A Correlational Study to assess the knowledge and practice of diet on Dysmenorrhea and occurrence of Dysmenorrhea among adolescent girls in a selected nursing college at Kollam
Soumya Pankaj1, Shereen Thomas2, Ancy Jose3, Angelchintu J2, Litty Stephen2,
Susy Mary Thomas1
1Lecturer, A Departmental Study of Obstetrical and Gynecological Nursing,
Holy Cross College of Nursing, Kottiyam, Kollam.
2Assistant Professor, A Departmental Study of Obstetrical and Gynecological Nursing,
Holy Cross College of Nursing, Kottiyam, Kollam.
3Associate Professor, A Departmental Study of Obstetrical and Gynecological Nursing,
Holy Cross College of Nursing, Kottiyam, Kollam.
*Corresponding Author Email: smsathesh1986@gmail.com, shainythomas2000@gmail.com
ABSTRACT:
Introduction: Dysmenorrhea is the painful menstruation of sufficient magnitude as to incapacitate day to day activities. Food customs are speculated to not only influence the present lifestyle but also to induce gynecological disorders such as dysmenorrhea and irregular menstruation daily eating habits of the women significantly affect reproductive changes. The primary objective of the study was to evaluate the correlation between the practice of diet on dysmenorrhea and occurrence of dysmenorrhea among adolescent girls in a selected nursing college at Kollam. Methodology: Quantitative approach with correlational research study undertaken in Holy Cross College of Nursing, Kollam. Non probability purposive sampling was used as sampling technique. The samples consist of 60 adolescent girls. The self-prepared and content validated structured questionnaire, checklist and WaLLIDD Score were used for the data collection. Data were analyzed by descriptive and inferential statistics. Result: The results showed that among 60 adolescent girls, 40% (24) have adequate knowledge and 60% (36) have moderate knowledge. In case of practice of diet on dysmenorrhea, 22(36.7%) has good practice and 38(63.3%) have poor practice. Karl Pearson co-efficient of correlation r =-0.107 shows that the practice of diet on dysmenorrhea was negatively correlated with occurrence of dysmenorrhea. At 0.05 level of significance, there is no association between knowledge on dysmenorrhea and selected sociodemographic variable. Conclusion: The study outcome revealed that the practice of diet on dysmenorrhea was inversely proportional to the occurrence of dysmenorrhea among adolescent girls.
KEYWORDS: Diet, Dysmenorrhea, Occurrence, Adolescent girls.
INTRODUCTION:
Menstruation is a landmark in every woman's life.1 Menstruation is a major part of life for millions of young girls and women worldwide. On an average, a woman will menstruate for 3,000 days during her lifetime.2 Menstruation is a huge problem in every woman's life. Its onset may occur as early as 9 years or as late as 17 years, but at the age 12 is the average to occur. Menstrual cycles are not always regular or stable; they may be disturbed by many disorders which commonly occur at the extremes of reproductive age3.
Today healthy adolescent girls are tomorrow’s mothers, who are strength of nation4.. Adolescent girls constitute 1/5th of the female population in the world. Generally this group is considered healthy and has not been given adequate attention in the health programs. The reason is specific mortality is comparatively low in this age group.. Menarche is a sign of growing up5. Adolescence is a stage of developmental transition, a bridge between childhood and adulthood. It involves progress from appearance of secondary sex characteristics (puberty) to sexual and reproductive maturity6. The single dietary change with the biggest impact on improving your nutrition and natural health would be to stop eating junk food.7
Dysmenorrhea is painful menstruation which include pain in lower abdomen, back of the legs, abdominal cramps, headache and fatigue. One of the major physiological changes that take place in adolescent girls is the onset of menarche, which is often associated with problems of irregular menstruation, excessive bleeding, and dysmenorrhea. Of these, dysmenorrhea is one of the common problems experienced by many adolescent girls8. Period pains, or dysmenorrhea, affect 40-70% of women of reproductive age. For about one in 10 women the discomfort and pain is bad enough to interfere with their daily lives9. Dysmenorrhea is a common problem among adolescents worldwide. Its prevalence varies greatly in different population and ethnic groups10. Dysmenorrhoea is a leading cause of short term school absentism and it is associated with negative impact on social, academic and sports activities of many females11 Thus, dietary habits in young women may determine their quality of life in subsequent middle or old age and should be evaluated from the perspective of total benefit throughout whole life12.
