Impact of Acupressure on Dysmenorrhea Among Adolescent

Girls

Dr: Sahar Anwar Rizk

Dr: Salwa Roushdy Al- Gendy

INTRODUCTION

Primary dysmenorrhea is a common gynecological complaint especially for a young women aged 17 -24 years. It may be severe enough to interfere with normal activities causing missed school days and affecting the academic performance .

Treatment of dysmenorrhea includes pharmacological as well as non pharmacological methods . One of the non pharmacological methods is acupressure .

Acupressure is an ancient Chinese healing method that applies pressure to certain meridian points on the body to relive pain. These meridians are pathways start at the pressure point on the skin , connect to the brain, then connect to the organ associated with the specific meridian .

The meridians are distinct channels that circulate electrical energy throughout the body . They are thought to be part of a master communication system of life energy , connecting the organs with all sensory , physiological and emotional aspects of the body .

Acupressure may reduce muscle pain,

tension, improve blood circulation and

release endorphins . It enables muscle

fibers to relax, allows blood to flow

more freely & toxins to be released and

eliminated.

So, acupressure may reduce menstrual pain and pain medication use . While others mentioned that , there is limited scientific evidence about the effectiveness of acupressure on relief of dysmenorrhea .

There is a rising interest in complementary therapies in midwifery , where non-invasive approach is needed to aid in relieving pain during reproductive period .Complementary therapies become increasingly popular with health care consumers in recent years .

As patients seek information and attempt to take decisions about this therapy , they often turn to nurses and ask their opinion . So, this study in turn pave the way to introduce acupressure in official nursing practice by testing the impact of acupressure on relieving of dysmenorrhea .

AIM OF THE STUDY

The aim of this study is to identify the impact of acupressure on dysmenorrhea among adolescent girls

MATERIAL AND METHODS

This study is an experimental study design, where the effect of an independent variable (acupressure ) on a dependent variable (pain intensity ) was measured .

MATERIAL

1)Setting :

The study was carried out at

King Abd EL-Aziz University (faculty

of Nursing ) Jeddah.

2)Subjects : Convenient sample of 50 Saudi nursing student , suffering from primary dysmenorrhea in various degrees , have regular menstruation and free from any medical diseases and accepted to participate in the study were included .

Tools

Two tools were used in the study

1-A questioner sheet was developed by the

researchers to assess the student information and

practices regarding dysmenorrhea .

2-Visual Analogue pain intensity Scale (VAS). It is a self- reported 10 cm straight line which represents the pain intensity, the two opposite ends representing no pain to pain as bad as it could be in between these two phrases , words like mild pain , moderate pain , severe pain , very severe pain are assigned to each 2 cm distance respectively .

METHODS.

Implementation of the study ;

-The study group was divided into equally 5 groups 10 student in each. The acupressure session lasted (2-3

hours) each for 2 days.

- In the first session , the researcher explain the general objectives of the subject, the general guideline of the study, then acupressure points, techniques and precautions to be taken before and after the implementation.

Acupoint 15On the middle finger, just above the nail,

on the side closest to the thumb

Acupoint 02Two thumb widths from the largest crease on the inside wrist; the point is between the tendons in

the middle of the wrist

Acupressure point

Acupoint 13One palm width below the navel; another point

with similar effect can be found two thumb widths below this one

Acupoint 05One palm width above the tip of the inner ankle bone, on the back of the shinbone; often used in

combination with acupoint #6

- In the second session the student was sit in a warm quiet room ,then they were asked to inhale deeply into the abdomen ,exhale slowly to relax .

-The researcher started to apply finger pressure to each acupressure point gradually and in a steady pressure without movement from 5 seconds to one minute.

-The pressure was applied in a slow rhythmic manner with the tips or ball of fingers . The pressure should not be in the form of massage or jerrying way. -Then the student started acupressure session by detecting the point with a clean warm, trimmed nails and practice the acupressure technique.

The student rotated on 4 points under the supervision of the researcher for about 20 minutes . -If the student hands started to fell tense lighten the pressure a bit .

-After acupressure session , the body heat is lowered so, the student is asked to wear extra clothes .

- Evaluation phase : Evaluation of the effectiveness of acupressure was measured for each student by re-assessing the student pain intensity in the first day of menstruation for two cycles after the implementation of first acupressure session.

