e
xpe
ri
ence
, besi
des
bas
e
d o
n
her
p
e
rso
n
a
l
co
m
p
reh
e
n
s
ion, is also
a
resu
lt o
f
d
i
alog
u
e
s
o
r
d
i
alectics between
h
e
r and
th
e so
cial con
t
ex
t [29
]
. Lang
ellier
an
d
Su
lliv
an
(1
998
)
p
r
o
p
o
s
ed
two
b
r
east fun
c
tio
ns o
f
t
h
ema
tic an
alys
is
o
f
th
e can
cer
patien
t
’s exp
r
essio
n
, as
fo
llows:
“
f
i
rst
, how
as
gl
a
n
d
u
l
a
r or
g
a
n
i
t
ena
b
l
e
s br
east
-f
eedi
ng
a
nd
n
u
rt
ur
a
n
ce,
an
d, sec
o
nd
, h
o
w
as
a p
a
rt
su
ppo
rting
th
e wh
o
l
e b
o
d
y
’s mo
vemen
t
, it e
n
ab
les pa
rticu
l
a
r
ph
ysica
l
a
c
t
i
vities
to
b
e
p
e
rfo
r
med
on
a
da
ily ba
sis .... b
r
ea
st in
vo
lves mean
ing
s
o
f
p
r
id
e, self-relia
n
c
e, and
a
c
comp
lish
m
en
t in
th
e bo
d
y
’s
mo
tility, its spon
tan
e
ou
s po
wers to
do
p
a
r
ticu
l
a
r
a
c
tivities
”
[
16]
(p
. 82
).
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJP
H
S V
o
l
.
4, No
. 2,
J
u
ne 2
0
1
5
:
13
1 – 1
3
9
13
6
In
ot
her
wo
r
d
s, t
h
e m
a
t
e
rn
al
funct
i
o
n (a
nd
not
t
h
e se
xual
o
r
vi
s
u
al
aspect
) o
f
t
h
e breast
i
s
e
m
p
h
a
sized
i
n
th
e fu
n
c
tion
a
l
b
r
east talk
.
It is in
teresting
that fo
r
Indo
nesian
wo
m
e
n
who b
eco
m
e
p
a
rticip
an
ts
in
th
is st
u
d
y
, th
e “d
e-sexu
alized
b
r
east
”
em
pha
si
zi
ng
i
t
s
f
u
nct
i
o
n
s
c
ont
ri
butes to he
r se
xual self-schem
a.
Th
e
find
ing
is
n
o
t
i
n
lin
e wit
h
th
e
Sev
e
lius’ find
ing
s
whic
h stated t
h
at “s
exualize
d
im
ag
es of fem
a
le
breasts
...
ha
ve a negative i
m
pact on som
e
wom
e
n’
s
willingness t
o
breastfeed”
[30] (p. ii). Acc
o
rding
Sev
e
liu
s,
sexu
al
i
s
at
i
o
n of
br
east
s
ha
s cha
n
ged
w
o
m
e
n vi
ewp
o
i
n
t
fr
om
the
breast that i
s
brea
stfeedi
n
g as the
reason
ab
le practice o
f
“cu
ltural” fo
llowing
t
h
e m
o
th
er’s
pregna
ncy a
n
d the
birth of a c
h
ild int
o
the
breast as
sexual objects
.
As a c
onse
que
nce, i
n
breastfeedin
g ac
tivity, breast sha
p
e cha
n
ge
(bec
om
ing “less/not
beaut
i
f
ul
”) i
s
gi
ve
n a m
o
re
val
u
e,
an
d i
t
m
a
de t
h
e
wo
m
e
n w
o
r
r
i
e
d.
Th
us,
Sevel
i
u
s
’
fi
ndi
ngs
i
m
p
l
i
e
d a
negat
i
v
e c
o
r
r
el
at
i
on bet
w
ee
n
sex
u
al
sel
f-sch
em
a and fu
nct
i
onal
bre
a
st
, w
h
ereas t
h
i
s
p
r
e
s
ent
st
udy
f
o
u
nd
a
p
o
s
itiv
e co
rrel
atio
n
in
th
e st
u
d
y
’s p
a
rticip
an
ts wh
o
we
re
Indo
n
e
sian
p
e
o
p
l
e.