Dysmenorrhea is characteristically begins when adolescents attain their ovulatory cycle, generally with in the first year after menarche. The first menstruation occurs between 11and 15 years with a mean of 13 years. Once the menstruation it continues cyclically at intervals of 21 - 35 day’s with a mean of 28 days. The duration of menstruation is about 4-5 days and the amount of blood lose is estimated to be 20-80 with an average of 35 ml13. It is defined as pelvic pain directly related to menstruation is associated with symptoms like headache, backache, nausea, vomiting and diarrhea. It is classified into two categories, primary when pelvic examination and ovulatory function are normal and secondary, when it is an identifiable as gynecological pathology14.
Dysmenorrhea is a painful menstruation of sufficient magnitude as to incapacitate day to day activities. The pain is related to dysrhythmic uterine contractions and uterine hypoxia. The pain begins a few hours before or just with the onset of menstruation. The severity of pain usually last for few hours or may extend to 24 hours but seldom persist beyond 48 hours. Naturally eating foods that decrease inflammation to the body will helps to reduce the menstrual cramps15.
Dysmenorrhea is one of the common gynecological problems among all women regardless of age or race. It is one of the most frequently identified etiologies of pelvic pain in females. The prevalence of dysmenorrhea can varies between 16% and 91% in women of reproductive age with severe pain observed in 2% to 29%. The symptoms associated with dysmenorrhea include gastrointestinal symptoms such as nausea, bloating, diarrhea, constipation or both along with vomiting and indigestion. Also irritability, headache and low back pain are prevalent among women penetrating with primary dysmenorrhea tiredness and dizziness is also associated with dysmenorrhea16.
The cause of primary dysmenorrhea is not well established. However, the responsible cause has been identified on the hyper-production of uterine prostaglandins, particularly of PGF 2a and PGF 2, thus resulting in increased uterine tone and high-amplitude contractions. Women with dysmenorrhea have higher levels of prostaglandins, which are highest during the first two days of menses17. Eating high amounts of fibre was significantly related to having less menstrual pain. By blocking the reabsorption of oestrogen, fibre helps to reduce oestrogen levels and subsequent menstrual cramps. Not only do animal products lack fibre, but they alsocan contribute to worse menstrual pain. The reabsorption of estrogens can be blocked with the fibre found in grains, vegetables, beans, and other plant foods18. The women who ate the most red meat (more than two servings a day) increased their risk of developing endometriosis by as much as 56%. Food customs are speculated to not only influence the present life style but also to induce gynaecological disorders such as dysmenorrhoea and irregular menstruation daily eating habits of the women significantly affect reproductive changes. Thus, it is an important issue to evaluate the present situation of eating habits in young women and estimate the influence of these habits on the quality of reproductive functions19.
· To assess the knowledge of diet on dysmenorrhea among adolescent girls.
· To assess the practice of diet on dysmenorrhea among adolescent girls.
· To identify the occurrence of dysmenorrhea among adolescent girls.
· To find out the correlation between practice of diet on dysmenorrhea and occurrence of dysmenorrhea among adolescent girls.
· To find the association between knowledge of diet on dysmenorrhea and selected socio demographic variables among adolescent girls.
H1: There will be significant relationship between practice of diet on dysmenorrhea and occurrence of dysmenorrhea among adolescent girls.
H2: There will be significant association between knowledge score on dysmenorrhea and selected demographic variables among adolescent girls.
A quantitative study was conducted to assess the correlation between the knowledge and practice of diet on dysmenorrhea and occurrence of dysmenorrhea among adolescent girls in a Holy Cross College of Nursing, Kollam in 2021. Non probability purposive sampling technique was adopted to select 60 samples. The research design was correlational prospective design. A self prepared questionnaire was used to assess the knowledge level of the participants regarding diet on dysmenorrhea. The checklist were used to assess the practice of diet on dysmenorrhea. WaLLID score was used to measure the occurrence of dysmenorrhea. The data were analyzed by using descriptive and inferential statistics.
