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Pathak S, Zajac KK, Annaji M, Govindarajulu M, Nadar RM, Bowen D, Babu RJ, Dhanasekaran M. Clinical outcomes of chemotherapy in cancer patients with different ethnicities. Cancer Rep (Hoboken) 2023; 6 Suppl 1:e1830. [PMID: 37150853 PMCID: PMC10440845 DOI: 10.1002/cnr2.1830] [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: 12/31/2022] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND Choosing the most effective chemotherapeutic agent with safest side effect profile is a common challenge in cancer treatment. Although there are standardized chemotherapy protocols in place, protocol changes made after extensive clinical trials demonstrate significant improvement in the efficacy and tolerability of certain drugs. The pharmacokinetics, pharmacodynamics, and tolerance of anti-cancer medications are all highly individualized. A driving force behind these differences lies within a person's genetic makeup. RECENT FINDINGS Pharmacogenomics, the study of how an individual's genes impact the processing and action of a drug, can optimize drug responsiveness and reduce toxicities by creating a customized medication regimen. However, these differences are rarely considered in the initial determination of standardized chemotherapeutic protocols and treatment algorithms. Because pharmacoethnicity is influenced by both genetic and nongenetic variables, clinical data highlighting disparities in the frequency of polymorphisms between different ethnicities is steadily growing. Recent data suggests that ethnic variations in the expression of allelic variants may result in different pharmacokinetic properties of the anti-cancer medication. In this article, the clinical outcomes of various chemotherapy classes in patients of different ethnicities were reviewed. CONCLUSION Genetic and nongenetic variables contribute to the interindividual variability in response to chemotherapeutic drugs. Considering pharmacoethnicity in the initial determination of standard chemotherapeutic protocols and treatment algorithms can lead to better clinical outcomes of patients of different ethnicities.
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Affiliation(s)
- Suhrud Pathak
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - Kelsee K. Zajac
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical SciencesUniversity of ToledoToledoOhioUSA
| | - Manjusha Annaji
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - Manoj Govindarajulu
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - Rishi M. Nadar
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - Dylan Bowen
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
| | - R. Jayachandra Babu
- Department of Drug Discovery and Development, Harrison College of PharmacyAuburn UniversityAuburnAlabamaUSA
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Parker MA, Kent AL, Sneddon A, Wang J, Shadbolt B. The Menstrual Disorder of Teenagers (MDOT) Study No. 2: Period ImPact and Pain Assessment (PIPPA) Tool Validation in a Large Population-Based Cross-Sectional Study of Australian Teenagers. J Pediatr Adolesc Gynecol 2022; 35:30-38. [PMID: 34171477 DOI: 10.1016/j.jpag.2021.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/09/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022]
Abstract
STUDY OBJECTIVE To validate the Period ImPact and Pain Assessment (PIPPA) self-screening tool for menstrual disturbance in teenagers. DESIGN Cross-sectional study. SETTING Three senior high schools in the Australian Capital Territory (ACT), Australia. PARTICIPANTS A total of 1066 girls between 15 and 19 years of age. INTERVENTIONS AND MAIN OUTCOME MEASURES A quantitative paper survey collected self-reports of menstrual bleeding patterns, typical and atypical symptoms, morbidities, and interference with daily activities. Multiple correspondence analysis was used to examine associations between PIPPA questions. Generalized linear models compared total score and subscores by validation criteria: pain, school absence, and body mass index (BMI). Receiver operating characteristic curves were used to evaluate the predictiveness of menstrual disturbance indicators by total PIPPA score. RESULTS Reports of pain, interference, and concern within the PIPPA items and between both the MDOT and PIPPA questionnaires were significantly correlated (P < .0001). The indicator "missing school" was highly associated (P < .0001) with pain and interference. Obesity (BMI ≥30) was associated with higher PIPPA scores, as was underweight (BMI≤18.4). Where 0 = no disturbance, 5 = high disturbance, aggregated PIPPA scores found 75% scoring 0-2 (out of 5) and 25% scoring 3-5 (257/1037). High scores of 4 or 5 (out of 5) were 7% (72/1037) and 3.7% (38/1037), respectively. CONCLUSION PIPPA is a valid screening tool for pain-related menstrual disturbance that affects functioning in young women. PIPPA subdomains of pain/interference have good validity relative to indicators of pain and interference and are responsive to age, BMI, and school absence differences.