Ho
w to
ex
p
l
ain
t
h
is po
sitiv
e
correlation
?
Sevel
i
u
s e
xpl
a
i
ned hi
s st
u
d
y
’
s res
u
l
t
by
usi
ng
Western
iza
tio
n
c
once
p
t
.
Acco
rdi
ng t
o
him
,
t
h
e
conce
p
t m
a
kes breast as the
object a
nd
give
s
the feelin
g o
f
a st
ro
ng se
x
u
al
nua
nce
a
nd
privacy to the breast.
This e
xpla
n
ation can only be counte
r
ed
by
the
disc
ourse
being circ
ulated in
the c
o
mmunity. T
h
ese
recent
years, a cam
pa
ign t
o
activate
m
o
ther
s to
breastfeed e
v
e
n
to enc
o
ura
g
e
e
x
clusi
v
e
breast
f
eedi
n
g by m
o
thers
becom
e
i
n
cre
a
si
ngl
y
p
o
pul
ar, a
nd i
t
i
s
al
so su
p
p
o
r
t
e
d by
t
h
e
G
ove
r
n
m
e
nt
and n
o
n
-
g
ove
rn
m
e
nt
al
or
ga
ni
zat
i
ons
i
n
I
n
d
o
n
esi
a
[
31]
-
[
33]
.
Gl
o
b
a
l
m
ovem
e
nt
t
h
r
o
u
g
h
s
o
ci
al
m
e
di
a aim
e
d at
pr
o
v
i
d
i
ng
wi
d
e
r
psychos
o
cial public s
p
aces
for breastf
ee
ding m
o
thers is also inc
r
easing in
the freque
ncy
and intensity by the
u
p
l
o
a
d
i
n
g
o
f
t
h
e n
u
rsing
m
o
th
er p
i
ctures in
th
e pu
b
lic p
l
aces to
th
e web
s
ites o
r
so
cial
m
e
d
i
a [34
]
. In
add
itio
n,
expressi
on and im
agery that
“
Breastfeedi
n
g mother
is sex
y
” has
ente
red
I
n
d
o
n
esia (e
.g
. [
3
5]
, [
3
6]
).
Wri
gh
t
mad
e
th
is ex
pressio
n
well elab
orated th
rou
g
h
h
i
s article, “
Breastfeedi
n
g is the New
Sexy
!
”, as fo
llows:
“
Whe
n
yo
u l
o
o
k
at
t
h
i
s
pi
ct
ur
e an
d t
h
e ot
he
rs of
m
o
t
h
ers
bre
a
st
f
eedi
n
g (
n
u
d
e o
r
n
o
t
)
, I w
ant
yo
u t
o
see confide
n
t,
sexy women w
h
o bare
d
it
all for breastfee
d
ing;
w
h
o feel se
xy at this very
stage
of life
an
d m
o
t
h
e
r
h
o
o
d
.
Pro
u
d
w
o
men
,
w
h
o acc
e
pt
w
h
ere t
h
ey
are n
o
w
an
d
mai
n
t
a
i
n
c
onf
i
d
ence i
n
t
h
e
grow
t
h
pr
oces
s t
o
come. C
o
ura
g
e
o
us w
o
m
e
n i
n
t
h
ei
r f
e
at
t
o
bri
n
g a
w
arene
ss a
nd
at
t
e
nt
i
on t
o
educ
at
e an
d
i
n
spi
r
e ot
hers
t
o
bre
a
st
f
eed!