RESULTS

General Characteristics No(50) %

Student’s age

< 20 years

>=20 years

15

35

30

70

Father’s education

Illiterate & read and write

<secondary school

≥ secondary school

18

15

17

36

30

34

Mother’s education

Illiterate & read and write

< secondary school

≥ secondary school

19

12

18

38

24

36

Father’s work

Working

Not working

46

4

92

8

Mother’s work

Working

Not working

5

45

10

90

General Characteristics of the students

Pharamacological Methodes

An

alge

sics

Mu

scle

rel

axan

tA

nti

infl

amm

ator

y10

20

30

40

50

Hot

dri

nks

Hot

Bat

h

Exe

rcis

es

Her

bal

Non Pharamacological Methodes

Percent Distribution of the student according to their methods used to relief dysmenorrhe before the implementation of acupressure

48%

20%

8 %

0 %

50 %48%

20 %

8 %

20

40

60

80

100

Col

d dr

inks

Spi

cy a

ctiv

ity

Percent distribution of the student according to the factors affecting their

Severity of dysmenorhea

Str

ess

Nul

l par

ity

100%

52%

34%

22%

10%

Before acupressure

Ver

y se

vere

mod

erat

e M

ild

pai

n10

20

30

40

50

Mil

d p

ain

seve

r

Mod

erat

e

After two months

No

pai

n

Percent Distribution of the student according to the severity of Dysmenorrhe before and after the implementation of acupressure

Mil

d

Mod

erat

e p

ain

No

pai

nM

oder

ate

seve

r

6064%

32%

6%

0%

36% 36%

24%

4%

46%

40%

14%

After one month

0 %

20

40

60

80

100100%

34%

26%

8%

22%

12% 6%

0%4%

8%14%

0%

1st day of menstruation

2nd day of menstruation

3rd day of menstruation

Before menstruation

Distribution of the students according to their occurrence

of dysmenorrhea before and after the implementation of acupressure

Before acupressure

After one monthAfter one month

Location of pain

Before acupressure

(n=50)

After 1 month

(n=50)

After

2 month

(n=50)

NO. % NO. % NO. %

- Abdomen- Abdomen, back- Abdomen, back, thigh- Abdomen, thigh- No pain

10

16

15

9

0

20.0

32.0

30.0

18.0

0.0

14

9

6

3

18

28.0

18.0

12.0

6.0

36.0

15

10

5

0

20

30.0

20.0

10.0

0.0

40.0

X², p 36.2,0.0001* 36.8,0.0001*

Distribution of the students according to their location

of dysmenorrhea before and after the implementation of acupressure

Symptoms Before acupressure

(n=50)

After 1 month

(n=50)

After

2 month

(n=50)

NO. % NO. % NO. %

Physical symptoms

-Backaches

-Nausea

-Headache

-vomiting

-Diarrhea

30

18

10

7

5

60

36

20

14

10

10

9

5

3

2

20

18

10

6

4

10

6

6

0.0

2

20

12

12

0.0

4

x² , P 12.98,0.002* 9.86,0.006*

:Percent distribution of the students according to the symptoms Associated with dysmenorrhea before and after the implementation of acupressure

Symptoms Before acupressure

(n=50)

After 1 month

(n=50)

After

2 month

(n=50)

NO. % NO. % NO. %

Psychological

-Insomnia

-Nervousness

-Loss of concentration

21

17

5

42

34

10

4

6

2

8

12

4

6

3

2

12

6

4

x² , P 21.65,0.0001* 32.3,0.0001*

cont.

Symptom Before acupressure

(n=50)

After 1 month

(n=50)

After

2 month

(n=50)

NO. % NO. % NO. %

Social symptom

School absence 15 30 6 12 3 6

x² , P 4.21,0.0021* 8.98,0.0001*

cont.

CONCLUSION

According to the results of this study , it can be concluded that , acupressure was one of the effective no pharmacological methods to reliving menstrual pain as well as pain medication used .

The result also showed that acupressure was effective in decrease the symptoms associated with dysmenorrhea .

Recommendations

• Provide an extensive orientation program for nurses about complementary therapy .

• Adolescent friendly clinic should be establish in the university to enable them to easily seek help regarding menstrual pain .

• brochure about acupressure and dysmenorrhea should be developed .

• Maternity hospital policies should encourage the concept of complementary therapy .

Thank You