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Chen CX, Rogers SK, Li R, Hinrichs RJ, Fortenberry JD, Carpenter JS. Social Determinants of Health and Dysmenorrhea: A Systematic Review. THE JOURNAL OF PAIN 2024:104574. [PMID: 38788887 DOI: 10.1016/j.jpain.2024.104574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Social determinants of health play a key role in health disparities. Dysmenorrhea is a highly prevalent and impactful public health problem affecting reproductive-age females. Systematically examining social determinants of health (SDoH) in dysmenorrhea is important for identifying gaps in the literature and informing research, policy, and clinical practice to reduce the public health burden associated with dysmenorrhea. The purpose of this systematic review was to synthesize the literature on SDoH and dysmenorrhea. The review protocol was prospectively registered. We searched Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Google Scholar through February 2024 using search strategies informed by the literature. Screening of the articles, data extraction, and risk-of-bias (RoB) assessment were conducted independently by at least 2 reviewers on the Covidence platform. Among 2,594 unique records screened, 166 met eligibility criteria and were included for data extraction and RoB assessment. Evidence suggests traumatic experiences, toxic environmental exposures, female genital mutilation, job-related stress, lack of menstrual education, and low social support were associated with worse dysmenorrhea outcomes. However, evidence was equivocal regarding the relationships between dysmenorrhea outcomes and SDoH factors, including socioeconomic status, geographical location, race/ethnicity, employment, and religion. Nearly all articles (99.4%) had a high or very high overall RoB. The relationships between SDoH and dysmenorrhea outcomes were often inconsistent and complicated by heterogeneous study populations and methodologies. More rigorous research examining SDoH in dysmenorrhea is needed to inform policy and clinical practice. PERSPECTIVE: This systematic review synthesizes evidence linking SDoH and dysmenorrhea. The relationships between SDoH and dysmenorrhea were often equivocal and complicated by heterogeneous study populations and methodologies. We identify directions for future research and SDoH factors that could be addressed clinically (eg, trauma, menstrual education, and occupational stress).
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Affiliation(s)
- Chen X Chen
- Indiana University School of Nursing, Indianapolis, Indiana.
| | - Sarah K Rogers
- Department of Psychology, School of Science, Indiana University Purdue University-Indianapolis, Indianapolis, Indiana
| | - Rui Li
- Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, Washington
| | - Rachel J Hinrichs
- Indiana University Indianapolis, University Library, Indianapolis, Indiana
| | - J Dennis Fortenberry
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
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Mantovan SGDM, de Arruda GT, Da Roza T, da Silva BI, Avila MA, da Luz SCT. Translation, cross-cultural adaptation, and measurement properties of the dysmenorrhea symptom interference (DSI) scale-Brazilian version. Braz J Phys Ther 2024; 28:101065. [PMID: 38848625 PMCID: PMC11192778 DOI: 10.1016/j.bjpt.2024.101065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 04/22/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The Dysmenorrhea Symptom Interference (DSI) scale is a reliable, valid, and responsive tool to assess the interference of menstrual pain in the physical, mental, and social activities of women. OBJECTIVE To translate and cross-culturally adapt the DSI scale into Brazilian-Portuguese (DSI-BrPt) and investigate the measurement properties of this version in on- and off-menses versions. METHODS The original (United States) scale was translated and culturally adapted following existing guidelines. Measurement properties of the DSI-BrPt were investigated in 1387 women with dysmenorrhea. Reliability was analyzed via intraclass correlation coefficients (ICC) and test-retest reliability. Furthermore, structural validity, internal consistency (Cronbach's alpha), cross-cultural validity, construct validity (correlation with WHODAS 2.0 and SPS-6 scores questionnaires), and floor and ceiling effects were determined. RESULTS No significant adaptations were needed during the translation process of the DSI-BrPt. The values of Cronbach's α were adequate (α ≥0.87) for the unidimensional scale. The test-retest reliability was considered adequate (ICC >0.78) and there was no systematic error for both on-menses and off-menses versions. Moreover, the DSI had a positive and strong correlation with WHODAS 2.0. There were no floor and ceiling effects neither for the total sample, nor among off-menses, or on-menses women. CONCLUSION The DSI-BrPt scale has been translated and cross-culturally adapted successfully. The DSI-BrPt scale presented adequate measurement properties. The scale is valid and reliable, and, therefore, an adequate tool for monitoring dysmenorrhea symptoms in Brazilian women during and between menses.