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Affiliation(s)
- M A Parker
- Canberra Endometriosis Centre, Department of Obstetrics and Gynaecology, ACT Health, Canberra, ACT, Australia.
| | - A L Kent
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York; Australian National University, College of Health and Medicine, Canberra, ACT, Australia
| | - A Sneddon
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
| | - J Wang
- Ocular Genomics Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - B Shadbolt
- ACT Centre for Health and Medical Research, ACT Health, Canberra, ACT, Australia
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Huang J, Ngai CH, Deng Y, Tin MS, Lok V, Zhang L, Yuan J, Xu W, Zheng ZJ, Wong MCS. Cancer Incidence and Mortality in Asian Countries: A Trend Analysis. Cancer Control 2022; 29:10732748221095955. [PMID: 35770775 PMCID: PMC9252010 DOI: 10.1177/10732748221095955] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background This study aimed to evaluate the updated burden and temporal trends of cancer incidence and mortality in Asian countries. Methodology The data used in this study were retrieved from the Global Cancer Observatory, Cancer Incidence in Five Continents volumes I-XI, and the World Health Organization mortality database. These data were used to calculate the Average Annual Percentage Change (AAPC), with a 95% confidence interval (CI) by joinpoint regression analysis to determine the epidemiological trend in the past decade. Results In 2020, the cancer incidence in Asia was 169.1 per 1 00 000, accounting for 49.3% of the global cancer incidence. The most common cancers included lung (13.8%), breast (10.8%) and colorectal (10.6%) cancers. Its mortality was 101.6 per 1 00 000 (58.3% of the global cancer death) with lung (19.2%), liver (10.5%) and stomach (9.9%) cancers being the most common causes of cancer death. The cancer incidence had been increasing in female population, with Korea (AAPC = 5.73, 95% CI [5.30, 6.17], P < .001), Japan (AAPC = 2.67, 95% CI [2.12, 3.23], P < .001) and Kuwait (AAPC = 2.08, 95% CI [.49, 3.69], P = .016) showing the most significant increases in the past decade. The incidence increase was also observed among population aged <40 years old, with Korea (female AAPC = 8.42, 95% CI [7.40, 9.45], P < .001; male AAPC = 5.28, 95% CI [4.23, 6.33], P <.001), China (female AAPC = 2.94, 95% CI [2.07, 3.81], P < .001; male AAPC = 1.37, 95% CI [.57, 2.18], P = .004) and Japan (female AAPC = 2.88, 95% CI [1.88, 3.88], P = .016; male AAPC = 1.59, 95% CI [.40, 2.78], P = .015) showing the most significant increases. However, there was an overall decreasing trend of cancer mortality. Conclusions There was a substantial burden of cancer incidence and mortality in Asia. Although there was a decreasing trend in cancer mortality, its incidence had been increasing especially among female and younger populations. Future studies could be done to further investigate the potential reasons for these epidemiologic trends.
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Affiliation(s)
- Junjie Huang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, 26451Chinese University of Hong Kong, Hong Kong, China
| | - Chun Ho Ngai
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, 26451Chinese University of Hong Kong, Hong Kong, China
| | - Yunyang Deng
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, 26451Chinese University of Hong Kong, Hong Kong, China
| | - Man Sing Tin
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, 26451Chinese University of Hong Kong, Hong Kong, China
| | - Veeleah Lok
- Department of Global Public Health, Karolinska University Hospital, 27106Karolinska Institute, Stockholm, Sweden
| | - Lin Zhang
- Centre of Cancer Research, 569586Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China
| | - Jinqiu Yuan
- Clinical Research Centre, The Seventh Affiliated Hospital, 543160Sun Yat-sen University, Shenzhen, China.,Scientific Research Centre, The Seventh Affiliated Hospital, 543160Sun Yat-sen University, Shenzhen, China
| | - Wanghong Xu
- School of Public Health, 12478Fudan University, Shanghai, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, 26451Peking University, Beijing, China
| | - Martin C S Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, 26451Chinese University of Hong Kong, Hong Kong, China.,School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China.,Department of Global Health, School of Public Health, 26451Peking University, Beijing, China
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Fennie T, Moletsane M, Padmanabhanunni A. Adolescents' experiences of menarche and menstruation in disadvantaged schools in South Africa: a qualitative exploration. HEALTH EDUCATION 2021. [DOI: 10.1108/he-12-2020-0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study explores how menstruation is perceived, experienced and navigated by school-going adolescent girls living in low-to-middle income settings in South Africa. Existing research from developing countries suggest that the onset of menstruation has implications for school attendance and academic performance. There is evidence that menstrual cycle–related symptoms (primarily physical) lead to difficulties in, or interference with, and disengagement from school, social relations, and physical activities (van Iersel et al., 2016; Steiner et al., 2011; Kiesner and Pastore, 2010; Taras, 2005). The onset of menstruation can be shame-inducing and has been associated with anxiety and confusion. Few studies have been conducted on menstruation in countries with a history of sectarian violence and characterised by substantial socio-economic disparities and high levels of gender-based violence. Understanding the experiences of girls in these contexts is important in generating contextually-grounded knowledge and appropriate interventions.Design/methodology/approachA qualitative, exploratory, descriptive and contextual research design was used to collect data from 48 adolescent girls aged 13–16 year-old. A total of six focus group discussions (FGDs) were conducted using a semi-structured questionnaire among a purposive sampling method. Data collected were transcribed verbatim and thematically analysed. Written parental consent was obtained for participants under 18 years old.FindingsThe findings illustrated complex psychological experiences in response to menarche and menstruation. Experiences of shame in relation to menstruation were aggravated by unsupportive responses from school teachers. Challenges such as scarcity of sanitary products were experienced as creating a barrier for girls' school attendance.Research limitations/implicationsExisting research from developing countries suggests that the onset of menstruation has implications for school attendance and academic performance. The research data includes the views of adolescent learners and their negative reactions and positive experiences towards menstruation within the school environment.Practical implicationsGiven the comparative paucity of research emerging from developing countries in sub-Saharan Africa, this paper addresses an important gap in the literature by providing contextually-nuanced information about the menstrual experiences of adolescent girls. The study can further provide information for efforts made by the Department of Education and Department of Health regarding the impact of menstruation on adolescent girls' school attendance.Social implicationsThis study provides important insights regarding the experiences of South African school girls in relation to menstruation. Although dominant feelings of shame, confusion and disgust may surround menstruation, the study also highlighted potential positive experiences associated with menstruation. Teachers and school administrators need to be oriented towards the needs of adolescent girls if issues regarding poor school attendance are to be addressed.Originality/valueTo reduce absenteeism in schools and ensure learners are provided with improved allocation of sanitary products in schools, there is a need for the advocacy regarding sexuality education and resources to promote the psychological health of adolescent girls.
