الفهرس 
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Abstract
Premenstrual syndrome is a highly prevalent cyclical disorder among women of childbearing age. It includes a constellation of mood, behavioral, and physical symptoms that become prevalent before menstruation and wanes off with full menstrual flow. it is a complex health problem in which women spend about half of their life with premenstrual problems and experience a reduction in self-confidence, social isolation, decline in academic achievement, increase in accident tendency and loss of Labor. So, management of these symptoms become more necessary.
Today, alternative medicine is one of the most common methods of treating any kind of disease because, in addition to cost-effectiveness, it leaves fewer side effects than chemical drugs. Relaxation strategies are required in nursing practice among the relaxation techniques, Jacobson’s Progressive Muscle Relaxation (JPMRT) it help patients feel more confident and control while minimizing the distress caused by specific symptoms. As well as, they are inexpensive, straightforward, and simple to teach and learn.
This study aimed to:
Determine the effect of progressive muscle relaxation technique on premenstrual syndrome among female nursing students.
To fulfill the study aim: A quasi experimental research design was used.
Materials and method
Setting:
This study was conducted at the faculty of nursing Damanhur University, at obstetrics &gynecologic nursing skill’s lab.
Subjects:
A convenience sample of 80 female students was selected to participate in the study according to the following inclusion criteria: had a history of regular menstrual cycle ranging from 21 to 35 days (mean 28 days), lasting from 3-7 days,suffer from either mild or moderate degree of premenstrual syndrome, symptoms were restricted to the luteal phase of the menstrual cycle (5-11 days) before menstruation, no prior history of gynecological disease, had no history of co-existing medical illness or psychiatric disorder, and take no medication or analgesics for pain during the study time.The selected subjects were equally assigned to either the control (40) or the study group (40).
Tools used in this study:
Two tools were used for data collection, tool I: Socio-demographic and clinical data structured interview scheduleandtool II: The premenstrual syndrome scale (PMSS).
• Collection of data consumed a period of 5 months from beginning of march 2021 until the end of July 2021.
• Data of tool I was collected from both groups through an interview schedule, which was conducted individually and in total privacy.
• The study subjects were divided into two group 40 study and 40 control.
• The researcher interviewed each student individually for about 30 minutes during any day the week before the menstruation to assess the severity of PMS symptoms by using tool II (pretest).
• The control group practiced their routine care.
• The study group receive the progressive muscle relaxation technique. The researcher starts to explain and demonstrate how to do progressive muscle relaxation technique using PowerPoint presentation & video, and demonstration of the progressive muscle relaxation technique while she is watching, after the completion of the explanation, each female student was asked to re-demonstrate it until the researcher ensures that the student was able to demonstrate the technique independently.
• The student was asked to practice progressive muscle relaxation technique for 30 minutes once in a dayfor 30 days. The student practiced progressive muscle relaxation technique during Saturday and Tuesday under direct supervision of the researcher and the rest of the week the student practiced it under indirect supervision by the researcher through online Microsoft teams meeting.
• Then after 30 days, they interviewed to reassess the severity of PMS symptoms by using the same tool (post-test).
The main findings of the present study were:
1. Subject’s general characteristics
- Regarding the age it was found that the mean age among study and control groups was (22.025+0.733 &21.950+0.678) years, respectively. Around three-quarters (70% & 77%) of the study and control groups, respectively were at third academic year. More than two-thirds (70% &67.5%) of the study and control groups, respectively were from rural areas.About two-thirds (67.5% & 65%) of the study and control groups, respectively had nuclear family. Where, three-fifths (60%) of the study group had their menarche at age from 12-16 years, compared to more than one- half (52.5%) of the control group.
- Around two-thirds (65% & 70%) of the study and control groups respectively mentioned that PMS affect their social relationships and friendships with others. Around one- quarter (22.5% & 30%) of the study and control groups respectively were being absent from college because of PMS. The majority (90% & 97.5%) of the study and control groups, respectively didn’t seek doctor visits for PMS.
2. Intensity of PMS physical symptoms
- All PMS physical symptoms were significantly decreased within the study group before and after intervention (p <0.0001). On the other hand, there was no significant change within the control group before and after intervention related to the same symptoms except weight gain (p= 0.025) and change in bowel habits (p=0.028).
3. Intensity of PMS psychological symptoms
- After intervention, there was a statistically significant decrease in intensity of all PMS psychological symptoms among the study group than the control group except forgetfulness (MCP = 0.381).While, there were no statistically significant decrease within the control group before and after intervention related to the same symptoms except easy crying (p=0.028).
4. Intensity of PMS behavioral symptoms.
It was found that there was a statistically significant decrease in intensity of all PMS behavioural symptoms within the study group before and after intervention except clumsiness (MCP= 0.317). On the other hand, it was found that there was no statistically significant decrease within the control group before and after intervention in relation to the same symptoms except feeling guilty (MCP= 0.002), and compulsive behaviour ( MCP= 0.034).
5. Total score of intensity of PMS symptoms.
It was found that the intensity of PMS symptoms before intervention was moderate among the majority (80% and 82.5%) of the study and control groups, respectively with no statistically significant difference between the two groups (P= 0.775). Meanwhile, after intervention about one-third (35%) of the study group were still suffering from moderate intensity of PMS compared to about three-quarters (72.5%) of the control group. Consequently, the difference between the two groups was found to be statistically significant (MCP= 0.000). In addition, the intensity of PMS symptoms among the study group was significantly decreased after intervention (p=<0.001). In contrast, the intensity of PMS symptoms among the control group was significantly increased after intervention (p=0.034). Where, the intensity of PMS symptoms became severe among 12.5% of control group after intervention compared to none of them before intervention
Recommendations
• Progressive Muscle Relaxation (PMR) technique should be advocated as a non-pharmacological approach for management of Premenstrual syndrome.
• The curriculum of basic nursing / midwifery education as well as continuing education should include the PMRT for management of premenstrual symptoms.
• Maternity nurses should encourage their clients to practice progressive muscle relaxation technique during PMS.
• Progressive muscle relaxation technique should be practiced in schools and colleges for girls at regular basis.
Future researches
• Replication of the present study under different circumstances (sampling, setting, measurement, and duration of intervention) to generalize the findings.
• Progressive muscle relaxation technique can be replicated among women with postmenopausal symptoms.