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Affiliation(s)
- Sara Giovanna de Melo Mantovan
- Department of Physical Therapy, College of Health and Sport Science, Universidade do Estado de Santa Catarina, UDESC, Florianópolis, SC, Brazil
| | - Guilherme Tavares de Arruda
- Study Group on Chronic Pain (NEDoC), Programa de Pós-graduação em Fisioterapia, Department of Physical Therapy, Universidade Federal de São CarlosUFSCar, São Carlos, SP, Brazil
| | - Thuane Da Roza
- Department of Physical Therapy, College of Health and Sport Science, Universidade do Estado de Santa Catarina, UDESC, Florianópolis, SC, Brazil
| | - Barbara Inácio da Silva
- Study Group on Chronic Pain (NEDoC), Programa de Pós-graduação em Fisioterapia, Department of Physical Therapy, Universidade Federal de São CarlosUFSCar, São Carlos, SP, Brazil
| | - Mariana Arias Avila
- Study Group on Chronic Pain (NEDoC), Programa de Pós-graduação em Fisioterapia, Department of Physical Therapy, Universidade Federal de São CarlosUFSCar, São Carlos, SP, Brazil.
| | - Soraia Cristina Tonon da Luz
- Department of Physical Therapy, College of Health and Sport Science, Universidade do Estado de Santa Catarina, UDESC, Florianópolis, SC, Brazil
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Lang AL, Bruhn RL, Fehling M, Heidenreich A, Reisdorf J, Khanyaree I, Henningsen M, Remschmidt C. Feasibility Study on Menstrual Cycles With Fitbit Device (FEMFIT): Prospective Observational Cohort Study. JMIR Mhealth Uhealth 2024; 12:e50135. [PMID: 38470472 DOI: 10.2196/50135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/26/2023] [Accepted: 01/24/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Despite its importance to women's reproductive health and its impact on women's daily lives, the menstrual cycle, its regulation, and its impact on health remain poorly understood. As conventional clinical trials rely on infrequent in-person assessments, digital studies with wearable devices enable the collection of longitudinal subjective and objective measures. OBJECTIVE The study aims to explore the technical feasibility of collecting combined wearable and digital questionnaire data and its potential for gaining biological insights into the menstrual cycle. METHODS This prospective observational cohort study was conducted online over 12 weeks. A total of 42 cisgender women were recruited by their local gynecologist in Berlin, Germany, and given a Fitbit Inspire 2 device and access to a study app with digital questionnaires. Statistical analysis included descriptive statistics on user behavior and retention, as well as a comparative analysis of symptoms from the digital questionnaires with metrics from the sensor devices at different phases of the menstrual cycle. RESULTS The average time spent in the study was 63.3 (SD 33.0) days with 9 of the 42 individuals dropping out within 2 weeks of the start of the study. We collected partial data from 114 ovulatory cycles, encompassing 33 participants, and obtained complete data from a total of 50 cycles. Participants reported a total of 2468 symptoms in the daily questionnaires administered during the luteal phase and menses. Despite difficulties with data completeness, the combined questionnaire and sensor data collection was technically feasible and provided interesting biological insights. We observed an increased heart rate in the mid and end luteal phase compared with menses and participants with severe premenstrual syndrome walked substantially fewer steps (average daily steps 10,283, SD 6277) during the luteal phase and menses compared with participants with no or low premenstrual syndrome (mean 11,694, SD 6458). CONCLUSIONS We demonstrate the feasibility of using an app-based approach to collect combined wearable device and questionnaire data on menstrual cycles. Dropouts in the early weeks of the study indicated that engagement efforts would need to be improved for larger studies. Despite the challenges of collecting wearable data on consecutive days, the data collected provided valuable biological insights, suggesting that the use of questionnaires in conjunction with wearable data may provide a more complete understanding of the menstrual cycle and its impact on daily life. The biological findings should motivate further research into understanding the relationship between the menstrual cycle and objective physiological measurements from sensor devices.
