A STUDY TO ASSESS THE EFFECTIVENESS OF JACOBSON PROGRESSIVE MUSCLE RELAXATION EXERCISE ON PREMENSTRUAL SYNDROME AMONG WOMEN ATTENDING GYNAECOLOGY OPD
IN KG HOSPITAL, COIMBATORE.
By
ANEESHA.V.B
A Dissertation submitted to the Tamil Nadu Dr. M.G.R. Medical University, Chennai, in partial fulfillment of requirement for the Degree of
MASTER OF SCIENCE IN NURSING
APRIL 2011
A STUDY TO ASSESS THE EFFECTIVENESS OF JACOBSON PROGRESSIVE MUSCLE RELAXATION EXERCISE ON PREMENSTRUAL SYNDROME AMONG WOMEN
ATTENDING GYNAECOLOGY OPD IN KG HOSPITAL, COIMBATORE.
A STUDY TO ASSESS THE EFFECTIVENESS OF JACOBSON PROGRESSIVE MUSCLE RELAXATION EXERCISE ON PREMENSTRUAL SYNDROME AMONG WOMEN
ATTENDING GYNAECOLOGY OPD IN KG HOSPITAL, COIMBATORE.
By
ANEESHA.V.B
A Dissertation submitted to the Tamil Nadu Dr. M.G.R. Medical University, Chennai, in partial fulfillment of requirement for the Degree of
MASTER OF SCIENCE IN NURSING
APRIL 2011
INTERNAL EXAMINER EXTERNAL EXAMINER
A STUDY TO ASSESS THE EFFECTIVENESS OF JACOBSON PROGRESSIVE MUSCLE RELAXATION EXERCISE ON PREMENSTRUAL SYNDROME AMONG WOMEN
ATTENDING GYNAECOLOGY OPD IN KG HOSPITAL, COIMBATORE.
CERTIFICATE
Certified that this is the bonafide work of ANEESHA.V.B of K.G.
College of Nursing, Coimbatore, submitted in partial fulfillment of the requirement for the Degree of Master of Science in Nursing to the Tamilnadu Dr. M.G.R.
Medical University under the Registration No: 30096421
Mrs. Vaijayanthi Mohan Das, Prof. (Mrs.) Sonia Das,
Director of Education, Principal, K.G. College of Health Sciences, K.G. College of Nursing,
Coimbatore. Coimbatore.
Approved by the Dissertation Committee on: 9.4. 2010
________________
Prof.( Mrs.) SHEEBA.R,
HOD, Obstetrics and Gynaecological Nursing, K.G. College of Nursing,
Coimbatore-641018
________________
Dr. (Mrs.) CHANDRAKALA MARAN, Chief Obstetrician and Gynaecologist, K.G. Hospital,
Coimbatore-641018
_________________
Prof.( Mr.) SUBRAMANIAN.K,
Department of Bio- Statistics and Research, K.G. College of Nursing,
Coimbatore-641018
A Dissertation submitted to The Tamil Nadu Dr. M.G.R. Medical University, Chennai, in partial fulfillment of requirement for the Degree of
MASTER OF SCIENCE IN NURSING
APRIL 2011
A STUDY TO ASSESS THE EFFECTIVENESS OF JACOBSON PROGRESSIVE MUSCLE RELAXATION EXERCISE ON PREMENSTRUAL SYNDROME AMONG WOMEN
ATTENDING GYNAECOLOGY OPD IN KG HOSPITAL, COIMBATORE.
ACKNOWLEDGEMENT
“ I Praise and thank God for his abundant blessings, Constant love and guidance”
With a profound sense of gratitude I praise and thank God Almighty for his constant help and blessings showered upon me throughout this study.
The essence of all beautiful art, all great art, is gratitude. Gratitude can never be expressed in words but this is only deep perception, which makes the words to flow from ones inner heart.
With a profound sense of gratitude, I praise and thank God Almighty for his constant help and blessings showered upon me throughout this study.
I am grateful to our honorable Chairman, Padma shri Dr. G. BAKTHAVATHSALAM, Chairman, K. G. Hospital, who gave me
this opportunity to utilize the facilities in this reputed institution.
I express my sincere, respectful and whole hearted gratitude to Mrs. VAIJAYANTHI MOHANDAS, Director of Education, K.G.
College of Health Sciences for her efficient guidance, encouragement and valuable suggestions, which helped me to lay strong foundation of this study.
It is my pleasure and privilege to express my deep sense of gratitude to Prof. (Mrs.) SONIA DAS, Principal, K.G. College of Nursing for her encouragement, inspirations and support as well as for providing all facilities for successful completion of this study.
I express my sincere gratitude to Prof. RAJI.K, Vice Principal and HOD, Medical Surgical Nursing, K.G. College of Nursing for her encouragement, inspirations and support for successful completion of this study.
My sincere and heartfelt thanks to, Prof. (Mrs.)SHEEBA.R, HOD, Obstetrics and Gynaecological Nursing, K.G. College of Nursing for her timely support, expert opinion and encouragement which helped in the successful completion of this study.
I express my sincere thanks and profound gratitude to Dr.(Mrs.)CHANDRAKALA MARAN, Chief Obstetrician and Gynaecologist, K.G. Hospital, for her excellent guidance and motivation in all matters large and small, since the inception of the study.
My special thanks and gratitude to Prof.( Mr.)SUBRAMANIAN.K, Professor in Biostatistics and Research , who gave me excellent ideas in statistical analysis and a positive approach to make the whole project in a good shape.
I submit my sincere thanks to Prof.(Mrs.)SOFIA CHIRSTOPHER, Class coordinator and HOD,Community Health Nursing, for her patience, affectionate, moral support and guidance throughout my study.
I express my sincere gratitude to Prof.(Mrs.) VIJAYALAKSHMI, HOD, Child Health Nursing, Prof. (Mrs.) TAMIL SELVI, HOD, Psychiatric Health Nursing.
I honestly express my thanks to ,( Mrs.) MUTHUKANNU, (Mrs.) VIMIJA. M, Associate Professors, (Mrs.)SANGEETHA, (Mrs.)DHANAPANDI,( Ms.)SANGEETHA Lectures, Department of Obstetrics and Gynaecological Nursing, K.G. College of Nursing, for their encouragement and guidance in the completion of this study.
I extend my special heartfelt thanks to all the experts, Dr. (Mrs.) ESTHER JOHN, Prof. (Mrs.) VIJAYALAKSHMI MOHANRAJ, Prof.(Mrs.)VIDHYA SESHAN, Prof.(Mrs.)JOHNSY SUNDARI, Prof( Mrs.) RENUKA, Prof. (Mrs.)SEENA, for validating the content of the tool and providing valuable suggestions.
My heartfelt thanks to all FACULTY MEMBERS of K.G. College of Nursing, for their guidance and encouragemet.