Section I: Description of Sample Characteristics of Adolescent Girls
|
S. No |
Demographic variable |
Frequency |
Percentage |
|
1 |
Age 18-20 |
60 |
100 |
|
2. |
Age at menarche Less than 10 years 11-15 years More than 16 years |
2 55 3 |
3 92 5 |
|
3. |
Duration of menstruation Less than 3 days 4-6 days More than 6 days |
2 57 1 |
3 95 2 |
|
4. |
Frequency of menstruation Less than 28 days 28-30 days More than 30 days |
9 45 6 |
15 75 10 |
|
5 |
Family history of dysmenorrheal Yes No |
28 32 |
47 53 |
|
6 |
Type of family Nuclear family Joint family |
54 6 |
90 10 |
|
7 |
BMI Less than 18.5 kg/m2 18.5-24.9 kg/m2 >24.9 kg/m2 |
11 46 3 |
18 77 5 |
|
8 |
Habit of doing exercise daily Once in a week once in a month |
2 5 53 |
3 8 88 |
|
9 |
Dietary pattern Non vegetarian |
60 |
100 |
|
10 |
Past history of gynecological diseases yes no |
10 50 |
17 83 |
|
11 |
Previous knowledge regarding diet on dysmenorrheal yes no |
20 40 |
33 67 |
This shows that out of 60 adolescent girls, 60 % (36) samples have moderate knowledge and 40 % (24) have adequate knowledge.
This shows that out of 60 adolescent girls, 36.76 % (22) samples have good practice, 63.3 % (38) have poor practice.
have mild dysmenorrhea, 75% (45) have moderate dysmenorrhea, 10% (6) samples have severe dysmenorrhea.
This section deals with correlation between practice of diet and occurrence of dysmenorrhea among selected adolescent girls. Karl Pearson correlation co-efficient r=-0.107, there is a negative correlation between practice of diet and occurrence of dysmenorrhea. The practice of diet and occurrence of dysmenorrhea is inversely proportional. Hence H1 was accepted.
Table 9: Chi-square test showing the association between knowledge and selected demographic variables among adolescent girls
|
Sl No. |
Sociodemographic variable |
Chi square |
Table value |
Significance |
|
|
1 |
Age |
0 |
9.49 |
NS |
|
|
2 |
Age of menarche |
1.1973 |
9.49 |
NS |
|
|
3 |
Duration of menstruation |
2.88 |
9.49 |
NS |
|
|
4 |
Frequency of menstruation |
6.973 |
9.49 |
NS |
|
|
5 |
Family history |
0.178 |
5.99 |
NS |
|
|
6 |
Type of family |
0.276 |
9.49 |
NS |
|
|
7 |
Body mass index |
0.0585 |
9.49 |
NS |
|
|
8 |
Habit of doing exercise |
1.023 |
9.49 |
NS |
|
|
9 |
Dietary pattern |
0.1605 |
5.99 |
NS |
|
|
10 |
Past history of gynecological Disease |
0.0704 |
5.99 |
NS |
|
|
11 |
Previous knowledge |
1.848 |
5.99 |
NS |
|
At 0.05 level of significance, the calculated chi square value is less than tabulated value. Hence, research hypotheses H2 was rejected and infer that there is no statistical association between level of knowledge and socio demographic variables.
Association of knowledge with selected demographic variables such as age, age at menarche, duration of menstruation, frequency of menstruation, family history, type of family, previous knowledge, dietary habits, body mass index, habits of doing exercise, past history of gynecological disease were computed by chi square test.