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Affiliation(s)
| | - Rosa-Lotta Bruhn
- Faculty of Health, University Witten Herdecke, Witten Herdecke, Germany
| | | | | | | | | | - Maike Henningsen
- Faculty of Health, University Witten Herdecke, Witten Herdecke, Germany
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Dong Y, Li MJ, Hong YZ, Li WJ. Insight into Dysmenorrhea Research from 1992 to 2022: A Bibliometric Analysis. J Pain Res 2023; 16:3591-3611. [PMID: 37915864 PMCID: PMC10617534 DOI: 10.2147/jpr.s430233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023] Open
Abstract
Dysmenorrhea, classified as primary dysmenorrhea and secondary dysmenorrhea, is a common gynecological symptom that seriously affects female daily life. At present, studies on dysmenorrhea are numerous and complex. To better reflect the trend and innovative progress of dysmenorrhea-related research, this study screened papers on the Web of Science from January 1, 1992, to December 31, 2022. A total of 1012 papers were selected and analyzed for their affiliated countries, institutions, authors, keywords, etc. China is the country with the most academic output, Beijing University of Traditional Chinese Medicine is the most influential institution, and Yang Jie, from Chengdu University of Traditional Chinese Medicine, China, is the scholar with the most papers. We consider that the current research focus is on pathogenesis, treatment, epidemiology, and self-management. With increasing research on functional connectivity between dysmenorrhea and various brain regions, functional connectivity has gradually become the forefront of research. We hope our study can promote the further study of dysmenorrhea.
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Affiliation(s)
- Yin Dong
- Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Ming-Jing Li
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Yan-Zhu Hong
- School of Medicine, Xiamen University, Xiamen, People’s Republic of China
| | - Wen-Jie Li
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
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de Arruda GT, de Melo Mantovan SG, Da Roza T, Silva BID, Tonon da Luz SC, Avila MA. WHODAS measurement properties for women with dysmenorrhea. Health Qual Life Outcomes 2023; 21:55. [PMID: 37280634 DOI: 10.1186/s12955-023-02140-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/29/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND There is an association of dysmenorrhea with human functioning and disability. However, no patient-reported outcome measure has been developed to assess this construct in women with dysmenorrhea. WHODAS 2.0 has been recognized as an important generic patient-reported outcome information of physical function and disability. Thus, the aim of this study was to assess the measurement properties of the WHODAS 2.0 in women with dysmenorrhea. METHODS This is an online and cross-sectional study conducted with Brazilian women aged 14 to 42 years with self-report of dysmenorrhea in the last three months. According to COSMIN, structural validity was evaluated by exploratory and confirmatory factor analysis; internal consistency by Cronbach's Alpha; measurement invariance by multigroup confirmatory factor analysis between geographic regions of Brazil; and construct validity by correlating WHODAS 2.0 to the Numerical Rating Scale for pain severity. RESULTS One thousand three hundred and eighty-seven women (24.7 ± 6.5 years) with dysmenorrhea participated in the study. WHODAS 2.0 presented a single factor by exploratory factor analysis and adequate model by confirmatory factor analysis (CFI = 0.924, TLI = 0.900, RMSEA = 0.038), excellent internal consistence (α = 0.892) for all items and an invariancy across geographic regions (ΔCFI ≤ 0.01 and ΔRMSEA < 0.015). Correlation between WHODAS 2.0 and numerical rating scale was positive and moderate (r = 0.337). CONCLUSION WHODAS 2.0 has a valid structure to assess functioning and disability related to dysmenorrhea in women.
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Affiliation(s)
- Guilherme Tavares de Arruda
- Study Group on Chronic Pain (NEDoC), Physical Therapy Post-Graduate Program and Physical Therapy Department, UFSCar, São Carlos, Brazil
| | - Sara Giovanna de Melo Mantovan
- Department of Physiotherapy, College of Health and Sport Science, Santa Catarina State University, UDESC, Florianópolis, Brazil
| | - Thuane Da Roza
- Department of Physiotherapy, College of Health and Sport Science, Santa Catarina State University, UDESC, Florianópolis, Brazil
| | - Barbara Inácio da Silva
- Study Group on Chronic Pain (NEDoC), Physical Therapy Post-Graduate Program and Physical Therapy Department, UFSCar, São Carlos, Brazil
| | - Soraia Cristina Tonon da Luz
- Department of Physiotherapy, College of Health and Sport Science, Santa Catarina State University, UDESC, Florianópolis, Brazil
| | - Mariana Arias Avila
- Study Group on Chronic Pain (NEDoC), Physical Therapy Post-Graduate Program and Physical Therapy Department, UFSCar, São Carlos, Brazil.
