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AN INVESTIGATION of BREAST SUPPORT for OLDER WOMEN by Deborah Judith Risius the Thesis Is Submitted in Partial Fulfilment Of

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AN INVESTIGATION of BREAST SUPPORT for OLDER WOMEN by Deborah Judith Risius the Thesis Is Submitted in Partial Fulfilment Of AN INVESTIGATION OF BREAST SUPPORT FOR OLDER WOMEN By Deborah Judith Risius The thesis is submitted in partial fulfilment of the requirements for the award of the degree of Doctor of Philosophy of the University of Portsmouth December 2012 Abstract Profound changes occur within the female breast with increasing age; glandular atrophy, increased skin laxity and stretched Cooper‟s ligaments cause an inferior lateral migration of the breast tissue. However, the current lingerie market predominantly revolves around bras designed for younger women that older women may feel are inappropriate for their physique. Literature regarding age- appropriate clothing has postulated that bras should be designed based on specific shapes, populations and usages. Yet the bra preferences of older women have been neglected in the literature. By determining women‟s requirements, the performance of current bras may be ascertained, and subsequent alterations may be recommended for bra design in order to optimise bras for older women if required. The aims of the current thesis were to: provide a wider understanding of the bra requirements of women aged 45 to 65 years, determine the key bra performance variables for this population, develop procedures to assess these variables and to determine the current appropriateness of a small sample of bras for this population. To achieve the research aims the thesis contained five studies. The first study was exploratory in nature, using focus groups and interviews to develop a knowledge base on the bra preferences of women aged 45 to 65 years. A survey was subsequently designed and implemented to determine the key bra performance variables among a wider sample of the population. The results of these studies identify the general dimensions that women consider when purchasing a bra (comfort, support, aesthetics, practicalities, and psychological aspects). From these dimensions, 11 key bra performance variables that are of importance to older women were derived (comfort, support, bra‟s ability to stay in place, appearance under clothes, silhouette, breast shape, breast lift, shoulder straps, discreetness, fabric and fit). Methods to quantify the key bra performance variables were required to assess the performance of current bras for older women. The third experimental study developed methods which minimised the limitations of existing procedures, and determined the validity and reliability of these methods. As a result of this study, methods to assess the 11 key bra i performance variables were deemed acceptable for both objective and subjective measures. In the fourth study, two bras were selected from a popular and unpopular brand; the performance of these bras was assessed with regard to the 11 key bra performance variables. The results indicate that women aged 45 to 65 years preferred a bra that minimises breast kinematics, provides greater breast projection and lifts the breast sufficiently. Although differences lay between the bare breasted and bra conditions, the two bras performed similarly despite the difference in popularity. The final study incorporated a four week wearer trial to elucidate any changes in performance that may appear with increased usage. Subjective ratings of breast support and the bras‟ ability to stay in place were lower following the wearer trial. The bras tested performed well for the bra variables; comfort, fit, support and shoulder strap position. However, the remaining key bra performance variables may require alteration to ensure their appropriateness for women aged 45 to 65 years. It is concluded that women aged 45 to 65 years are generally cognisant of changes to their breasts as they age, subsequently seeking bras that are different from those they previously would have worn. The findings of this thesis suggest that alterations in bra design are required to optimise bras for older women. ii Declaration Whilst registered as a candidate for the degree of doctor of philosophy, I have not been registered for any other research award. The results and conclusions embodied in this thesis are the work of the named candidate and have not been submitted for any other academic award. iii Dissemination Risius, D., Thelwell, R., Wagstaff, C., & Scurr, J. (2012) Influential factors of bra purchasing in older women. Journal of Fashion Marketing and Management, 16 (3), 366-380. Risius, D., Milligan, A., Ayres, B., & Scurr, J. (2011). An investigation of the relationship between breast kinematics and subjective ratings of breast support during treadmill activity. In M. Sellens, G. Sandercock, M. Taylor, & D. Mickelwright (eds.), Proceedings of the BASES Annual Conference (pp. S51). September 2011, Essex, UK. Risius, D., Milligan, A., & Scurr, J. (2012). Biomechanical breast support requirements for younger and older women during walking. Presented at the Helal and Harries Prize and Olympics Meeting. Royal Society of Medicine. London, Friday 21st September 2012. Risius, D., & Scurr, J. (2012). A method to assess bra slippage during everyday activity. Presented at the University of Chichester/University of Portsmouth Sport & Exercise Sciences Postgraduate Research Conference. University of Chichester, Monday 18th June 2012. Risius, D., Thelwell, R., & Scurr, J. (2010). Brassiere requirements of the ageing breast. Presented at the Health Development Forum Showcase, University of Portsmouth, Friday 5th November 2010. iv Acknowledgements It is a pleasure to thank the following people, without whom the completion of this thesis would not have been possible. First and foremost, my doctoral supervisor Dr Joanna Scurr, for her continued support, guidance and enthusiasm during my time as a PhD student. To Dr Richard Thelwell and Dr Chris Wagstaff for their critical eye and qualitative expertise throughout. To Dave and Wendy for their excellent technical support in experimental work. To all members of the Research Group in Breast Health, all past and present researchers and all DSES staff members, of which there are too many to name individually. To Jenny and Alex, for their emotional support, camaraderie and entertainment throughout. I am very grateful to have had you both with me over the past few years. To all participants, for volunteering their time and modesty to take part. I am grateful to Playtex for funding the initial two years of this programme of work, and to the British Foundation of Women Graduates for their Foundation Grant award in 2011. Finally, to my sister, Eleanor, for setting the bar high, and to my parents, Andrew and Francesca, who have supported my every academic decision. I dedicate this thesis to you. v Table of Contents Abstract ................................................................................................................... i Declaration ............................................................................................................. iii Dissemination ....................................................................................................... iv Acknowledgements ................................................................................................ v Table of Contents .................................................................................................. vi List of Figures ....................................................................................................... xii List of Tables........................................................................................................ xvi Chapter 1. Introduction .......................................................................................... 1 1.1 Aims of thesis ................................................................................................... 3 1.2 Thesis summary ............................................................................................... 3 Chapter 2. Review of Literature ............................................................................. 7 2.1 Anatomy of the breast ...................................................................................... 7 2.1.1 The skin ................................................................................................... 8 2.1.2 The corpus mammae ............................................................................... 9 2.1.3 The subcutaneous tissue of the breast .................................................. 10 2.1.4 Breast size ............................................................................................. 11 2.1.5 Hormone Replacement Therapy (HRT) .................................................. 12 2.1.6 Mastalgia ................................................................................................. 12 2.1.7 Biomechanical support ............................................................................ 13 2.2 Psychological effects of ageing ...................................................................... 14 2.3 Brassieres ...................................................................................................... 15 2.3.1 The structure of brassieres ..................................................................... 15 2.3.2 Correctly fitting brassieres ....................................................................... 15 2.4 Brassieres for Women aged 45 to 65 years ................................................... 17 2.5 Summary........................................................................................................ 20 Chapter 3. An exploratory investigation of
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