I am very grateful to Mrs. JOSEPHINE PRINCEY, English Lecturer, K.G. College of Nursing, for her valuable editorial support.
My special thanks to Prof. (Mrs.) SUSILA VICTOR, Lecturer, K.
G. College of Arts and Science , for her valuable editorial support.
A word of appreciation to Mr. KATHIR VADIVELU, chief Librarian of K.G. College of Health Sciences, for rendering his support and help in procuring the literature related to the study.
I would like to extend my deepest thanks to the PARTICIPANTS for their co-operation, without them it would have been impossible to complete the study.
Above all with grateful heart I express my love to my beloved HUSBAND, my MOTHER and my DAUGHTERS for their unconditional love, immense help, encouragement, care and supporting prayers.
My special heartfelt thanks to my FAMILY MEMBERS who skillfully, almost invisibly blended my inabilities in to a melody of inspiration.
I am extremely thankful to Mr.RANGARAJ, Krishna Xerox, Saravanampatti, who spent hours to work to prepare the script of this thesis.
My heartfelt thanks to my CLASSMATES AND JUNIORS who helped and supported me for the successful completion of this study.
I thank one and all who directly or indirectly helped in successful completion of this dissertation.
INDEX
CHAPTER CONTENT PAGE NO.
I INTRODUCTION 1-10
Need for the study 2-5
Statement of the problem 5
Objectives 5
Operational definitions 5-6
Assumptions 6 Hypothesis 6 Limitations 7
Projected outcome 7
Conceptual Framework 7-10
II REVIEW OF LITERATURE 11- 20
III METHODOLOGY 21-32
Introduction
Research approach 21
21
Research Design 21-22
Setting of the study 24
Variables 25-26
Population 27
Sample size 27
Sampling technique 28
Criteria for sample selection 28
Description of the tool 28-29
Content validity 30
Reliability 30
Pilot study 30
Method of data collection 31
Plan for data analysis 32
IV DATA ANALYSIS AND INTERPRETATION 33-55
V RESULTS AND DISCUSSION 56-60
VI SUMMARY,RECOMMENDATIONSAND
NURSING IMPLICATIONS OF THE STUDY 61-64 BIBLIOGRAPHY
APPENDICES
LIST OF TABLES
TABLE NO.
TITLE
PAGE NO.
1
2
3
4
5
6
7
8
9
Distribution of demographic variables among women with premenstrual syndrome in experimental and control group.
Distribution of menstrual variables among women with premenstrual syndrome in experimental and control group.
Distribution of intensity of premenstrual syndrome pre test and post test scores among women in experimental and control group.
Comparison of pre test and post test scores of premenstrual syndrome among women in experimental group.
Comparison of intensity of premenstrual syndrome among women in experimental group and control group.
Association of intensity of premenstrual syndrome among women with selected demographic variables in experimental group.
Association of intensity of premenstrual syndrome among women with selected menstrual variables in experimental group.
Association of intensity of premenstrual syndrome among women with selected demographic variables in control group.
Association of intensity of premenstrual syndrome among women with selected menstrual variables in control group.
35-36 40-41
44
46
47
48
50
52
54
LIST OF FIGURES
FIGURE NO.
TITLE PAGE NO.
1.
2.
3.
4.
5.
6.
Conceptual framework
The schematic representation of study design Relationship of Variables
Diagram showing the distribution of demographic variables according to family birth order of women with premenstrual syndrome in experimental group and control group.
Diagram showing the distribution of menstrual variables according to the duration of menstruation of women with premenstrual syndrome in experimental group and control group.
Diagram showing the distribution of intensity of premenstrual syndrome pre test and post test score among women in experimental group and control group.
10 23 26
39
43
45
LIST OF APPENDICES
APPENDIX
TITLE
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
Letter seeking permission for conducting the study Letter granting permission for conducting the study Letter seeking experts opinion for content validity of the tool
Format for content validity
List of experts for content validity
Certificate For Jacobson Progressive Muscle Relaxation Exercise.
Certificate For English Editing Certificate For Tamil editing.
Tool I -Section- A: Demographic variable.
Section- B: Menstrual variable.
Tool II – Modified COPE (Calendar of premenstrual experiences) four point Likert scale.
(English and Tamil)
Procedure of Jacobson progressive muscle relaxation exercise
CHAPTER -1 INTRODUCTION
“One day she is in all smiles and happiness then, the another day there will be no living with her, she flies into a rage.”
- Greek Poet
Menstruation is the visible manifestation of cyclic physiologic uterine bleeding due to shedding of the endometrium. In majority, apart from bleeding per vagina, there may be premonitory symptoms such as pelvic discomfort, backache, fullness of breast, mastalgia, headache or depression just prior to menstruation. If these premonitory symptoms are predominant, these are grouped into a syndrome called premenstrual syndrome (D.C. Dutta, 2007).
Premenstrual syndrome is a collection of physical, psychological, and emotional symptoms related to one’s menstrual cycle.
30-40% women suffer some impairment of daily activities , 75% has mild symptom and 3-8% has severe premenstrual syndrome. An estimated 3 of every 4 menstruating women experience mild form of premenstrual syndrome. These problems tend to peak in the late 20s and early 30s (Mayo clinic, 2009).
Pre menstrual syndrome is reported in women of all culture all over the world. In a survey of women,88% reported moderate to severe premenstrual symptoms. Premenstrual signs and symptoms usually occur about one week before a woman’s period starts and disappear soon as her period begins. The signs and symptoms disable a woman in some
ways and disrupt her day to day activities (American Psychiatric Association, 2003).
More than 80% treatment have been proposed for alleviating the symptoms of Premenstrual syndrome but no treatment has been found to be consistently effective. Treatments include diuretics, prostaglandin inhibitors, progesterone inhibitors, ovulation inhibitors, vitamins, lithium and antidepressants. It also includes life style measures like charting of symptoms daily diet restriction(salt, carbohydrate, caffeine, chocolate, alcohol) exercise, stress management, yoga, progressive muscle relaxation, relationship skills, self groups and education.
Pharmacotherapy may be initiated only when these measures have failed (Women’s Health, 2002).
Jacobson Progressive Muscle Relaxation exercise is one of the relaxation techniques. It is a systematic tensing and relaxing of each muscle groups starting from head to toe. The advantages of this relaxation exercise includes, it reduces anxiety and pain, promotes sleep, decrease fatigue and skeletal muscle tension, increases confidence and ability to handle pain (Stout. A.L, 2008).
NEED FOR THE STUDY
Premenstrual syndrome is an entity that causes considerable morbidity, in about 3% of the women, it may disrupt the woman's life when severe symptoms recur. Many women have premenstrual cyclic symptoms of psychological or physical nature and sometimes these limit their functional capacity. The symptoms due to neurohormonal imbalance or ageing may start as early as 35 years of age. The prevalence of
premenstrual syndrome in general is about 2-10% for disabling symptoms, while minor symptoms present up to 80% of women. In the present series, a high prevalence of premenstrual syndrome was observed in premenopausal women. A recent survey of 3,913 women of 15-54 years of age have premenstrual syndrome (J.V Joshi, S. N Pandey, 2010).