The Chi-square value for age (table value = 9.49); for age at menarche (table value = 9.49); for duration of menstruation (table value = 9.49); for frequency of menstruation (table value = 9.49); for family history (table value 5.99); for type of family (table value 9.49); for previous knowledge (table value = 5.99); for dietary habit (table value 5.99); for BMI (table value 9.49); for habit of doingexercise (tablevalue 9.49); for pasthistory of gynaecological disease (tablevalue 5.99). As calculated, Chi-square values are less than table value at 0.05 level of significance. So research hypotheses H2 was rejected. So there is no association between level of knowledge and socio demographic variables.
DISCUSSION:
The present study shows that among 60 adolescent girls, 40% (24) have adequate knowledge, 60% (36) have moderate knowledge and none of them have inadequate Knowledge. The present study was supported by descriptive cross-sectional survey was conducted by M. Mirzaei-Alavijehon 2018 to assess the Prevalence of Dysmenorrhea in Female Students of ShahidSadoughi University of Medical Sciences and their Knowledge, and Practice among 300 female students. 300 samples were drawn up through simple sampling. The data were collected by a researcher-made questionnaire. The data were analyzed by SPSS (ver. 17) using Chi - Square and Kruskal-Wallis tests. The result shows that the Prevalence of dysmenorrhea was 38.3% and the knowledge of 6.3% of students was good. There was a significant difference between participants regarding their knowledge and age. The first source of awareness of 39% of students was their mother. The practice of 17.7% of subjects was good. The results of this study showed that the knowledge and practice of participants about dysmenorrhea was low, so there is necessary to plan training programs for university students.20
The present study shows that among 60 adolescent girls, 36.7% (22) have good practice and 63.3% (38) have poor practice. The present study was supported by a cross-sectional study conducted among 140 nursing students at Nepal to assess Effects of Food Habits on Menstrual Cycle. Samples were collected through simple random sampling. The data collection method used is structured questionnaire and visual analogue scale. The result showed that 87.9% had problems; and 80.7% have dysmenorrhea. Similarly, 68.6% of the participants eat fast food and 91.6% of them have menstrual problems. Meal skipping habit was found to significantly associated with the menstrual problems (P = 0.03). The intensity of dysmenorrhea was more in the participant having non-vegetarian diet. Further, the pain is more severe among the participants who consume tea and coffee more frequently. The study concluded that excessive intake of junk/fast food, alcohol, and tea/coffee had a significant association with menstrual problems21.
The present study shows that among 60 adolescent girls, 17% (1) samples have no dysmenorrhea, 8% (14) samples have mild dysmenorrhea, 75% (45) have moderate dysmenorrhea, 10% (6) samples have severe dysmenorrhea. The present study was supported by across-sectional study conducted among 1000 healthy female student sat South India to assess the prevalence, and impact of primary dysmenorrhea. The samples were collected using purposive sampling. the data collection method used is Standardized Self-reporting Questionnaires. The result shows that prevalence of dysmenorrhea was 70.2%.
Among the other factors, association of pain intensity with anemia and absenteeism was highly significant (P=0.000). The Chi-square test show extremely significant associations between intensity of pain and frequency of occurrence of pain as well as the pain length. (P=0.000). The study concluded that Suboptimal use of the medical advice and the barriers to seek medical attention by dysmenorrhea females need exploration22.
The findings of present study shows that correlation coefficient, r =-0.107. There is a negative correlation between practice of diet and occurrence of dysmenorrhea. The present study was supported by a correlation study to assess the prevalence and Correlation between diet and dysmenorrhea among High School and College Students in Saint Vincent and Grenadines (2018). 478 samples were selected through convenience sampling. The data was collected through self-administered questionnaire and visual analogue scale was used to assess the prevalence. The result shows that statistical correlation between diet and dysmenorrhea was insignificant (p > 0.05). Consumption of caffeinated beverages correlated with dysmenorrhea (p<0.05). Although not statistically significant (p> 0.05), the study reported dysmenorrhea in a large proportion of participants who consumed high quantities of sugars. The study concluded that No relationship wasestablishedbetweendietandtheincidenceandseverityofdysmenorrheaamongstthesample screened in Saint Vincent and the Grenadines. However, it appears that diet high in sugars might benefit from further research study23.