” [37]
In
o
t
h
e
r wo
rd
s, th
ere is a sh
ift
o
r
am
elio
ratio
n
to
wa
rd the meaning of “sexy” and “breastfeeding”. It
i
s
al
so ca
n
not
be
deni
e
d
t
h
at
b
r
east
f
ee
di
n
g
act
i
v
i
t
y
has a
sex
u
al
di
m
e
n
s
i
o
n
f
o
r
som
e
peo
p
l
e
,
as t
o
l
d
by
a
B
a
by
C
e
nt
er m
e
m
b
er [3
8]
. S
h
e sai
d
t
h
at
h
e
r hu
sba
n
d w
a
s ann
o
y
e
d w
h
en s
h
e was
breast
f
eedi
ng
her s
on
because he
r
husband re
ga
rded breastfee
di
ng a
c
tivity
“as som
e
thing
sexual” [
38]. Vari
ous disc
ourses
circu
l
atin
g us i
n
d
i
cate t
h
at the fu
n
c
tion
a
l
b
r
east is no
t
r
eally
“dese
xualize
d
”. In othe
r
words, the
r
e a
r
e
sexual
l
a
y
e
rs t
h
at
covere
d t
h
e f
u
nc
t
i
onal
brea
st
. Ho
we
ver
,
t
h
e que
st
i
on i
s
:
“Wo
u
l
d
t
h
e co
nt
est
a
t
i
on bet
w
een t
h
e
sex
u
al
ove
rt
o
n
e
s of t
h
e
breas
t
(t
hat
have a
negat
i
v
e c
o
nn
o
t
at
i
on, beca
use
i
t
i
s
seen as
m
a
ki
n
g
t
h
e w
o
m
e
n b
e
an
“o
bj
ect”) an
d th
e fu
n
c
tion
o
f
th
e
breast (th
a
t
h
a
v
e
a po
sitiv
e co
nno
tatio
n advo
catin
g
t
h
e in
terests of
breast
f
ed
chi
l
d
ren as
f
u
t
u
re g
e
nerat
i
o
ns
) be pr
o
duct
i
v
e
dis
c
ourses
for t
h
e
advancem
ent of
our underst
andi
ng
o
f
wo
m
e
n
’
s lives in
g
e
n
e
ral as well as for im
p
r
o
v
i
ng
th
e
wo
m
e
n
qu
ality
o
f
life
?
”. Th
e
fo
llowing
issue stated
by
The
u
ri
ng m
i
ght
be a
n
i
m
port
a
nt
ad
vi
ce t
h
at
t
h
e f
u
nct
i
o
nal
/
m
a
t
e
rnal
br
east
t
a
l
k
does
not
need t
o
ne
gat
e
o
r
d
e
n
y
t
h
e sexu
ality o
f
th
e
fem
a
le b
r
east:
“
I
wan
t
to
feel co
n
fid
en
t and p
r
oud
wh
en
I
b
r
ea
stfeed
m
y
ch
ild
. I
t
’
s
very em
po
wering
! And
feelin
g
sexu
al
l
y
at
t
r
ac
t
i
ve i
s
al
so j
u
st
as em
pow
eri
n
g …
.
I d
o
n
o
t
c
o
n
d
one t
h
e ove
r
-sex
ual
i
z
i
n
g o
f
w
o
men
or
sex as
a w
a
y t
o
co
nt
r
o
l
w
o
m
e
n,
but
I
d
o
n
o
t
f
eel
t
hat
w
e
need t
o
de
sexu
al
i
z
e o
u
rsel
ves
i
n
or
der t
o
g
a
i
n
va
lu
e fo
r
mo
t
h
ering
i
n
ma
i
n
stream society. I
do
n’t t
h
in
k we
n
eed t
o
a
s
su
me tha
t
sexua
lity is a
di
rt
y t
h
i
n
g.
Sex
i
s
n
o
t
di
rt
y or
sha
m
ef
ul
.
” [39]
Th
eu
ring’s stat
e
m
en
t [39
]
ab
ov
e
wou
l
d
clarify wh
y
th
e
p
a
rticip
an
ts
of th
is
stu
d
y
h
a
v
e
t
h
e
p
e
rcep
tion
th
at fu
nctio
n
a
l
b
r
east talk
is
p
o
s
itiv
ely co
rrelated
with
sex
u
a
l self-sch
ema. It is
v
e
ry lik
ely th
at
th
e b
r
east
cancer s
u
rvivors who becam
e participan
ts
of this study had receive
d a
new im
age of the sexual nua
n
ce of
breast
f
eedi
n
g.