A cross sectional community survey was conducted among the women in 25-40yrs age group. Among the subjects surveyed 75.8%was recorded to be having problem related to menstruation. Physical problem were present in 32(35.2%) and psychological problem in 5(55%) where as 32 (35.2%) had both physical and psychological problems. Most common physical problem was abdominal pain (49.5% ) and backache(41.8%) and the most common psychological problem was the desire to be alone (18.7%) and depression(17.6%).Intolerable abdominal pain and backache were reported by 15(16.5%) and 10(11%) subject respectively (M. Arunkumar, Walia, 2003) .
Pre menstrual syndrome is a combination of physical and psychological symptoms seen among women in reproductive age, in their 30 years or older. Symptom occur in luteal phase with resolution within one or two days of onset of menses. The management of premenstrual syndrome include simple measures like Jacobson progressive muscle exercise, dietary changes and vitamin supplementation. Pharmacological agents may be useful in selected clients, support and counseling is of paramount importance in management of premenstrual syndrome. Nurses can manage woman who have minor physiological and emotional changes associated with a mild degree of pre menstrual syndrome.
Women with severe and moderate symptoms should be referred for evaluation and follow up (Hsia and Hong, 2008).
A study was conducted on relaxation intervention used for the
treatment of pain in adults. Based on the type of relaxation interventions (Progressive muscle relaxation exercise, autogenic training, jaw relaxation, rhythmic breathing and other relaxation exercises) and summarized with respect to various study characteristics and results, the most frequently used support technique was Jacobson progressive muscle relaxation exercise particularly for premenstrual pain ( Kristine. L.
K 2006).
Jacobson progressive muscle relaxation can be used effectively in alleviating premenstrual syndrome physical symptoms such as fatigue, sleeplessness, dizziness, headaches, breast tenderness and swelling, back pain, abdominal pain and bloating, muscle cramps and behavioral symptoms such as food cravings, irritability, anger, depressed mood, crying and tearfulness, anxiety, tension, mood swings, lack of concentration, confusion, forgetfulness, loneliness, tension (Krishna Seshadri,2006).
Studies showed that yoga, exercise and relaxation therapy are effective to reduce premenstrual syndrome. It will be highly beneficial to implement this approach to those who are having premenstrual syndrome.
So the researcher had the interest in Jacobson progressive muscle relaxation exercise in reduction of premenstrual syndrome and selected as research topic. If practiced properly it will be highly beneficial for the women suffering from premenstrual syndrome.
STATEMENT OF THE PROBLEM
A Study To Assess The Effectiveness Of Jacobson Progressive Muscle Relaxation Exercise On Premenstrual Syndrome Among Women Attending Gynaecology OPD in K.G. Hospital, Coimbatore.
OBJECTIVES
1. To assess the intensity of premenstrual syndrome of the women in experimental and control group.
2. To provide Jacobson progressive muscle relaxation exercise to women in experimental group.
3. To assess the effectiveness of Jacobson progressive muscle relaxation exercise on premenstrual syndrome among women in the experimental group.
4. To compare the intensity of premenstrual syndrome among women in both experimental and control group.
5. To associate the findings with selected demographic variables and menstrual variables.
OPERATIONAL DEFINITIONS
Effectiveness
Effectiveness refers to the reduction in the intensity of premenstrual syndrome experienced by women after providing Jacobson progressive muscle relaxation exercise.
Premenstrual syndrome
Premenstrual syndrome is a physical, psychological and behavioural symptoms that occur two weeks prior to menstruation.
Jacobson progressive muscle relaxation exercise
Jacobson Progressive muscle relaxation is a relaxation techniquein which the patient first tenses and then relaxes major muscle groups of the body in a pre-fixed and systematic order, usually beginning at the top of the body and progressing downwards up to feet.
Women
Women in reproductive age group of 20-45 years.
ASSUMPTIONS.
1. Women experience pre menstrual syndrome two weeks prior to menstruation.
2. Jacobson progressive muscle relaxation exercise is a means of relaxation and decreases pre menstrual syndrome.
3. Most of the women are unaware of regarding Jacobson progressive muscle relaxation exercise.
HYPOTHESIS
There is a significant difference in premenstrual syndrome among women following Jacobson progressive muscle relaxation exercise and in women not following the exercise
LIMITATIONS
The study is limited to
• Women attending Gynaecology OPD in K.G . Hospital, Coimbatore.
• Women in reproductive age group of 20-45 years.
• Women who are able to understand Tamil and English.
• Women who have regular menstrual period
• Women not having medical and surgical problems.
PROJECTED OUTCOMES
• The findings of the study will identify the need and effectiveness of simple non pharmacological measures of reducing pre menstrual syndrome such as Jacobson progressive muscle relaxation exercise.
• The findings of the study will help in relaxation, comfort, reduction of premenstrual syndrome in women without any complications.
CONCEPTUAL FRAMEWORK
This study was aimed at determining the effectiveness of Jacobson Progressive Muscle Relaxation Exercise in reduction of premenstrual syndrome.
The investigator adopted “J.W. Kenny’s open system model ” as a basis for conceptual framework. According to J.W. Kenny’s, all living system are open and they are in continuous exchange of matter, energy and information, which results in varying degree of interaction with the environment from which the system receives input and gives back output in the form of matter energy and information. System model consists of three phases input, through put and output.
Input
Based on J.W .Kenny’s open system model input can be a matter, energy and information that enter into the system from the environment through its boundaries.
In this study input refers to the information needed by the system and collecting history from the experimental and control group.
Throughput process
The process that allows the input to be changed so that it is useful to the system. Through put is the operation phase or manipulation and activity phase.
In this study, the throughput is the process of evaluating the effectiveness of Jacobson Progressive Muscle Relaxation Exercise by COPE(Calendar of premenstrual experiences) four point Likert scale. For experimental group Jacobson Progressive Muscle Relaxation Exercise is provided and for control group routine care is given.
Output
Output is any information that leaves the system and enters the environment through system boundaries. It refers to the ultimate results, which are expected following program implementation.
In this study output is the difference in the intensity of premenstrual syndrome between experimental and control group.
Feed back
Feedback is the result of through put, it allows the system to be rectified as part of the input of the same system.
According to the theorist, feedback is the information of environment responses to the system. Output is utilized by the system in adjustment, correction and accommodation to the interaction with the environment.
The effectiveness of Jacobson progressive muscle relaxation exercise in reducing the intensity of premenstrual syndrome is considered as the difference observed and expected. For the present study feedback is not included.