Association of knowledge score with selected demographic variables includes age, age of menarche, duration of menstruation, frequency of menstruation, family history, type of family, previous knowledge, dietary habits, body mass index, habits of doing exercise, past history of gynecological disease were computed by Chi-square test, shows that there is no association between knowledge among the students of Holy Cross College of Nursing and source of knowledge at (p<0.05) level of significance. The present study was supported by a descriptive research approach to assess the knowledge regarding home remedies to relieve dysmenorrhea among the adolescent girls at selected schools of Ludhiana Punjab. 60 samples were drawn up through purposive sampling. The data was collected through self-administered questionnaire. The study revealed that age, class, area of residence, duration of menstrual cycle, duration of menstrual period and education of parents had no significant impact on knowledge of adolescent girls’ regarding home remedies to relive dysmenorrhea24.
CONCLUSION:
The present study was aimed to find the correlation between the knowledge and practice of diet on dysmenorrhea and occurrence of dysmenorrhea among adolescent girls in a selected college at Kollam. The result of the study showed that, the correlation coefficient was -0.107. There is a negative correlation between practice of diet and occurrence of dysmenorrhea. This shows that as the practice of diet is inversely proportional to the occurrence of dysmenorrhea. Hence H 1 was accepted. Chi-square test shows that there is no association between knowledge on dysmenorrhea and socio demographic variables. Hence H2 was rejected
REFERENCE:
1. P. Padmavathi, Raja Sankar, N. Kokilavani. A Study on the Prevalence of Premenstrual Syndrome among Adolescent Girls in a Selected School at Erode. Asian J. Nur. Edu. and Research 2(3): July-Sept. 2012; Page 154-157.
2. Supriya Sushant Chakre. A Study to assess the Effectiveness of Planned Teaching regarding Reproductive Health among adolescent girls in Pune City. Asian J. Nursing Education and Research. 2018; 8(4):493-497. doi: 10.5958/2349-2996.2018.00101.5
3. Pathak K, Udapi G. A Study to Assess the Knowledge Regarding Psychological Problems of Premenstrual Syndrome and its Management among Adolescent girls at Selected PU College of Belgaum City, with a View to Develop Informational Booklet. Asian J. Nur. Edu. and Research.2017; 7(1): 9-11.
4. S. Sasikala, T. Kalyani Devi. A Study to assess the Effectiveness of Structured Teaching Program on Menstrual Hygiene for Adolescent Girls. Int. J. Adv. Nur. Management. 2017; 5(1): 55-58
5. Dhanalakshmi N. The Assessment of Knowledge, Beliefs and Practices of Adolescent Girls and the Effect of a Structured Teaching Programme in Knowledge and Beliefs Regarding Menstruation, Pregnancy and Sexual Behaviour in Selected Areas of Pediatric Wards, the Out Patient Department and Medicine OPD of Christian Medical College, Vellore. Asian J. Nur. Edu. and Research 5(2): April-June 2015; Page172-176. doi: 10.5958/2349-2996.2015.00035.X
6. Jincy John, Jisha Ashi Rocha, Jubin Raju, Jyothi George, Linta P Mariyam, Feby Fulgen. A Descriptive Study to assess the Knowledge of Adolescent girls regarding Junk foods in selected areas of Pallithottam, Kollam. Asian J. Nursing Education and Research. 2020; 10(1):41-44.
7. Agarwal AK, Agarwal A. A study of dysmenorrhea during menstruation in adolescent girls. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2010 Jan;35(1):159.
8. V. Savitha, D. Roopa , K. M. Sridhara. A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge regarding Home Remedies on reducing Dysmenorrhea among Adolescent girls at St. Paul’s Girls High school, Davangere. Asian J. Nur. Edu. and Research. 2016; 6(3): 327-330.