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Park S, Chung C. Effects of a dietary modification intervention on menstrual pain and urinary BPA levels: a single group clinical trial. BMC Womens Health 2021; 21:58. [PMID: 33563271 PMCID: PMC7871389 DOI: 10.1186/s12905-021-01199-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/31/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Exposure to endocrine-disrupting chemicals (EDCs) occurs mainly through dietary intake. Due to current lifestyle trends, young people tend to consume fast food, to use disposable products, and to utilize convenient household items, all of which are major sources of EDCs. This study aimed to investigate the effects of a dietary modification intervention on menstrual pain and urinary bisphenol A (BPA) levels throughout three menstrual cycles in female college students who experienced severe menstrual pain. We also analyzed participants' adherence to the intervention and examined whether their level of adherence was associated with differences in the effects of the intervention. METHODS A single-group pretest and repeated posttest experimental design was employed. Thirty female college students with a score of 5 or higher on a menstrual pain scale were recruited through convenience sampling. During three menstrual cycles, menstrual pain was scored on a 10-point scale after each cycle, and urinary BPA levels were measured from the first morning urine collected after each cycle. The intervention involved three components: small-group education, follow-up monitoring, and peer support via social network communication. Statistical analyses were conducted using Friedman one-way repeated-measure analysis of variance by ranks, non-parametric two-way analysis of variance, and the Wilcoxon signed-rank test as a post-hoc test. RESULTS The dietary modification intervention had significant effects on menstrual pain at all three time points of menstrual cycles (χ2 = 119.64, p = 0.000) and on urinary BPA levels until the 2nd menstrual cycle (χ2 = 205.42, p = 0.000). Slightly fewer than half (43.3%) of the participants were highly adherent. Menstrual pain differed according to adherence level (F = 4.67, p = 0.032) and decreased over time through the third cycle post-intervention (F = 18.30, p = 0.000). Urinary BPA levels also decreased significantly (F = 7.94, p = 0.000), but did not differ according to adherence level. CONCLUSIONS The dietary modification intervention was effective and sustainable for reducing menstrual pain and urinary BPA levels. Detailed information about EDCs and dietary experiences seemed to encourage the young women to become more concerned about EDCs and to perform self-protective actions. Further experimental research is suggested to examine the relationships of EDCs with various health indicators in women. TRIAL REGISTRATION KCT0005472 at 2020-9-24 retrospectively registered.
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Affiliation(s)
- SoMi Park
- Department of Nursing, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju, Gangwon-do, Korea
| | - ChaeWeon Chung
- College of Nursing, Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Korea.
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Kim YJ, Park YJ. Menstrual Cycle Characteristics and Premenstrual Syndrome Prevalence Based on the Daily Record of Severity of Problems in Korean Young Adult Women. J Korean Acad Nurs 2020; 50:147-157. [PMID: 32131079 DOI: 10.4040/jkan.2020.50.1.147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/31/2019] [Accepted: 01/19/2020] [Indexed: 01/12/2023]
Abstract
PURPOSE This descriptive study aimed to identify the menstrual cycle characteristics and premenstrual syndrome (PMS) prevalence in Korean young adult women using the retrospective and prospective Daily Record of Severity of Problems (DRSP). METHODS In the first stage, participants included 151 nursing students studying in a university located in Seoul. Data were collected from April 20 to June 2, 2017, using the questionnaire on menstrual characteristics, pictorial blood assessment chart, and retrospective DRSP. In the second stage, participants included 17 students with PMS, based on the screening conducted in the first stage. Data were collected using the prospective DRSP from May 29 to 2 September 2, 2017. RESULTS Of the study sample, 104 participants (68.9%) had regular periods. Those with regular periods had 11.97 periods annually with a menstrual cycle of 29.38 days and a period duration of 5.72 days. Fifty-five participants (37.4%) showed menorrhagia. Sixty-four participants (42.4%) were found to have PMS based on their retrospective DRSP. When the ratio of women (52.9%) with PMS shown in the prospective DRSP was used as a positive predictive value, the estimated PMS prevalence was 22.4%. CONCLUSION This study provides clinically significant PMS prevalence among Korean young adult women, positive predictive value of the retrospective DRSP, and valid data to basically understand the menstrual cycle characteristics experienced by these women.