10
INPUT
O THROUGH PUT
(PROCESS) Collection of
demographic data and menstrual data from both
experimental&control group of women having pre menstrual syndrome
Assessment of intensity of pre menstrual syndrome in experimental and control group using modified COPE four point likert scale
To evaluate the
effectiveness of Jacobson progressive muscle relaxation exercise by checking pre menstrual syndrome score.
Experimental group Providing Jacobson progressive
muscle relaxation exercise Control group Routine care given
Effectivenes Jacobson progr muscle relax exercise in red of intensity o menstrual syn by Modified C four point liker CLINICAL SET UP
CLINICAL SET UP
---not included in this study
FIGURE – 1
CONCEPTUAL FRAMEWORK BASED ON MODIFIED J.W. KENNY’S OPE
10
CHAPTER II
REVIEW OF LITERATURE
Review of literature is a written summary of the state of an art of a research problem. It helps the researcher to familiarize themselves with the knowledge base. It includes the activities involved in identifying and searching comprehensive picture of a state of knowledge on that topic ( Polit and Hungler 2009).
Woman with pre menstrual syndrome can suffer from all of the most common signs and symptoms. Breast pain and tenderness, bloating, backache, painful thighs, mood swings, irritability, loss of control, headache, nausea, vomiting, diarrhea, tearfulness, outbursts, depression, anxiety, fatigue, weakness, dizziness. Some women can become isolated and withdrawn because of these symptoms ( Dorrisnoel, Klinger,2002).
SECTION A
:
Studies related to prevalence and perception of premenstrual syndrome.SECTION B
:
Studies related to management of premenstrual syndrome.SECTIONC
:
Studies related to relaxation techniques on premenstrual syndrome.SECTION D
:
Studies related to Jacobson progressive muscle relaxation exercise in premenstrual syndrome.SECTION A: STUDIES RELATED TO PREVALENCE AND PERCEPTION OF PREMENSTRUAL SYNDROME.
A qualitative research was conducted to study the prevalence of premenstrual syndrome among 300 female BSc nursing students between 17-25 years of age from selected nursing colleges in Mangalore. The findings revealed that majority(55%) were in age group of 20-22 years. The prevalence of premenstrual syndrome based on ICD-10 diagnostic criteria was found to be 13.33%. Based on premenstrual syndrome scale the majority (76%) of samples had premenstrual syndrome as mild,15% as moderate, 7% as severe and 2 % of subjects reported to have no impairment. There was significant association between the prevalence of premenstrual syndrome and variables like age and performing relaxation technique (Mathias. J, 2007).
A study was conducted on prevalence and impact of premenstrual syndrome in 700 college women aged 20-25 years in Al-An city. Subjects were interviewed about cyclic and recurrent behavioral and premenstrual symptoms using a structured and validated questionnaire. The prevalence of premenstrual syndrome was 16.4%.Only 52 affected subjects(45.2%)were currently taking treatment for premenstrual syndrome and majority (60%) used pharmacological therapy. Premenstrual syndrome had a moderate but significant impact (p=0.001) on quality of life, social interaction, lifestyle and emotional wellbeing. Difficulty in performing daily functions and decrease in stigma were the two most adversely affected parameters ( Ritz. D. E. et al., 2006).
A study was conducted on the prevalence and frequency of symptoms of premenstrual syndrome in female undergraduate students of university of Calabar. A survey of 200 nulliparous subjects aged between 16 and 31 years revealed that 83.5% of them regularly experienced symptoms suggestive of premenstrual syndrome .The commonest symptom were lower abdominal pain, pimples, puffy face, tender or painfully engorged breast and depression or tension.
The least frequent symptom were backache and common cold.42% of subjects complained of severe abdominal pain. There was an association between severity of abdominal discomfort and symptoms experienced by subjects (Diana. C. Dell, 2004).
A study was conducted on prevalence and prediction of premenstrual syndrome among college aged women in Saudi Arabia , using a self report questionnaire (n=464). At least one premenstrual symptom was experienced by 448 women(96.61%)and 176 (37.5%) had a high symptom severity score.
Premenstrual symptom frequency was significantly associated with menstrual history, self perception of mental stress, physical activity, consumption of sweet tasting foods and coffee (Rasheed. R, et al., 2003).
The comparative study was conducted to measure the effect of menstrual cycle phase on personality variables in women with and without premenstrual syndrome. The personality diagnostic questionnaire revised was administered in both the follicular and luteal phases to women with premenstrual syndrome(n=40). An appropriate control group(n=20) also completed the questionnaire in both phases. Only women with premenstrual syndrome
demonstrated a significant increase in total personality diagnostic questionnaire revised score from the follicular to the luteal phase. Women with premenstrual syndrome had significantly higher total personality diagnostic questionnaire revised scores than the asymptomatic controls during the follicular and luteal phases (Berlin, R. et al., 2001).
SECTION B: STUDIES RELATED TO MANAGEMENT OF PREMENSTRUAL SYNDROME
A study was conducted to compare the efficiency of Vitrex agnus castor fruit with placebo for women with the premenstrual syndrome in China. Eligible patients were randomly assigned into vitrex agnus castor fruit or placebo group.
Symptoms were documented with a daily rating scale with four symptom factors (negative affect, water retention, food cravings and pain). Sixty-seven patients were enrolled and randomly assigned to receive one tablet of vitrex agnus castor fruit or placebo once a day. All the four symptom factor scores were significantly reduced by the 3rd treatment cycle. Premenstrual syndrome sum scores decreased 60% ,the efficacy rate in treatment group was significantly higher than that in placebo group at the 3rd treatment cycle. Vitex agnus castor extract shows effective in treating moderate to severe premenstrual syndrome in especially in symptoms of negative affect and water retention ( Lin. S, et al., 2010).
A qualitative study was conducted in Institute of Psychological Sciences, UK among women aged 18-45 years with regular menstrual cycles who were prospectively diagnosed with mild premenstrual syndrome. Women who were eligible after three screening cycles (n = 36) underwent a two-cycle placebo run-in phase. They were randomly assigned to receive Hypericum
perforatum (St John’s wort) tablets 900 mg/day or identical placebo tablets for two menstrual cycles. After a placebo-treated cycle, the women crossed over to receive placebo or Hypericum perforatum for two additional cycles. Symptoms were rated throughout the trial using the Daily Symptom Report. There was a significant reduction in premenstrual syndrome among women receiving Hypericum perforatum than placebo ( Orsi. N, et al., 2007).
A case control study was conducted on calcium and vitamin D intake and risk of incident premenstrual syndrome in Amherst among women aged 27-44 years. Intake of calcium and vitamin D was measured by a food questionnaire.
After adjustment for age, parity, and other risk factors, women in highest quintile of total vitamin D intake had a relative risk of 6.59 compared with those in the lowest quintile. The intake of calcium from food sources was also inversely related to premenstrual syndrome; compared with women with a low intake. The intake of low fat milk was also associated with a lower risk (p<0.001). A high intake of calcium and vitamin D reduce the risk of premenstrual syndrome (Johnson. E. R, Berton. et al., 2005).