Fun
c
tio
n
a
l
b
r
east talk
s still e
x
ist in
th
e
b
r
east can
cer
surv
i
v
or as a m
e
m
o
ry. Th
is is consisten
t
with
the statem
ent
of Conne
rton
[40] (p. 80),
“T
he
body is t
h
e
m
a
in ‘c
ontainer’
of
habitual
m
e
m
o
ry … because
t
h
e
past
i
s
pass
ed on
t
o
us
i
n
pract
i
ces of
t
h
e
b
ody
or
i
n
t
h
e way
s
o
f
doi
ng
and
bei
ng”
. A wom
a
n’s
e
x
pe
ri
ence
i
n
n
u
rt
uri
ng a
n
d cari
n
g
t
h
e
ot
hers
wi
t
h
he
r
breast
i
n
t
h
e
p
a
st
has
gi
ve
n s
e
nse
of
w
o
rt
h
t
o
he
r s
o
t
h
at
i
t
can
p
r
ov
id
e sexu
al
m
o
t
i
v
a
tio
n
now
an
d in
t
h
e
f
u
tu
r
e
.
Why m
e
dicalized brea
st talk has no effect on se
xual self-schem
a
?
Breas
t cancer survivors
have a
dile
mm
a when encountering
med
i
cal-clin
ical-h
ealth
in
terv
en
tion
s
t
o
wa
rd their
brea
sts. Thom
as-MacLean
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Sexu
al
Sel
f
-
Sc
hem
a
,
Perce
p
t
i
ons
of
Bre
a
st
T
a
l
k
,
an
d
Physi
c
al
Sel
f
-
C
o
n
cep
t
i
n
.
...
(
J
u
n
em
an
A
b
ra
h
a
m)
)
13
7
through their
qualitativ
e study had succee
ded in showi
ng
(and soci
alizing as well) t
h
at phe
nom
e
nologically,
medical therapy expe
rience
bri
ngi
ng t
r
ans
f
orm
a
tive e
xpe
ri
ence i
n
ad
di
t
i
on t
o
t
h
e
psy
c
hol
ogi
cal
s
u
f
f
eri
n
g
ex
p
e
rien
ce as b
e
liev
e
d
b
y
th
e
g
e
n
e
ral
p
u
b
lic [4
1
]
.
In
ad
d
ition
,
wo
men
are
in
th
e ten
s
ion
b
e
tween
the
t
e
nde
ncy
o
f
ap
pr
oac
h
i
n
g an
d
away
fr
om
t
h
e breast
t
r
eat
m
e
nt
. I
n
ot
he
r w
o
r
d
s, t
h
e m
e
di
cal
i
zat
i
on ex
pe
ri
ence
is a p
o
s
itiv
e an
d
n
e
g
a
tiv
e exp
e
rien
ce as well. Fo
r ex
am
p
l
e, p
a
rticip
atin
g in
th
e m
e
d
i
calizatio
n
cau
ses p
a
in
and l
o
s
s
of a
u
t
o
n
o
m
y
, ri
sk, and
unce
r
t
a
i
n
t
y
,
but
l
eavi
n
g or
di
scon
nect
i
n
g
wi
t
h
m
e
di
cal
izat
i
on has al
so
been
realized to be
e
l
iminating t
h
e
chance
o
f
(1
) u
nde
rst
a
n
d
i
n
g
t
h
e di
sease, (
2
)
bui
l
d
i
n
g
t
h
e
f
r
a
m
e
wor
k
of
m
eani
n
g
o
f
th
e illn
ess,
an
d
(3) h
a
v
i
ng an
ex
isten
tial self-und
er
stand
i
ng
[4
1
]
. Th
e en
tire ex
p
e
rien
ces req
u
i
re certain
st
ru
ggl
e i
n
v
o
l
v
i
n
g dy
nam
i
c-
cont
radi
ct
o
r
y
m
e
m
o
ri
es, and
,
t
h
ere
f
o
r
e,
ha
ve va
ry
i
ng e
f
f
ect
s on se
xual
sel
f
-
schem
a
of t
h
e
survi
v
ors, s
o
there a
p
pears
no correla
tion
b
e
tween
m
e
d
i
calized
breast
talk
and
sexu
al self-
schem
a
.
Wh
y p
e
rcep
tion
s
to
ward
sexu
alized
and
g
e
n
d
e
red
b
r
east talk
are n
o
t
ab
le to
p
r
ed
ict sexu
al self-
sch
e
m
a
?
