http://doi.org/10.33698/NRF0089  -Navdeep Kaur, Ramesh Thakur

Abstract : Premenstrual syndrome are the symptoms which occur during one week before menstruation and some time symptoms are so severe enough to disturb life cycle of a women. She adopt different method to cope-up with problem. A descriptive study was conducted among nursing students, NINE, PGIMER, Chandigarh during the month of February 2008 to assess the premenstrual syndrome and coping behaviour among them. A total 248 students from all classes were selected for collection of data. The questionnaire consisted of two parts. Part one is assessment of premenstrual syndrome and part two is for check list on coping behaviour. The most commonly (79.43%) out of 248 students having were lower abdominal pain. (66.12%) having backache, (52.01%) having low efficiency of work performance. Majority of students were using healthy coping strategies. (89.11%) do not blame themselves for the this problem, (75.40%) accept it as nothing can be done 181 (98.11%) take hot or cold drinks.

Key words :

Premenstrual Syndrome. Coping behaviour, Nursing Students.

Correspondence at : Navdeep Kaur

National Institute of Nursing Education

PGIMER, Chandigarh

Introduction

Menstruation is a normal physiological impact in each girls life. Menstruation is a monthly uterine bleeding for 3-5 days after every 28 days from puberty till menopause.1 A change in mood, behaviour, appearance of some abnormal vague symptoms is often noticed in second half of the cycle. But if the symptoms are severe enough to disturb life cycle of a women or require medical help, called premenstrual syndrome (PMS)2. Natu says symptoms which occur during one week before menstruation are collectively known as PMS. Atleast one of the following somatic & affective symptoms appear 5 days before menses or prior menstrual cycle3. Affect symptoms are depression, anger outburst, irritability, anxiety, confusion & social withdrawals. While in somatic symptoms there are breast tendemess, abdominal bloating headache.4 These symptoms are relieved within 4 days of the onset of menses5. Etiology of these disorder remain uncertain. Research suggest that altered regulation of neurohormones transmiters is involved. Between the age of 25-35 year upto 85% of menstruating women report having one or more PMS. During the follicular phase the woman should be full of symptoms. Dalton says PMS is caused by an imbalance during luteal phase of menstrual cycle. Successful treatments was reported with progesterone supplementation. PMS certainly seems to be associated with the luteal phase of the cycle, that is the phase during which progesterone is produced. Studies suggest that progesterone was deficient in the luteal phase in PMS patients. The level of beta endorphin increases in the peripheral blood during the luteal phase of the menstrual cycle. Endorphin can affect mood. Endorphin prematurely decreased during the menstrual cycle. Recent finding shows that many women with PMS have hot flushes showing a relative estrogen deficiency correlates well with the concept of a beta- endorphin deficiency as the cause of PMS. Prostaglandin inhibitors (mefenamic acid) can improve symptoms of PMS. There is some influence of prostaglandin on beta- endorphin production that could link these two possible etiologies of PMS. Forty percent of all women between the age of 14-50 years experience PMS. 10-12% noticed severe symptoms which disrupt their lives (Newyork times) women who have severe symptoms may be diagnosed with premenstrual dysphoric disorder. Premenstrual symptoms diary that record nature and date of occurrence should be maintained and it can aid in diagnosis. Ninty percent of girls are expected to have pain during this period according to Brook a study conducted in Israel (1984)7.

Abraham in his study found that 54% of women who had experienced menarche complained of irritability, 40% abdominal bloating as premenstrual syndrome. The present study has been undertaken to find out the symptoms of PMS in nursing students of National Institute of Nursing Education (NINE), PGIMER, Chandigarh and how they cope-up. With the following objectives in view8.

Objective

To assess the premenstrual symptoms and coping behaviour among nursing students NINE, PGIMER, Chandigarh.

Materials and Methods

Setting & Subjects: A descriptive study was being conducted on all the students of National Institute of Nursing Education, (NINE), PGIMER, Chandigarh in the month of January 2008. NINE is one of the premier institute offering three programmes, B.Sc. Nursing (4 years). B.Sc. Nursing (Post Basic) and M.Sc. Nursing. For B.Sc. Nursing (Post Basic) training candidates have completed general nursing and midwifery diploma course: M.Sc. Nursing students have completed basic B.Sc. Nursing or B.Sc. Nursing (Post Basic) and B.Sc Nursing (4 years) join directly after the 10+2 Medical stream. The students have to qualify an entrance test before getting admission into each course. The study was conducted on 248 students of NINE. Total population was 251. Prior to data collection questionnaire & checklist was prepared, permission was obtained from the Principal NINE, PGIMER, Chandigarh and also from the coordinators of all the classes. Questionnaire was filled by students and data collected.

Results

In present study 248 students were studied. The results of observation were calculated by finding out the frequency and percentage. The observation were put under different table and plot on bar diagram, pie char t, line char t. Table-l depict the age variation of subjects. The study revealed that 83 (33.5%) students were in the age group <20 years, 152 (61.3%) subjects were 21- 30 years and 13 (5.2%) subjects were > 30 years.

Table 1: Distribution of Subjects according to age variation.

Age Group Frequency (%)
< 20 Years 83 (33.5%)
21-30 152 (61.3%)
> 30 years 13 (5.2%)

Table 2 depicts the distribution of study subjects according to the age of menarche. 221 (98.1%) students had menarche at age 12-15 years, 12 (4.9%) subject had menarche at 15 years of age.