A study was conducted to assess the efficiency of homeopathic treatment in reducing symptom associated with premenstrual syndrome in Hadassah hospital, Jerusalem. A sample of 20 women aged 20-48 years with premenstrual syndrome were treated randomly with one oral dose of a homeopathic medication or placebo. The subjects completed menstrual distress questionnaire before and after the treatment. The results revealed that improvement of more than 30% was observed in 90% patients receiving active treatment and 37.5% receiving placebo (p=0.048). Homeopathic treatment was found to be
effective in alleviating the symptoms of premenstrual syndrome on comparison to placebo (Yakir. et al., 2003).
A qualitative study was conducted in The clinical research centre, Cambridge, USA regarding the consumption of carbohydrate-rich beverage to alleviate negative mood symptoms and food cravings in women with severe premenstrual syndrome. Subjects (n =53) completed daily symptom ratings of mood and food cravings for two baseline menstrual cycles. Subjects were randomized to isocaloric active or placebo beverage groups after baseline. Active powder contained complex and simple carbohydrates and the placebo was sucrose, gelatin, vitamins flavorings and citric acid. The powder was mixed with fluid and taken twice daily for the 5 days preceding anticipated menstruation. Mean age of the sample was 36 years(22-46years). Outcome was measured with daily symptom ratings and The Profile of Mood States. Premenstrual consumption of the carbohydrate-rich beverage reduced mood symptoms for approximately one third of women, in comparison to those consuming placebo (E.W. Freeman, A. L.
Stout, et al., 2002).
A comparative clinical trial was conducted to evaluate the efficiency of bromocriptine over placebo in management of premenstrual syndrome in GSVM Medical College, Kanpur. A sample of 15 women with severe premenstrual syndrome participated in a 6 month study which included 2 months of control cycle followed by bromocriptine 2.5 mg/day or placebo for next 4 months.
Symptoms were evaluated using the calendar of premenstrual experiences. The results showed that bromocriptine was effective in managing premenstrual
syndrome symptoms specially mastidynia and fluid and electrolyte symptoms like water retention and edema than placebo (Singh, V.K. 2002).
A study was conducted on using acupuncture to treat premenstrual syndrome in Croatia. More than 60% of the women in both groups suffered from premenstrual symptoms such as anxiety, mastalgia, insomnia, nausea, gastrointestinal disorders, where as smaller number of women suffered from phobic disorders, premenstrual headache and migrains. There were 3 women from the first group and 7 women from the second group who continued the medication treatment with fluoxetine. In the first group 9 women having premenstrual syndrome symptoms stopped taking acupuncture, after 2 treatments, 8 women stopped taking acupuncture after 3 treatments and one women stopped taking acupuncture after 4 treatments. The success rate of acupuncture in treating premenstrual symptoms was 77.8%,where as it was 5.9% in the placebo group (Habek. D, et al., 2002).
SECTION C: STUDIES RELATED TO RELAXATION TECHNIQUES ON PREMENSTRUAL SYNDROME.
A qualitative study was conducted on 50 clinically healthy women volunteers who were in their premenstrual period. Thirty women having premenstrual syndrome were compared with twenty control women to evaluate 1 week training of 61-points relaxation yogic exercise. In both the groups cold pressor test was performed, systolic blood pressure , diastolic blood pressure and heart rate were measured. Basal systolic blood pressure, diastolic blood pressure
& heart rate of women with premenstrual syndrome was significantly higher than the control subjects suggesting the presence of stress in women with premenstrual syndrome. Following 1 week of 61-points relaxation training, the control group showed a significant decline in systolic blood pressure, diastolic blood pressure and heart rate respectively, the premenstrual syndrome group showed a significant reduction in systolic blood pressure, diastolic blood pressure and heart rate, immediately after cold pressor test. These results suggest a reduction in sympathetic activity by 61-points relaxation training and it can be used as an effective relaxation tool during premenstrual stress (Dvivedi J, Kaur H, 2009).
A comparative study was conducted to find out whether premenstrual symptoms were relieved by massage therapy in Touch research institute, USA. 24 women were randomly assigned to a massage therapy or a relaxation therapy group. The massage therapy group showed decrease in anxiety, depressed mood and pain immediately after the first and last massage sessions. The longer term (5 week) effects of massage therapy included a reduction in pain and water retention and overall menstrual distress. The study findings suggest that massage therapy is an effective adjuvant therapy for treating severe premenstrual symptoms ( Reif.
M. H, et al., 2007).
SECTION D: STUDIES RELATED TO JACOBSON PROGRESSIVE MUSCLE RELAXATION EXERCISE IN PREMENSTRUAL SYNDROME
A quantitative study was conducted in the Oozhiasthanam Teacher Training Institute, Tirunelveli district among women aged 20-25 years and were screened for premenstrual syndrome using a rating scale. 30 eligible women were recruited in the experimental group. Jacobson progressive muscle relaxation
exercise was taught to the experimental group with the help of video CD and each participant was advised to do, twice daily for 4 weeks. The investigator checked the performance every day. Post test was conducted after 28 days after the administration of Jacobson progressive muscle relaxation exercise . There was a significant reduction in premenstrual syndrome (p< 0.05). Jacobson progressive muscle relaxation exercise was effective in reducing premenstrual syndrome among college women. (Lindsie Mary. l, Tamilmani. R, 2009).
A qualitative study was conducted among six female subjects who were between 31-44 years of age attended a pre menstrual syndrome clinic and participated in a group therapy program designed to alleviate their pre menstrual symptoms. Rational-emotive therapy and Jacobson progressive muscle relaxation exercise were offered in an effort to alleviate severe psychological symptoms. Pre treatment assessments were carried out using Moods Menstrual distress Questionnaire. Significant differences were found in a number of psychological and physical symptoms of menstrual distress, in cognitive functioning and neuroticism, following the combined group therapy (Micheal .E, Bernard. L, 2009).
A study was conducted on relaxation in women with premenstrual syndrome in 107 women compared with three interventions: progressive muscle relaxation exercise, reading leisure material, and charting. Participants in the relaxation response group received tape instructions on relaxation of all muscles to elicit the relaxation response. The first trial found evidence that relaxation response (15–20 minutes twice daily for 3 cycles) significantly improved physical symptoms at 5 months compared with reading leisure material or charting
symptoms. In women with severe premenstrual symptoms, relaxation response also improved emotional symptoms and social withdrawal symptoms compared with reading leisure material or charting symptoms (Irene Kwan, Joseph Loze Onwude 2009).