Langellier an
d
Su
lliv
an
pu
t forward
th
at in
g
e
nd
ered
b
r
east talk
, th
e b
r
east is “a sig
n
o
f
fem
i
n
i
n
ity,
b
eau
ty, an
d
sex
u
a
l
d
e
sirab
ilit
y” [1
6
]
(p
.
8
4
) an
d
in
sexu
alized
breast talk
, th
en
breast “in
c
orp
o
rated
b
o
th
the
lo
ok
and
th
e
feel o
f
th
e
b
r
easted
ex
p
e
rien
ce ... inv
o
l
v
e
d
bo
th
sexu
al
d
e
si
rab
ility to
o
t
h
e
rs an
d
feeling
sex
u
a
l
desi
re
one
sel
f
”
[1
6]
(
p
.
87
, 8
8
)
. Em
pi
ri
cal
da
t
a
of t
h
i
s
st
udy
i
ndi
cat
ed t
h
at
t
h
e ge
nd
ere
d
a
nd
sex
u
al
i
zed
breast
i
s
no l
o
n
g
e
r
i
m
port
a
nt
, or
d
o
n
o
t
cont
ri
bu
t
e
t
o
sexual
sel
f-sc
h
em
a. This
m
i
ght
be cause
d by
t
h
e conc
ret
e
situation
e
x
perienced by brea
st
cancer
survivors, or e
v
en the
new i
d
e
n
tity
they successfully achieve
d.
Recent
b
r
east con
d
ition
s
m
a
y in
d
eed p
r
ov
id
e a
feel
in
g
o
f
im
p
e
rfectio
n
o
r
i
n
co
m
p
letio
n
as a wo
m
a
n
[8
].
Howev
e
r,
rath
er th
an
fo
cu
sing
o
n
it, th
e p
a
rticip
an
ts in th
is stud
y ap
pe
a
r
s
to b
e
mo
r
e
f
o
cu
s
e
d
on
th
e c
o
n
s
id
er
a
tio
n
o
f
the
e
m
o
tio
n
a
l ab
ilities o
f
th
e breast th
at is con
t
ain
e
d
o
r
cov
e
red
in
t
h
e th
e h
i
sto
r
ical m
e
m
o
ry o
f
its fun
c
tion
,
as
m
e
nt
i
oned
ab
o
v
e. T
h
i
n
gs
w
h
i
c
h can
be m
a
naged
by
t
h
e s
u
r
v
i
v
ors am
on
g
ot
he
rs are
(
1
) t
h
e em
ot
i
onal
aspect
s
o
f
t
h
e
b
r
east,
an
d (2
) th
e
physical asp
ects
o
f
t
h
e
p
a
rts of
self th
at are co
rpo
r
ally still h
ealth
y.
In
terven
tio
ns
suc
h
as “e
ducation a
n
d lifestyle change
s to se
xual
co
un
seling
,
p
e
l
v
ic fl
o
o
r th
erap
ies, sexu
al aid
s
,
m
e
di
cat
i
ons, a
n
d
di
et
ary
s
u
p
p
l
e
m
e
nt
s” [4
1]
(
p
.
S2
0)
fi
r
s
t
o
f
all are
no
t fo
r th
e sh
ak
e
o
f
“pu
b
lic i
n
terest”, lik
e
to
look fem
i
nine or
i
n
crease sexual
a
ttractiv
en
ess i
n
th
e ey
es o
f
th
e
pu
b
l
i
c
, bu
t to
cop
e
with
,
o
r
m
i
n
i
mize th
e
sexu
al d
y
sfunctio
n
p
o
t
en
tial. Th
erefore, t
h
ey h
a
v
e
to rely o
n
o
t
h
e
r
m
o
d
a
lities, n
a
mely “p
sych
o
l
o
g
i
cal-
e
m
o
tio
n
a
l m
o
d
a
lities” (wh
i
ch
is en
co
m
p
assed
in th
e
fun
c
tion
a
l breast talk), as th
e
prim
ar
y co
n
s
titu
en
t
of th
eir
sexual self-sche
m
a.