Table 2: Distribution of study subjects according to the age of menarche

Age of Menarche Frequency (%)
before 12 years 15 (6.0%)
12-15 years 221 (89.1%)
Mter 15 years 12 (4.9%)

Table 3 depicts premenstrual symptoms faced by students. The study revealed that 197( 78.2%) subject having lower abdomen pain, 164 (66.1%) back ache, 160 (64.5%) irritability, 147 (59.21%)fluctuation of mood, 129 ( 52.01%) lower efficiency of work performance , 126 (50.8%) restlessness , 113 (45.6%) pain in thighs, 106 (42.7%) distraction from work, 105 (42.3%) breast tenderness, 104 (41.9%) difficulty in concentration, 104 (42.7%) body ache, 95 (38.3%) avoid social activities.

Problem Frequency (%)
Lower abdomen pain 197 (78.2%)
Back Ache 164 (66.1%)
Irritability 160 (64.5%)
Fluctuation of Mood 147 (59.2%)
Lower efficiency of work performance  

129 ( 52.0%)

Restlessness 126 (50.8%)
Pain in thighs 113 ( 45.6%)
Distraction from work 106 (42.7%)
Breast Tenderness 105 (42.3%)
Difficulty in concentration 104 (41.9%)
Body Ache 104 (41.9%)
Avoid Social Activity 95 (38.3%)

 

Table 3: Distribution of Subjects according to premenstrual symptoms.

Table 4 depict coping behaviour adopted by students. 221(89.1%) subjects donot blame them self, 187 (75.4%) accept it as nothing can be done, 181 ( 73.1%) take hot/cold drink, 178 (71.8%) donot express anger on other, 149 ( 60.1%) turn to study & forget things, 142 (57.3%) talk to family members.

Table 4 : Coping behaviour adopted by students.

Adaptive Coping Behaviour Frequency (%)
Donot blame themselves 221 ( 89%)
Accept PMS as natural process nothing can be done 187 (75.4%)
Take hot/ cold drink 181 (73.0%)
Donot express anger on other 178 (71.8%)
Turn to study & forget things 149 (60.1%)
Talk to family members 142 (57.3%)

Discussion

It is an accepted fact that menstruation is a normal physiological impact in each girls life9. Adolescent and younger age period of the girl is crucial phase. In our culture it is believed that girls should not express their feeling toward sexual aspects.

Premenstrual syndrome is the primary reason by women to miss work, school or college2. Some time their symptoms are so severe that she need medical care. The present study was conducted on 248 students of NINE, PGIMER, Chandigarh revealed that majority 152 (61.28%) were of age group 21- 30 years and majority 221 (89.11%) had menarche at 12-15 years of age, 163 (65.72%) had at interval of menstrual cycle between 28- 30 days only 1 (0.40%) was having irregular cycle, 186 (75%) had duration of menstrual cycle 4-5 days.

Majority 197 (79.43%) students were having pain in lower abdomen, 164 (66.12%) were having backache, 160 (64.51%) were having irritability, 113 (45.05%) had pain in thighs & 73 (29.43%) had pain in breast. Mortie Joseph F (1986) mentions in his study that premenstrual syndrome demonstrated depressive episodes that occurred selectively in the luteal phase of the cycle at least 1 or 2 following somatic and affective symptoms appear during the 5 days before menses5. The present study also indicate that mostly students were having problem 5 days before the menses. Brooks Israel study (1984) shows that 90% of girls are expected to experience pain during this period10. Abraham Studied among 1,367 young Australian women age 14-19 years showed that 54%women experience irritability, 40%abdominal bloating as premenstrual syndromes12. In present study 79.43% were having lower abdomen pain, & 64.51% were having irritability.

In present study mostly students used adapted behavior to cope up with these problems. Majority of students were using healthy coping strategies. i.e., (89.11%) do not blame themselves for this problem, 187 (75.40%) accept it in healthy way that nothing can be done, 181 (72.98%) take hot or cold drinks. 178 (71.77%) do not express their anger on others. They accept it as a natural process as nothing can be done and try to cope up in healthy way.

Conclusion

It was concluded from the findings of the study that majority of students were having lower abdomen pain, backache, irritability, fluctuation of mood. Minority of students were having somatic symptoms like feeling of suffocation, chest pain, feeling of tingling sensation and ringing in ear. In order to over come it majority of students adopts healthy coping strategies for these problem. i.e., do not blame themselves, They accept it as natural process as nothing can be done. They take hot drinks to feel better. They do not express their anger on others.

References

  1. Lori M Dickerson, Pamela J Mazyck, Melissa H Hunter. premenstrual syndrome. American family physician 2003 ; 67 (8) : 1-15.

 

2 .   Premenstrual Syndrome. Premenstrual Syndrome Britannica online Encyclopedia EiJe:/ /G:\Premenstraul Syndrome Britannica online                     Encyclopedia.htm 2008; 1-4.

  1. Premenstrual Syndrome (PMS) Premenstrual  Dysphoric disorder  (PMDD). File :/ /G:\Premenstrual % 20 Syndrome 0/0 20 (PMS)% 20 VS % Premenstrual % 20 dysphoric 0/0 2.3.2008.
  1. Pre menstrual syndrome. Jason’s Tribute ideas of life an international women holistic health resource File; // G:\ Premenstrual Syndrome.htm.1-8.
  2. Mortole Study of menstrual pattern of college girls of Poona. Indian Journal of obstetric and gynecology 1986; 161 (6) : 1682- 1687.
  3. Pre Menstrual Syndrome. American Family Physician 2003 ; 67( 8): 1743-52.
  4. Premenstrual Obstetric and Gynecology Clinics of North America 1990;17(2): 457-469.
  5. Abraham Menstruation, menstrual protection and menstrual cycle problems. The Medical Journal of Australia 1985;142: 247-251.
  6. Amonda Lifting the curse. Nursing times 1987;83 (18): 50-51.
  7. Hystrectomy & Bilateral oophorectomy for sever PMs Hormone Reproduction 19 (9):2152-2155.