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Affiliation(s)
- Yae Ji Kim
- Health Insurance Review & Assessment Service, Seoul, Korea
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Abstract
INTRODUCTION Premenstrual syndrome (PMS) is one of the most prevalent disorders at reproductive age and has a negative impact on emotions and performance of women. Since various factors play a role in the development of this syndrome, the present study was aimed to examine biopsychosocial etiology of PMS in the form of a narrative review. MATERIALS AND METHODS Relevant studies were collected based on the three subjects of biological, psychological, and social etiologies during 1987-2015. First, Medical Subject Headings was used to specify the relevant keywords such as biological, psychological, social, and premenstrual syndrome which were used to search Internet databases including Google Scholar, Scopus, PubMed, PMDR, Ovid, Magiran, and Iranmedex, which led to collection of 1 book and 26 Persian and English articles. RESULTS The results were classified into three sections. In the biological section, the effect and role of sex hormones and their changes in PMS were examined. In the psychological section, hypotheses on PMS and the role of psychological problems in the development of PMS were examined. In the social section, the role and social, religious, and cultural position of women and its relationship with PMS were examined. CONCLUSION To reduce negative experiences of PMS, it is recommended that girls should be provided with necessary scientific information on puberty and premenstrual health. The results showed that paying attention to the complaint on premenstrual symptoms is significant in women's comprehensive assessment, and it plays an essential role in diagnosing psychological and physical annoying diseases.
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Affiliation(s)
- Mojgan Zendehdel
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Forouzan Elyasi
- Research Center of Psychiatry and Behavioral Sciences, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Investigation of Self-Esteem in High School Students with Premenstrual Syndrome. RAZAVI INTERNATIONAL JOURNAL OF MEDICINE 2018. [DOI: 10.5812/rijm.12249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Omidvar S, Amiri FN, Bakhtiari A, Begum K. A study on menstruation of Indian adolescent girls in an urban area of South India. J Family Med Prim Care 2018; 7:698-702. [PMID: 30234040 PMCID: PMC6132001 DOI: 10.4103/jfmpc.jfmpc_258_17] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Menstrual cycle is an important indicator of women's reproductive health. However, menstruation has a different pattern within a few years after menarche, which might not be well understood by many adolescent girls. Materials and Methods: A cross-sectional study was conducted on 536 healthy menstruating females aged 10–19 years. Standardized self-reporting questionnaires were used to obtain relevant data. The categorical data were analyzed using Chi-square or Fisher's exact test. Results: Mean age of menarche was 13 ± 1.1 years with wide variations, i.e., 10–17 years. 73.1% had cycle duration of 21–35 days. More than half of them reported 5–6 days’ duration of menstrual blood flow and 12% of the participants had >7 days of flow. Long blood flow duration was more prevalent in early than in late adolescence. 30.1% reported abundant blood loss. 66.8% had dysmenorrhea and no difference was observed between early and late adolescents. Menstrual cycles tend to be shorter in early adolescence period. Conclusion: A comprehensive school education program on menarche and menstrual problems may help girls to cope better and seek proper medical assistance.
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Affiliation(s)
- Shabnam Omidvar
- Department of Midwifery, Babol University of Medical Sciences, Babol, Mazandaran Province, Iran
| | - Fatemeh Nasiri Amiri
- Department of Midwifery, Babol University of Medical Sciences, Babol, Mazandaran Province, Iran
| | - Afsaneh Bakhtiari
- Department of Midwifery, Babol University of Medical Sciences, Babol, Mazandaran Province, Iran
| | - Khyrunnisa Begum
- Department of Food Science and Nutrition, University of Mysore, Mysore, Karnataka, India
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Nam GE, Han K, Lee G. Association between sleep duration and menstrual cycle irregularity in Korean female adolescents. Sleep Med 2017; 35:62-66. [DOI: 10.1016/j.sleep.2017.04.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/17/2017] [Accepted: 04/18/2017] [Indexed: 01/10/2023]
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Yu M, Han K, Nam GE. The association between mental health problems and menstrual cycle irregularity among adolescent Korean girls. J Affect Disord 2017; 210:43-48. [PMID: 28012351 DOI: 10.1016/j.jad.2016.11.036] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 11/10/2016] [Accepted: 11/25/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Menstrual cycle irregularity is common among adolescents and can induce mental health problems such as stress, depression, and suicidal ideation. We examined the association between mental health problems and menstrual cycle irregularity among adolescent Korean girls. METHODS This population-based cross-sectional study was on 808 female adolescents (12-18 years of age) participating in the 2010-2012 Korean National Health and Nutrition Examination Survey. Psychological stress, depressive mood, suicidal ideations, suicide attempts, and psychological counseling were assessed through questionnaires and surveys, and hierarchical multivariable logistic regression analysis was performed. RESULTS The risk of menstrual cycle irregularity tended to increase, as the number of mental health problems increased (P for trend=0.016). High stress levels, depressive mood, and psychological counseling were associated with increased risks of menstrual cycle irregularity (odd ratio [95% confidence interval]=1.88 [1.1-3.21], 2.01 [1.01-4.03], and 2.92 [1.16-7.34], respectively) even after adjusting for age, body mass index, alcohol consumption, smoking status, physical activity, hemoglobin level, monthly household income, weight loss attempts, age at menarche, and sleep duration. Suicidal ideation was not significantly associated with menstrual cycle irregularity. LIMITATIONS Menstrual irregularity was evaluated based solely on subjects' self-reports, which are subject to their subjective perceptions and appraisal. Cross-sectional design and retrospective data could not draw causal relationship. CONCLUSIONS Positive associations were observed between mental health problems and menstrual cycle irregularity among adolescent Korean girls. More attention should be paid towards mental health, to improve menstrual cycle regularity and help prevent related chronic diseases later in life.