Women with mild premenstrual syndrome may not need any medication, if the symptoms are severe and causing discomfort some drugs, like antidepressants are used to reduce premenstrual syndrome. For mild premenstrual syndrome, some dietary changes like avoiding salty foods, caffeine and alcohol, eating fresh fruits and vegetables, having small but frequent meals, increasing calcium intakes, and taking multivitamin supplements can help in curbing the premenstrual syndrome. Incorporating exercise in the daily routine like walking, cycling, swimming, etc. getting plenty of sleep, and practicing Jacobson progressive muscle relaxation to reduce stress and help to control the premenstrual syndrome and lead a regular life (Kanika Khara, 2009).
A study was conducted among thirty healthy college women with regular menstrual cycles for 3 months in Duke University, North Carolina. The subjects completed the Menstrual Distress Questionnaire (MDQ) at the beginning and end of the study, recorded their menstrual cycles for 3 months on an investigator-developed calendar recording sheet. Subjects were then given an audiotape with a Jacobson progressive muscle relaxation exercise. The total premenstrual distress scores declined significantly, as did the subscales measuring behavior and negative affect (Groer. M, et al., 2008).
CHAPTER III
RESEARCH METHODOLOGY
INTRODUCTION
Research methodology is the techniques used to structure a study and to gather and analyze information in a systematic fashion (Polit and Beck, 2007).
In this section, following topics are discussed in relation to methodology adopted by the investigator. It includes the description of research design, setting of the study, variables, population, sample size, sampling technique and sample selection criteria, description of the tool, content validity, reliability, pilot study, method of data collection and plan for data analysis.
RESEARCH APPROACH
In this present study the researcher had adopted quantitative approach.
RESEARCH DESIGN
Quasi experimental research design was adopted in this study. The investigator assigned the participants in two groups namely experimental and control groups and introduced the experimental subjects to Jacobson progressive muscle relaxation exercise and routine care given to control group to reduce pre menstrual syndrome. Effectiveness was measured through Modified COPE (calendar of premenstrual experiences) by four point Likert scale.
Experimental group: O1 X O2
Control group : O3 - O4
O1 -Pre test score of intensity of premenstrual syndrome in experimental group
X – Jacobson progressive muscle relaxation exercise
O2 - Post test score of intensity of premenstrual syndrome in experimental group
O3- Pre test score of intensity of premenstrual syndrome in control group O4- Post test score of intensity of premenstrual syndrome in control group
FIGURE-2
SCHEMATIC REPRESENTATION OF RESEARCH DESIGN
Quasi- Experimental study research design Quantitative approach
Study Setting: Gynaecology OPD, K.G.Hospital, Coimbatore
Target Population: Women attending Gynaecology OPD in, K.G.Hospital, Ciombatore.
Accessible Population: Women attending Gynaecology OPD having premenstrual syndrome as per inclusion criteria in K.G.Hospital, Coimbatore
Assessment of intensity of premenstrual syndrome Modified COPE by four point Likert scale.
Sample Size- 40(experimental group 20 and control group 20)
Assessment of effectiveness of Jacobson progressive muscle relaxation exercise, Modified COPE(calendar of premenstrual experiences) by Four point Likert scale.
Data Analysis and interpretation: Descriptive and inferential statistics
Experimental group Control group
Routine care Jacobson progressive muscle relaxation exercise
Study findings and conclusions Sampling Technique: Convenience Sampling technique
SETTING OF THE STUDY
Setting are the more specific places where data collection occurs (Polit and Beck, 2004).
The study was conducted in K.G.Hospital, Coimbatore, which is a 550 bedded multispeciality, NABH certified hospital. It is situated in the heart of Coimbatore City. The hospital is renowned for its excellent medical expertise, nursing care and quality of diagnostic services. The Obstetrics and Gynaecology department of K.G hospital is well staffed with two chief Gynaecologist,6 duty doctors and 12 staff nurses with twenty four hours services and emergency care. It offers advanced and affordable health care to the people. All the facilities are provided for conducting normal and instrumental delivery. The facilities include maternity wards, 4 outpatient departments, well equipped 3 labour rooms and one neonatal ICU and operation department for emergency management. There are about 1000 cases attending the out patient department per month and nearly 150 deliveries are conducting per month.
Out of these 150 deliveries, there are 50 cesarean deliveries.
The investigator selected this setting for the following reasons
• .Availability of study sample.
• Economic feasibility of conducting the study
VARIABLES
Variables are the measurable characteristics of a concept and consist of logical group of attributes (Polit and Beck, 2007).
Independent variable
Jacobson progressive muscle relaxation exercise.
Dependent variable
Premenstrual syndrome.
Influencing variables
Age, education, occupation, dietary pattern.
Extraneous variables
Support system, knowledge regarding alternative therapies.
FIGURE-3
RELATIONSHIP BETWEEN VARIABLES
Influencing variables Age, education,
occupation, dietary pattern.
Independent Variable
Jacobson progressive muscle relaxation exercise
Extraneous variables
Support system, knowledge regarding alternative therapies Dependent variable Premenstrual syndrome
POPULATION
Population represents the entire aggregation of cases that meet a designed set of criteria that are accessible to the researcher for a study and for which researcher is able to make generalizations (Polit and Beck, 2004).
Total population of the present study is 100. Target population is 50
SAMPLESIZE
Sample size was determined by using Mahajan formula and it follows allowable error method
Sample size (n) = 4pq/L2 4=Constant number
P=Percentage of population Q=100-p
L=Allowable errors
P=Target population/Total populationx100 P =50/I50x100=33
q =100-P=100-33=67 L= 15
n=4x33x67/15x15=39.3~40
According to this the researcher decided to have the sample size as 40 for study.
SAMPLING TECHNIQUE
Sampling technique is the process of selecting a subset of population in order to obtain information regarding a phenomenon in a way that represents the entire population. (Polit and beck, 2007).
Convenience sampling technique was used for the study. The investigator selected the persons who fulfilled the inclusion criteria formed for the study.
CRITERIA FOR SAMPLE SELECTION
Inclusion criteria
• Women having regular menstruation.
• Women who are willing to participate in the study.
• Women who are able to understand Tamil and English.
• Women attending Gynaecology OPD, K.G. Hospital, Coimbatore.
Exclusion criteria
• Women having medical and surgical problems
DESCRIPTION OF THE TOOL
The researcher developed the tool on the basis of objectives, hypothesis and extensive review of literature of the study. The following steps were adopted prior to the development of the tool. Review of literature provided adequate content for the tool presentation, personal experience of the investigator in clinical field and expert opinion from teachers of Obstetrics and Gynaecological department, were of extreme help in devising a tool. The tool was developed in English.
TOOL I
SECTION A- DEMOGRAPHIC VARIABLES
A self designed questionnaire developed by researcher herself which comprises of 10 items for obtaining demographic data of the mother through personal interview.
SECTION B- MENSTRUAL VARIABLES
It comprises of 10 items for obtaining menstrual data of the mother through personal interview.