Th
e fi
n
d
i
n
g
s of th
is presen
t stu
d
y
is in
lin
e
with
th
e Ellio
t
t
state
m
en
t [4
2] wh
ich
em
p
h
a
sized
th
at
m
o
th
erh
ood
(as stressed
in
the fu
n
c
tion
a
l breast talk
), a
nd
not
m
e
rel
y
gen
i
t
a
l
funct
i
on (
w
hi
c
h
i
s
affect
ed by
b
r
east m
e
d
i
catio
n), is on
e
of
t
h
e as
pects that
can a
ffect t
h
e s
e
nse
of se
xual
self.
4.
CO
NCL
USI
O
N
Thi
s
st
u
d
y
co
ncl
u
ded t
h
at
t
h
e pe
rcept
i
on
of f
u
nct
i
o
nal
breast
t
a
l
k
an
d
phy
si
cal
sel
f
-
c
once
p
t
pl
ay
ro
les
i
n
p
r
ed
ictin
g
sexu
al
self-s
chem
a in bre
a
s
t can
cer s
u
rvivors.
As t
h
e im
p
lica
tio
n
,
end
e
av
ors to
bu
ild
women
’
s
ph
ysical self-wo
r
t
h
in
t
e
rn
ally sin
c
e early stag
e
of
life becam
e urgent. It is e
v
i
d
ent t
h
at a
dimension of
the breast whic
h is ass
u
m
e
d as “asexual”,
i.e. its
nu
rt
u
r
ance
fu
n
c
t
i
on, i
n
dee
d
cont
ri
b
u
t
e
s t
o
t
h
e sex
u
al
fu
n
c
tio
n
and
sch
e
ma later
in
life, in
clud
ing
in ti
m
e
s
wh
ile
b
eari
n
g
p
a
in
su
ch
as can
cer. Th
is is the con
t
ribu
tion
o
f
th
is st
u
d
y
’s
find
ing
s
.
In
breast
cancer
su
rv
ivo
r
, p
e
rcep
tion
s
reg
a
rd
ing
t
h
e histo
r
icity
o
f
fe
m
a
le
b
r
east streng
th
i
n
su
ppo
r
ting
lif
e tu
rn
ed
ou
t to
b
e
g
i
v
i
ng
sex
u
al
m
ean
in
g
th
at g
o
e
s
b
e
yond
th
e ef
for
t
to
meet th
e n
e
ed
─
wh
ich
is
becom
i
ng ve
ry
di
ffi
cul
t
─
fo
r “b
eing
d
e
sired
ero
tically-sexu
a
lly b
y
th
e p
u
b
lic”, alth
o
ugh
it
is h
a
rd
to
d
e
n
y
th
at
th
e sex
u
a
l
layers m
i
g
h
t
also
ex
ist in th
e
fun
c
tio
n
a
l
breast
.
Red
e
fin
ition
o
f
fem
a
le sex
u
ality th
at is not on
ly
foc
u
se
d o
n
a
p
peara
n
ces a
nd
phy
si
cal
pa
ra
m
e
t
e
rs has bec
o
m
e
a cl
assi
cal
debat
e
an
d re
di
sco
v
ere
d
i
t
s
cont
e
x
t
in
th
is
research.
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BIOGRAP
HI
ES OF
AUTH
ORS
June
man A
b
r
a
ham
is the Faculty
Member
-Subject Content Coordinator
(FM-SCC) on
Com
m
unity
P
s
ycholog
y S
t
udi
es
at Bin
a
Nus
a
ntar
a Univers
i
t
y
(BI
NUS
.ac.id);
S
e
c
r
etar
y-Gen
e
ra
l
of Asian Ps
y
c
h
o
logical Association (APs
y
A
.o
rg
); President o
f
Association o
f
Behaviour
al
Research
ers on Asians-Indonesia Chapter (AB
R
AI
ndonesia.or
g); and Head of Organizational
Compartment at Indonesian
Psy
c
hological
A
ssociation (HIMPSI.or.
id). Personal pag
e
:
http://about.me/juneman
Miran
t
i
Ayu
P
u
teri
is an
alu
m
na of Ps
y
c
ho
l
o
g
y
D
e
partm
e
nt
, Facu
lt
y
of Hu
m
a
nities,
Bina
Nusantara Univ
ersity
, Jak
a
rta, In
donesia.
Evaluation Warning : The document was created with Spire.PDF for Python.