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Affiliation(s)
- Mi Yu
- College of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinju-si, Republic of Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, Catholic University, Seoul, Republic of Korea
| | - Ga Eun Nam
- Department of Family Medicine, Sahmyook Medical Center, Seoul, Republic of Korea.
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Ravi R, Shah P, Palani G, Edward S, Sathiyasekaran BWC. Prevalence of Menstrual Problems among Adolescent School Girls in Rural Tamil Nadu. J Pediatr Adolesc Gynecol 2016; 29:571-576. [PMID: 26537316 DOI: 10.1016/j.jpag.2015.10.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 04/20/2015] [Accepted: 10/21/2015] [Indexed: 11/18/2022]
Abstract
STUDY OBJECTIVE Adolescent girls face a gamut of problems of which the menstrual problems are the most common. Because menstrual problems are subtle, the problems often are unreported. The objective of this study was to estimate the prevalence of menstrual problems, namely dysmenorrhea, menorrhagia, and irregular menstrual cycles. DESIGN Cross sectional study. SETTING School-based study conducted in a rural school of the Thiruvallur district, Tamil Nadu. PARTICIPANTS The participants were adolescent girls who attained menarche at least 1 year before the data collection period were selected using a simple random sampling method. A total of 350 participants were included in the study. INTERVENTIONS No interventions were done. A structured, pretested questionnaire was used to collect data. MAIN OUTCOME MEASURES The main outcome measured in this study was the prevalence of menstrual problems, namely dysmenorrhea, menorrhagia, and irregular menstrual cycles. RESULTS The mean age of the study participants was 14.74 years. The mean age at menarche was 12.4 years. In this study, 87.7% of the girls suffered from a menstrual problem. Overall, dysmenorrhea was prevalent in 72.6%, and menorrhagia and irregular menstrual cycles were present among 45.7% and 31.7% of the participants, respectively. CONCLUSION Menstrual problems form an important domain of adolescent health and because these problems go unreported, it is necessary that adequate attention and care is provided. The consequences of the neglect of menstrual problems results in impaired reproductive and sexual health in older women.
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Affiliation(s)
- Rama Ravi
- Department of Community Medicine, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Chennai, Tamil Nadu, India.
| | - Pankaj Shah
- Department of Community Medicine, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Chennai, Tamil Nadu, India
| | - Gopal Palani
- Department of Community Medicine, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Chennai, Tamil Nadu, India
| | - Shanthi Edward
- Department of Community Medicine, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Chennai, Tamil Nadu, India
| | - B W C Sathiyasekaran
- Department of Community Medicine, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Chennai, Tamil Nadu, India
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Lee JA, Park S, Jung J, Jun JH, Choi J, Lee MS. Herbal medicine (Gyejibongneyong-hwan) for treating primary dysmenorrhoea: a protocol for a systematic review of randomised controlled trials. BMJ Open 2016; 6:e011071. [PMID: 27683510 PMCID: PMC5051328 DOI: 10.1136/bmjopen-2016-011071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Gyejibongneyong-hwan (GBH), also known as Guizhi Fuling formula, and is widely used for uterine fibroids in East Asian countries. Many clinical trials assessing the efficacy and safety of GBH formula for the treatment of dysmenorrhoea have been reported. This review will assess the clinical evidence for and against the use of GBH formula as a treatment for dysmenorrhoea. It will also discuss the proposed mechanism(s) that could link herbal medicine to improvements in dysmenorrhoea. METHODS AND ANALYSIS Fourteen databases will be searched until September 2016. We will include randomised controlled trials (RCTs) examining GBH decoctions for any type of dysmenorrhoea. All RCTs of decoctions or modified decoctions will be included. The methodological qualities of the RCTs will be assessed using the Cochrane Collaboration tool for assessing risk of bias. ETHICS AND DISSEMINATION This systematic review will be published in a peer-reviewed journal. The review will also be disseminated electronically and in print. It will be updated to inform and guide healthcare practices. TRIAL REGISTRATION NUMBER CRD42015023419.