TOOL II
SECTION C- MODIFIED COPE (calendar of premenstrual experiences)
• To assess the intensity of pre menstrual syndrome among women attending Gynaecology OPD.
• In order to assess the intensity of premenstrual syndrome, Modified COPE by four point Likert scale was used by the investigator. It consist of 22 items to rate the intensity of pre menstrual syndrome.
The items are scored as none, mild, moderate and severe on the scale.
Each subject is assessed according to the scorings.
The scoring system is divided into the following categories 0 = NONE
1-22 = MILD
23-44 = MODERATE 45-66 = SEVERE
CONTENT VALIDITY
Content validity is the degree to which the items in an instrument adequately represent the universe of content for concept being measured (Polit and Beck, 2004).
The tool was submitted to experts of the departments of Obstetrics and Gynaecological nursing .A criterion rating scale for validation of tool was developed. Experts were asked to give their opinions and suggestions about content of the tool.
RELIABILITY
Reliability of the tool was established by using split half technique.
It showed rhh = 0.9 and hence the tool was found to be reliable.
PILOT STUDY
Pilot study is the scale version, or trial done in preparation for main suitability, practicability, appropriateness and flexibility of the study and tool (Denise F. Polit, 2004).
The investigator conducted the pilot study in K.G. hospital, Coimbatore. For the pilot study, the investigator selected a total of 10 samples who were assigned to specific group (experimental group 5,control group 5). The study purpose was explained to the sample subjects. After the pilot study the researcher found the need for minor modification in demographic data, menstrual data, making required modifications in the tool. When analyzed, the results gave evidence that the tool was feasible.
After the pilot study, the investigator proceeded for the main study.
METHOD OF DATA COLLECTION
Data collection was done by using structured interview schedule. The researcher introduced herself and obtained an oral consent from the subjects to participate in the study. The data was collected by using a self designed questionnaire.
DESCRIPTION OF INTERVENTION
A written permission was obtained to conduct the study from the human ethical committee of K.G. hospital, Coimbatore. Data collection was done within the given period of 4 weeks. The investigator personally explained the purpose of the study and established good rapport with the women attending Gynaecology OPD and were screened for premenstrual syndrome using Modified COPE (calendar of premenstrual experiences) before giving the intervention and assured confidentiality.
The data was collected from the samples as follows,
The intensity of premenstrual syndrome was assessed in both experimental and control group by Modified COPE (Calendar of premenstrual experiences) four point Likert scale. After the pre test Jacobson progressive muscle relaxation exercise was given to the samples in experimental group, it was done twice daily for 20 minutes for one month.
Then the intensity of premenstrual syndrome was again assessed using the same scale in experimental group and control group after one month.
PLAN FOR DATA ANALYSIS
Data were planned to analyze on the basis of objectives and testing of hypothesis by using descriptive and inferential statistics.
Descriptive statistics were used to analyze the frequency, percentage, mean and standard deviation of the following.
• Demographic and menstrual variables of women.
• Intensity of pre menstrual syndrome
Inferential statistics was used to determine the relationship association and comparison to identify the differences.
• To compute the significance of difference between the pre test and post test scores of women in experimental group was by paired ‘t’
test
• To compare the effectiveness in experimental and control group was by ‘z’ test.
• To associate the selected demographic and menstrual variables with premenstrual syndrome level in both the groups by chi-square test.
CHAPTER IV
DATA ANALYSIS AND INTERPRETATION
Analysis is categorizing, ordering, manipulating and summarizing of data to obtain answers to research hypothesis and questions. This section deals with the analysis and interpretation of data collected from 40 women with premenstrual syndrome in K.G. Hospital, Coimbatore.
The findings based on descriptive and inferential statistical analysis are tabulated as following heading,
Table-1 Distribution of demographic variables among women with premenstrual syndrome in experimental and control group.
Table-2 Distribution of menstrual variables among women with premenstrual syndrome in experimental and control group.
Table-3 Distribution of intensity of premenstrual syndrome pre test and post test scores among women in experimental and control group.
Table-4 Comparison of intensity of premenstrual syndrome among women in experimental group and control group.
Table-5 Comparison of pre test and post test scores of premenstrual syndrome among women in experimental group.
Table-6 Association of intensity of premenstrual syndrome among women with selected demographic variables in experimental group.
Table-7 Association of intensity of premenstrual syndrome among women with selected menstrual variables in experimental group.
Table-8 Association of intensity of premenstrual syndrome among women with selected demographic variables in control group.
Table-9 Association of intensity of premenstrual syndrome among women with selected menstrual variables in control group.
TABLE- 1
DISTRIBUTION OF DEMOGRAPHIC VARIABLES AMONG WOMEN WITH PREMENSTRUAL SYNDROME IN
EXPERIMENTAL AND CONTROL GROUPS
Experimental group
Control group
S
No
Demographic variables
Number (n
1=20)
Percentage %
Number (n
2=20)
Percentage %
1 Age in years a)20-25 years b)26-30 years c)31-35 years d)36-40 years e)41-45 years
3 4 3 7 3
15 20 15 35 15
2 4 4 6 4
10 20 20 30 20 2 Education
a)Primary b)Secondary c)Graduate
3 7 10
15 35 50
2 9 9
10 45 45 3 Occupation
a)House wife b)Coolie c)Professional d)Business
7 1 10 2
35 5 50 10
6 2 9 3
30 10 15 45 4 Marital status
a)Married b)Unmarried
12 8
60 40
11 9
55 45
5 Habitation a)Rural b)urban c)Semi urban
2 9 9
10 45 45
1 10 9
5 10 45
6 Dietary pattern a)Vegetarian b)Non- vegetarian
6 14
30 70
5 15
15 75
7 Type of family a)Nuclear family b)Joint family
12 8
60 40 %
10 10
50 50 8 Family birth
order a)First b)Second
c)Third and above
11 6 3
55 30 15
10 5 5
50 25 15 9 Social support
a)Family b)Neighbors c)Friends d)Others
11 4 4 1
55 20 20 5
10 3 5 2
50 15 25 10 10 Sources of
health
information a)Newspaper b)Radio c)TV d)Internet
11 1 6 2
55 5 30 10
9 2 5 4
45 10 25 20
The above table showed that the distribution of demographic variables of women in both group.
According to age of the women in experimental group,3(15%) were between 20-25 years,4(20%) were between 26-30 years,3(15%) were between 31-35 years,7(35%) were between 36-40 years and 3(15%) were between 41-45 years. Considering the education 3(15%) had primary education, 7(35%) had secondary education and 10(50%) were graduates.
Considering the occupation of the woman, 7(35%) were house wife, 1(5%) was coolie, 10(50%) were professional and 2(10%) were business people in experimental group. In control group 6(30%) were housewife, 2(20%) were coolie, 9(45%) were professional and 3(15%) were business people.
With regard to marital status in experimental group 12(60%) were married and 8(40%) were unmarried. In control group 11(55%) were married and 9(45%) were unmarried.