9. Sonam Zangmu Sherpa, Ranjita Devi, Anjana Dangol, Asha Limbu, Isha Chettri, Jecika Gurung, Jyotika Poudyal, Lakhi Bhutia, Lhamu Bhutia, Namrata Gurung, Prajala Chettri, Sarina Ghaju, Shova Kunwar. Knowledge Regarding Dysmenorrhea and its Health Seeking Behavior in Colleges of Sikkim. Asian J. Nur. Edu. and Research.2017; 7(4): 477-481. doi: 10.5958/2349-2996.2017.00093.3
10. Deepa. R. Ginger Rhizome Powder on Dysmenorrhea. Int. J. Adv. Nur. Management. 2016; 4(4): 417-422. doi: 10.5958/2454-2652.2016.00092.5
11. Champion VL, Wagner LI, Monahan PO, Daggy J, Smith L, Cohee A, Ziner KW, Haase JE, Miller KD, Pradhan K, Unverzagt FW. Comparison of younger and older breast cancer survivors and age‐matched controls on specific and overall quality of life domains. Cancer. 2014 Aug 1;120(15):2237-46.
12. Hiralalkonar, DC Dutta’s textbook of gynecology,8 edition, published by Jaypee Brothers Medical Publishers, page no:67,147
13. Fujiwara T, Nakata R. Current problems of food intake in young women in Japan: their influence on female reproductive function. Reproductive Medicine and Biology. 2004 Sep;3(3):107-14.
14. Schweiger U, Tuschl RJ, Platte P, Broocks A, Laessle RG, Pirke KM. Everyday eating behavior and menstrual function in young women. Fertility and Sterility. 1992 Apr 1;57(4):771-5.
15. Fitrianingsih AD, Santanu AM. Primary Dysmenorrhea Risk Based on Characteristics, Dietary Habits, and Types of Exercise. Jurnal Ilmu Kesehatan Masyarakat. 2021 Mar 31;12(1):21-37.
16. Verma A, Kadam A. Does Dark Chocolate Relieve Menstrual Pain in Adult Women: A Study Among Indian Population. International Journal of Physiology. 2019 Oct;7(4):17.
17. Goodman MT, Wilkens LR, Hankin JH, Lyu LC, Wu AH, Kolonel LN. Association of soy and fiber consumption with the risk of endometrial cancer. American Journal of Epidemiology. 1997 Aug 15;146(4):294-306.
18. Baghianimoghadam MH, Mohamadloo A, Falahzadeh H, Mirzaei Alavijeh M. A survey about the prevalence of dysmenorrhea in female students of Shahid Sadoughi University of Medical Sciences and Their Knowledge, and Practice toward it. Journal of Community Health Research. 2012 Dec 10;1(2):93-8.
19. Parra Fernández ML, Onieva Zafra MD, Fernández Martínez E, Abreu Sánchez A, Iglesias López MT, García Padilla FM, Pedregal González M. Relationship between Diet, Menstrual Pain and other Menstrual Characteristics Among Spanish Students.
20. Kapil Amgain, Sujana NeupaneEffects of Food Habits on Menstrual Cycle among Adolescent Girls, Europasian Journal of Medical Science Vol 1 No 1 (2019): EJMS | July - December Issue
21. Monday I, Anthony P, Olunu E, Otohinoyi D, Abiodun S, Owolabi A, Mobolaji B, Fakoya AO. Prevalence and correlation between diet and dysmenorrhea among high school and college students in Saint Vincent and Grenadines. Open access Macedonian Journal of Medical Sciences. 2019 Mar 30;7(6):920.
22. A.A. Moghadamnia, N. Mirhosseini, M. Haji Abadi, A. Omranirad, Sh. Omidvar, Effect of Clupeonellagrimmi (anchovy/kilka) fish oil on dysmenorrhea, Eastern Mediterranean Health Journal Vol. 16
23. David D. study to assess the knowledge regarding home remedies to relieve dysmenorrhea among adolescent girls in selected schools of Ludhiana Punjab. International Journal of Current Research. 2014;6(10):9279-82.-9282, October, 2014
Received on 25.11.2021 Modified on 29.03.2022
Accepted on 14.06.2022 ©A&V Publications All right reserved
Asian J. Nursing Education and Research. 2022; 12(3):307-312.
DOI: 10.52711/2349-2996.2022.00064