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Affiliation(s)
- Ju Ah Lee
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Sunju Park
- Department of Preventive Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Jeeyoun Jung
- KM Fundamental Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ji Hee Jun
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jiae Choi
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Myeong Soo Lee
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
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Wang YJ, Wang YZ, Yeh ML. A Prospective Comparison Study of Heart Rate Variability During Menses in Young Women With Dysmenorrhea. Biol Res Nurs 2016; 18:465-72. [DOI: 10.1177/1099800416640875] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Numerous studies have demonstrated autonomic abnormalities in various pain conditions. However, few have investigated heart rate variability (HRV) in young women with primary dysmenorrhea, and the conclusions have been inconsistent. More evidence is required to confirm the reported trend for consistent fluctuation of HRV parameters in dysmenorrhea. Purpose: The study’s aim was to determine whether significant differences exist between young women with and without dysmenorrhea for heart rate (HR), blood pressure (BP), and HRV parameters during menses. Design: A prospective comparison design with repeated measures was used. Setting and participants: Sixty-six women aged 18–25 with dysmenorrhea and 54 eumenorrheic women were recruited from a university in northern Taiwan. Methods: High-frequency and low-frequency HRV parameters (HF and LF), LF/HF ratio, BP, and HR were measured daily between 8 p.m. and 10 p.m. from Day 1 to Day 6 during menses. The generalized estimating equation was used to analyze the effects of group, time, and Group × Time interaction on these variables. Results: HF values were significantly lower in the dysmenorrhea than in the eumenorrhea group, but there were no differences in BP, HR, LF, or LF/HF ratio. Conclusion: Reduced HF values reflect reduced parasympathetic activity and autonomic instability in young women with dysmenorrhea. Future longitudinal studies are warranted to examine autonomic regulation in menstrual pain of varying intensities associated with dysmenorrhea-related symptoms and to clarify the causal relationship between dysmenorrhea and HRV fluctuations.
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Affiliation(s)
- Yu-Jen Wang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
| | - Yi-Zen Wang
- National Taiwan University Hospital, Taipei City, Taiwan
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Mei-Ling Yeh
- Graduate Institute of Integration of Traditional Chinese Medicine with Western Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
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Suvitie PA, Hallamaa MK, Matomäki JM, Mäkinen JI, Perheentupa AH. Prevalence of Pain Symptoms Suggestive of Endometriosis Among Finnish Adolescent Girls (TEENMAPS Study). J Pediatr Adolesc Gynecol 2016; 29:97-103. [PMID: 26169662 DOI: 10.1016/j.jpag.2015.07.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/26/2015] [Accepted: 07/01/2015] [Indexed: 01/27/2023]
Abstract
STUDY OBJECTIVE To evaluate the prevalence of pain symptoms suggestive of endometriosis among adolescent girls aged 15-19 years. DESIGN Cross-sectional study. SETTING University hospital. PARTICIPANTS Adolescent girls aged 15-19 years attending elementary school, high school, or vocational institute at 3 cities in Southwest Finland in 2010-2011. INTERVENTIONS The school nurses distributed a detailed questionnaire to 2582 girls who were attending school at the time of the study. Completion of the questionnaire was voluntary and anonymous. MAIN OUTCOME MEASURES Prevalence and severity of dysmenorrhea, acyclic abdominal pain, dyspareunia, dyschezia, and dysuria. Severity was evaluated with an 11-point numerical rating scale (NRS). RESULTS A total of 1103 eligible answers were analyzed. The prevalence of dysmenorrhea was 68% (738/1092) with mean NRS of 7.0 (SD = 2.0). Acyclic abdominal pain, dyspareunia, dyschezia, and dysuria were less frequent (19% [207/1085], 12% [53/458], 8% [87/1088] and 5% [50/1084], respectively). The prevalence of severe dysmenorrhea (NRS 8-10) was 33% (355/1089). Severe dysmenorrhea was associated with increased risk of concurrent acyclic abdominal pain (odds ratio [OR] = 2.7; 95% confidence interval [CI], 2.0-3.6), dyschezia (OR = 2.5; 95% CI, 1.6-3.9), and regular absenteeism from school or hobbies (OR = 10.0; 95% CI, 4.2-23.6). Using different criteria, 2%-10% (21-106/1103) of all girls could be identified as having symptoms suggestive of endometriosis. Five percent of girls (n = 53/1103) had severe dysmenorrhea, used oral contraceptive pills, and reported inadequate relief from pain medication. CONCLUSION One-third (355/1089) of 15- to 19-year-old girls had severe menstrual pain and 14% (49/355) of them were regularly absent from school or hobbies. Five percent of all teenage girls (53/1103) were poor responders to conventional therapy for primary dysmenorrhea.