Considering the habitation in experimental group 2(10%) were from rural, 9(45%) were from urban and 9(45%) were from semi urban. In control group 1(5%) was from rural, 10(50%) were from urban and 9(45%) were from semi urban.
Regarding the dietary pattern 6(30%) were vegetarian, 14(70%) were non vegetarian in experimental group. In control group 5(25%) were vegetarian, 15(75%) were non vegetarian.
Considering the type of family in experimental group 12(60%) were from nuclear family,8(40%) were from joint family. In control group 10(50%) were from nuclear family and 10(50%) were from joint family.
Considering the family birth order 11(55%) were first born,6(30%)were second born and 3(15%) were born third and above in experimental group. In control group 10(50%) were first born,5(25%) were second born and 5(25%) were born third and above.
Considering the social support 11(55%) got support from family, 4(20%) got support from neighbors, 4(20%) got support from friends and 1(5%) got support from others in experimental group. In control group 10(50%) got support from family, 3(15%) got support from neighbors, 5(25%) got support from friends and 2(10%) got support from others.
With regard to sources of health information in experimental group 11(55%)got information from newspaper,1(5%) got information from radio, 6(30%) got information from TV and 2(10%) got information from internet.
In control group 9(45%) got information from newspaper, 2(10%) got information from radio, 5(25%) got information from TV and 4(20%) got information from internet.
FIGURE – 4
DIAGRAM SHOWING THE DISTRIBUTION OF DEMOGRAPHIC VARIABLES AMONG WOMEN WITH PREMENSTRUAL SYNDROME IN EXPERIMENTAL AND CONTROL GROUPS
PERCENTAGE (%)
TABLE- 2
DISTRIBUTION OF MENSTRUAL VARIABLES AMONG WOMEN WITH PREMENSTRUAL SYNDROME IN
EXPERIMENTAL AND CONTROL GROUPS
Experimental
Group Control group
S
No
Menstrual variables
Number (n
1=20)
Percentage %
Number (n
2=20)
Percentage %
1 Parity a)One b)Two
c)Three & above
11 8 1
55 40 5
10 7 3
50 35 15
2 Pain during menstruation a)Yes
b)No
17 3
85 15
15 5
75 25 3 Duration of
menstruation a)2-3 days b)3-4 days c)5-6 days
6 10 4
30 50 20
5 8 7
25 40 35 4 Family history
of premenstrual syndrome
a)Yes
b)No 13
7
65 35
11 9
55 45
5
Food preference during
menstruation a) Vegetarian b) Non-
vegetarian
13 7
65 35
11 9
55 45
6 Awareness on JPMRE
a)Yes b)No
3 17
15 85
1 19
5 95
7 Any experience of JPMRE
a)Yes b)No
0 20
--- 100
0 20
--- 100
The above table showed that the distribution of menstrual variables of women in experimental and control groups.
With regard to parity 11(55%) had one child,8(40%) had two children and 1(5%) had three children in experimental group. In control group 10(50%) had one child,7(35%) had two children and 3(15%) had three children.
Considering pain during menstruation in experimental group 17 (85%) had pain during menstruation,3(15%) had no pain during menstruation. In
control group 15 (75%) had pain during menstruation and 5(25%) had no pain during menstruation.
Considering duration of menstruation 6(30%) had 2-3 days of menstruation,10 (50%) had 3-4 days of menstruation and 4 (20%) had 5-6 days menstruation in experimental group. In control group 5 (25%) had 2-3 days menstruation,8 (40%) had 4-5 days menstruation and 7 (35%) had 5-6 days menstruation.
Considering the family history of premenstrual syndrome 13(65%) had family history of premenstrual syndrome,7(35%) had no family history of premenstrual syndrome in experimental group. In control group 6(30%) had family history of premenstrual syndrome and 14(70%) had no family history of premenstrual syndrome.
With regard to food preference during menstruation in experimental group 13(65%) were vegetarian and 7(35%) were non vegetarian. In control group 11(55%) were vegetarian and 9(45%) were non vegetarian.
Considering the awareness on Jacobson progressive muscle relaxation exercise 3(15%) had awareness and 17(85%) had no awareness in experimental group. In control group 1(5%) had awareness 19 (95%) had no awareness on Jacobson progressive muscle relaxation exercise.
Considering the experience of Jacobson progressive muscle relaxation exercise in experimental group 20(100%) had no experience and in control group also 20(100%) had no experience of Jacobson progressive muscle relaxation exercise.
FIGURE-5
DIAGRAM SHOWING THE DISTRIBUTION OF MENSTRUAL VARIABLES AMONG WOMEN WITH PREMENSTRUAL SYNDROME IN EXPERIMENTAL AND CONTROL GROUPS
PERCENTAGE (%)
TABLE-3
DISTRIBUTION OF INTENSITY OF PREMENSTRUAL SYNDROME PRE TEST AND POST TEST SCORES AMONG WOMEN IN EXPERIMENTAL AND
CONTROL GROUP n=40
In control group, during the pretest, 17(85%) had moderate premenstrual syndrome, 3(15%) had severe premenstrual syndrome and no one had mild premenstrual syndrome. During the posttest 14(70%) had moderate premenstrual syndrome, 6(30%) had severe premenstrual syndrome and no one had mild premenstrual syndrome.
Experimental group control group Pre test
score
Post test score
Pre test score
Post test score
S No
PMS scores
NO % NO % NO % NO %
1
2
3
Mild
Moderate
Severe
---
15
5
----
75
25
15
5
---
75
25
---
---
17
3
---
85
15
---
14
6
---
70
30
From the table In experimental group, during the pretest, 15(75%) had moderate premenstrual syndrome, 5(25%) had severe premenstrual syndrome and no one had mild premenstrual syndrome. During the posttest 15(75%) had mild premenstrual syndrome, 5(25%) had moderate premenstrual syndrome.
FIGURE-6
DIAGRAM SHOWING THE DISTRIBUTION OF INTENSITY OF PREMENSTRUAL SYNDROME AMONG WOMEN IN EXPERIMENTAL AND CONTROL GROUP
PERCENTAGE (%)
TABLE- 4
COMPARISON OF PRE TEST AND POST TEST SCORES OF PREMENSTRUAL SYNDROME AMONG WOMEN IN
EXPERIMENTAL GROUP
n=20
S No
Premenstrual syndrome scores
Mean
SDCalculated value of ‘ t’
Tabulated value of ‘t’
at 5% level of
significance
1 Pre test score 40.95 4.5
2 Post test score 20.65 3.47
4.403 2.093
From the above table
The calculated value of‘t’ (4.403) is greater than the tabulated value of‘t’
(2.093) at 5 % level of significance. The null hypothesis is rejected. It is concluded that there is a significant difference between the pre test and post test scores among women in experimental group.
TABLE- 5