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Correyero-León M, Llamas-Ramos R, Calvo-Rodrigo J, Alvarado-Omenat JJ, Llamas-Ramos I. Transcutaneous Tibial Nerve Stimulation for Primary Dysmenorrhea: A Protocol for a Randomized Controlled Trial. Healthcare (Basel) 2023; 11:healthcare11111633. [PMID: 37297773 DOI: 10.3390/healthcare11111633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/18/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Primary dysmenorrhea (PD) is a painful menstruation that can persist for the duration of a woman's fertile life. Non-steroidal anti-inflammatory drugs, hormonal therapy, physiotherapy techniques, etc., are the main treatments. The main objective of this study is to evaluate the effectiveness of transcutaneous posterior tibial nerve stimulation (TTNS) in PD patients. The study will consist of a single-blind randomized clinical trial, parallel-assigned with two arms. Women with PD (18-43 years) with regular menstrual cycles and at least 4 points in VAS will be randomly divided into experimental (TTNS) and placebo (simulated stimulation) groups during 12 treatment sessions (1 session/week) and several follow-ups: monthly during treatment and 1, 3 and 6 months after. Maximum and mean pain intensity, pain duration, pain severity, number of anti-inflammatory drugs, quality of life, sleep quality, overall improvement, treatment satisfaction and secondary effects will be measured once a month every 6 months and at 3 and 6 months. The Student's t-test for independent samples or the Mann-Whitney U test will be used. The literature shows effective physiotherapeutic techniques for PD in the short term, which do not act on causes and have limitations. The TTNS technique can be used in transcutaneous and percutaneous modalities, with similar effectiveness, but the transcutaneous causes less discomfort. TTNS modulates pain, and long-term benefits could be achieved at low cost and without patient discomfort.
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Affiliation(s)
| | - Rocío Llamas-Ramos
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, Universidad de Salamanca, Avda, Donantes de Sangre s/n, 37007 Salamanca, Spain
| | | | | | - Inés Llamas-Ramos
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, Universidad de Salamanca, Avda, Donantes de Sangre s/n, 37007 Salamanca, Spain
- University Hospital of Salamanca, P.° de San Vicente, 182, 37007 Salamanca, Spain
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Curative Effect of Heat-sensitive Moxibustion on Primary Dysmenorrhea: A Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1281336. [PMID: 35942380 PMCID: PMC9356805 DOI: 10.1155/2022/1281336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022]
Abstract
Background Primary dysmenorrhea (PD) refers to functional dysmenorrhea, typically characterized by cyclical, pronounced lower abdominal pain and seriously affects a woman's work and quality of life. Some studies have reported that heat-sensitive moxibustion (HSM) is expected to alleviate the clinical symptoms. This systematic review aimed to evaluate the current evidence regarding the efficacy and safety of HSM on PD. Methods 7 databases including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wan Fang Data Knowledge Service Platform (Wan Fang Data), and China Science and Technology Journal Database (VIP) were searched for clinical randomized controlled trials. Meanwhile, Revman 5.3 software was used to evaluate the methodological quality of the included literature. The confidence interval (CI) of either relative risk or mean difference was set to 95%. Besides, the heterogeneity of the research results is tested by I2. Results 19 studies were ultimately included in this meta-analysis. All of them were declared as random controlled trials. 18 studies reported the total effective rate of the test group and the control group, which was significantly higher (RR: 0.92; 95% CI: 0.85,0.99; P=0.031 < 0.05) than the control group. It is demonstrated that the VAS score of the test group, totally 9 studies included, was significantly lower (SMD: −0.98; 95% CI: −1.15, −0.81; P < 0.001). The meta-analysis of 6 studies showed the symptom score of the test group was significantly lower (SMD: −0.67; 95% CI: −0.87, −0.47; P < 0.001). There were the CMSS results of 3 studies which were significantly lower (SMD: −0.88; 95% CI: −1.13, −0.62; P < 0.001). Combined with the results of subgroup analysis, compared with the control group, the test group had advantages in the VAS score, symptom score, and CMSS score. Conclusions The result has revealed the effectiveness and feasibility of HSM in treating PD, especially in improving the total effective rate and reducing the VAS score, symptom score, and CMSS score.
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