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Affiliation(s)
- P A Suvitie
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland; Department of Obstetrics and Gynecology, University of Turku, Turku, Finland; Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland.
| | - M K Hallamaa
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland; Department of Obstetrics and Gynecology, University of Turku, Turku, Finland
| | - J M Matomäki
- Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - J I Mäkinen
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland; Department of Obstetrics and Gynecology, University of Turku, Turku, Finland
| | - A H Perheentupa
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland; Department of Obstetrics and Gynecology, University of Turku, Turku, Finland; Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland
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Mishra SK, Dasgupta D, Ray S. A study on the relationship of sociocultural characteristics, menstrual hygiene practices and gynaecological problems among adolescent girls in Eastern India. Int J Adolesc Med Health 2016; 29:/j/ijamh.ahead-of-print/ijamh-2015-0111/ijamh-2015-0111.xml. [PMID: 26926863 DOI: 10.1515/ijamh-2015-0111] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/14/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The present study aims to understand the relationship of socioeconomic characteristics, menstrual hygiene practices and gynaecological problems among adolescent girls residing in rural and urban areas in the state of West Bengal, India. METHODS The study was based on a sample of 715 adolescent girls from rural (325) and urban (390) areas of West Bengal, a state in Eastern India. These girls belong to the Bengali-speaking Hindu community. Data on socioeconomic characteristics, menstrual hygiene practices (such as type of absorbents used and mode of cleaning of genitals during days of menstrual discharge) and gynaecological problems were collected using pretested questionnaires. RESULTS Rural and urban girls differ (p<0.01) for age at menarche, menstrual hygiene practices and prevalence of gynaecological problems. Urban girls have better menstrual hygiene practices (β=0.343, p<0.01) than rural girls. A similar trend is noted for gynaecological problems (β=0.080, p<0.01) among the study participants. Apart from socioeconomic characteristics, menstrual hygiene (β=-0.121, p<0.01) remains a significant predictor of gynaecological problems. The results of path analysis also indicate that girls of higher socioeconomic status have better menstrual hygiene practices which subsequently reduce the prevalence of gynaecological problems among them. CONCLUSION A concerted effort from parents, educational institutions and existing healthcare institutions along with media may ensure safe and secure reproductive health prospects for adolescents in the region.
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Lee SE, Yang JY, Lee JH, Kim HW, Kim HS, Lee HJ, Oh JY, Sung YA. Relationship of age at menarche on anthropometric index and menstrual irregularity in late adolescent girls in Seoul. Ann Pediatr Endocrinol Metab 2013; 18:116-21. [PMID: 24904864 PMCID: PMC4027074 DOI: 10.6065/apem.2013.18.3.116] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 09/27/2013] [Accepted: 09/29/2013] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To examine the relationship between menarcheal age and anthropometric indices and menstrual irregularity in late adolescent girls in Seoul. METHODS We surveyed 4,218 fertile adolescent girls between the ages of 16 and 18 years to determine their anthropometric indices and menarcheal age. Measurements were taken from June 2008 to October 2009 at seven girl's high schools in Seoul, Korea. Participants were offered self-report questionnaire as a survey tool that included questions on anthropometric indices (height, weight, waist circumference), menarcheal age, menstrual pattern, frequency of menstruation per year. RESULTS THE PARTICIPANTS WERE CATEGORIZED INTO THREE GROUPS BASED ON MENARCHEAL AGE: early menarche group (younger than 2 standard deviations [SD]), mid menarche group (within ±2 SD), late menarche group (older than 2 SD). The mean age of early menarche group was 9.9±0.2 years, mid menarche group 12.5±0.9 years, late menarche group 15.1±0.3 years (P < 0.001). Heights were recorded as 160.4±5.2 cm, 161.8±4.9 cm, 162.3±4.7 cm in early, mid, and late menarche group, respectively (P = 0.001). Body mass index (BMI) and waist circumference significantly were lager in early menarche group than mid and late menarche ones (P < 0.001). The menarcheal age had a positive correlation with height and negative correlations with weight, BMI, waist circumference (P < 0.001). The prevalence of oligomenorrhea was more frequent in late menarche group than early and mid menarche group. CONCLUSION The menarcheal age have positive relationship with height and inverse relationship with BMI and waist circumference in late adolescent girls in Seoul. Late menarcheal girls are disposed to have menstrual irregularity compared to early menarcheal girls.
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Affiliation(s)
- Seung Eun Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Joo Yun Yang
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Ji Hyun Lee
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Han Wool Kim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hye Jin Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Ji Young Oh
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Yeon Ah Sung
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
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Ahn JH, Lim SW, Song BS, Seo J, Lee JA, Kim DH, Lim JS. Age at menarche in the Korean female: secular trends and relationship to adulthood body mass index. Ann Pediatr Endocrinol Metab 2013; 18:60-4. [PMID: 24904853 PMCID: PMC4027094 DOI: 10.6065/apem.2013.18.2.60] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 06/11/2013] [Accepted: 06/13/2013] [Indexed: 01/14/2023] Open
Abstract
PURPOSE The objective of this study is to estimate the trend in age at menarche in the Korean female and evaluate the relationship between age at menarche and adult body mass index (BMI), which is a indicator of later-life health. METHODS We conducted a cross-sectional analysis of a nationally representative sample (self-reported age at menarche and measured height and weight) of 11,065 females aged 15 and older. Data were obtained from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV, 2007-2009). RESULTS We found a statistically significant decline in age at menarche in successive birth groups, indicating a 0.726 year decrease per decade. The age at menarche in 1990-1994 year birth group was 12.60 years, which showed a significant decreased from 3.11 years in the 1980-1984 birth group. We also found a significant negative association between age at menarche and current BMI. A one-year decrease in age at menarche was associated with mean BMI increase of 0.109 kg/m(2) (95% confidence interval [CI], 0.069 to 0.150) after adjustment for age. In multivariate logistic regression, the odds ratios of obesity in females with early menarche (<12 years) was 1.845 fold (95% CI, 1.441 to 2.361). CONCLUSION We found that age at menarche is still falling in the Korean female. We also found that early menarche is a risk factor for obesity in adults.
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Affiliation(s)
- Ju Hyun Ahn
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
| | - Se Won Lim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
| | - Bong Sub Song
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
| | - Juhee Seo
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
| | - Jun Ah Lee
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
| | - Dong Ho Kim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
| | - Jung Sub Lim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
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Yeh ML, Hung YL, Chen HH, Lin JG, Wang YJ. Auricular acupressure combined with an internet-based intervention or alone for primary dysmenorrhea: a control study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:316212. [PMID: 23653661 PMCID: PMC3638620 DOI: 10.1155/2013/316212] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 02/11/2013] [Accepted: 03/05/2013] [Indexed: 12/28/2022]
Abstract
Background. Primary dysmenorrhea is prevalent in adolescents and young women. Menstrual pain and distress causes poor school performance and physiological damage. Auricular acupressure can be used to treat these symptoms, and Internet-based systems are a flexible way of communicating and delivering the relevant information. Objective. This study investigates the effects of auricular acupressure (AA) alone and combined with an interactive Internet-based (II) intervention for the management of menstrual pain and self-care of adolescents with primary dysmenorrhea. Design. This study adopts a pretest/posttest control research design with a convenience sample of 107 participants. Results. The outcomes were measured using the short-form McGill pain questionnaire (SF-MPQ), visual analogue scale (VAS), menstrual distress questionnaire (MDQ), and adolescent dysmenorrheic self-care scale (ADSCS). Significant differences were found in ADSCS scores between the groups, and in SF-MPQ, VAS, MDQ, and ADSCS scores for each group. Conclusion. Auricular acupressure alone and a combination of auricular acupressure and interactive Internet both reduced menstrual pain and distress for primary dysmenorrhea. Auricular acupressure combined with interactive Internet instruction is better than auricular acupuncture alone in improving self-care behaviors.
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Affiliation(s)
- Mei-Ling Yeh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
| | - Yu-Ling Hung
- Taipei Municipal First Girls' Senior High School, Taipei 100, Taiwan
| | - Hsing-Hsia Chen
- Department of Applied Mathematics, Chung-Yuan Christian University, Chungli 320, Taiwan
| | - Jaung-Geng Lin
- School of Chinese Medicine-Acupuncture Science, China Medical University, Taichung 404, Taiwan
| | - Yu-Jen Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
- Department of Nursing, Chang Gung Universityof Sciences and Technology, Taoyuan 333, Taiwan
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Mohamadirizi S, Kordi M. Association between menstruation signs and anxiety, depression, and stress in school girls in Mashhad in 2011-2012. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2013; 18:402-7. [PMID: 24403944 PMCID: PMC3877464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Menstruation signs are among the most common disorders in adolescents and are influenced by various environmental and psychosocial factors. This study aimed to define the association between menstruation signs and anxiety, depression, and stress in school girls in Mashhad in 2011-2012. MATERIALS AND METHODS This was a cross-sectional study on 407 high school girls in Mashhad who were selected through two-step random sampling. The students completed a questionnaire concerning demographic characteristics, menstruation, Depression, Anxiety, and Stress Scale of 21 questions (DASS-21), and menstruation signs in three phases of their menstruation. Data were analyzed by the statistical tests of Pearson correlation coefficient, Student's t-test, one-way analysis of variance (ANOVA), and regression through SPSS version 14. RESULTS Based on the findings, 74% of the subjects reported pre-menstruation signs, 94% reported signs during bleeding, and 40.8% reported post-menstruation signs. About 44.3% of the subjects had anxiety, 45.5% had depression, and 47.2% had stress. In addition, Pearson correlation coefficient test showed a significant positive correlation between menstruation signs and depression, anxiety, and stress (P < 0.05). CONCLUSION With regard to the association between menstruation signs and psycho-cognitive variables, prevention and treatment of these disorders by the authorities of education and training and the Ministry of Health are essential.
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Affiliation(s)
- Soheila Mohamadirizi
- Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Kordi
- Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Ms. Masoumeh Kordi, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran. E-mail:
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