GARDEN CITY

COLLEGE OF

NURSING

Rajiv Gandhi University of Health Sciences, Karnataka

SYNOPSIS PROFORMA FOR REGISTRATION OF

SUBJECT FOR

DISSERTATION

1 NAME OF THE CANDIDATE AND ADDRESS

MS AMRITA BHATTACHARYYA1ST YEAR M.SC.NURSINGGARDEN CITY COLLEGE OFNURSING16K.M.OLD MADRAS ROADVIDYANAGAR.BANGALORE-560049, KARNATAKA

2 NAME OF THE INSTITUTION

GARDEN CITY COLLEGE OF NURSING16TH K.M.OLD MADRAS ROADVIDYANAGAR.BANGLORE-560049, KARNATAKA

3 COURSE OF THE STUDY AND SUBJECT

M.SC.NURSING 1ST YEARCOMMUNITY HEALTH NURSING

4 DATE OF ADMISSION TO THE COURSE

22.10.2011

5 TITLE OF THE TOPIC A STUDY TO EVALUATE THE EFFECTIVENESS OF AROMATHERAPY TO REDUCE PREMENSTRUAL SYMPTOMS AMONG COLLEGE GIRLS IN A SELECTED COLLEGE BANGLORE, KARNATAKA

6 BRIEF RESUME OF THE INTENDED WORK

“True healing is found in the memory of wholeness” -Deepak Chopra

INTRODUCTION:-

The word aromatherapy is derived from the French word “aromatherapie”coined by a French chemist Gattefosse in 1930.1Aromatherapy is the practice of using the natural oils extracted from flowers ,bark ,stems, leaves, roots or other parts of a plant to enhance psychological and physical well being ,The inhaled aroma from these “essential” oils is widely believed to stimulate brain function. Essential oils can also be absorbed through the skin where they travel through the blood stream and can promote whole body healing.2 Aromatherapy is used in a wide range of setting –from health spas to hospitals-to treat a variety of conditions. In general, it seems to relieve pain, improve mood, and promote a sense of relaxation.3

The premenstrual symptoms are experienced every month when ovulation happens till the start of the menses. The main reasons behind the occurrence of these signs is changes in the hormonal levels .The factors which are responsible for these hormonal changes are plenty. Some of the physical sign of premenstrual symptoms are fatigue, bloating, pelvic discomfort, and tenderness in the breasts, headaches, constipation, or diarrhea, weight gain, changes in sleep pattern, fluid retention, appetite changes and oily skin. The psychological signs are depression, stress, anxiety, lack of concentration, mood swings and irritability. The causes of premenstrual symptoms (PMS) have been linked with primarily with hormonal imbalances .Other causes of PMS are dietary habits, stress, depression and chemical changes in brain. All these factors can be responsible to create these symptoms in the woman’s body before the onset of menstruation. Medications like anti-inflammatory, anti-depressants, diuretics and oral contraceptives pills are available to treat these problems. But natural remedies for PMS are a way to get rid of these problems.4

Aromatherapy help to Reduce some symptoms like Bloating Headaches, irritability digestive upset and tenderness of breast.5

6.1 NEED FOR THE STUDY:-

For years, premenstrual syndrome (PMS) was not treated seriously by doctors or the general public. Today, it is universally accepted in medical circles as a genuine condition.6

Premenstrual symptoms (PMS) has emerged as a twentieth century phenomenon in part due to the fact that women are increasing control over reproduction has eliminated the cycle of repeated pregnancy and lactation that for merely characterized the lives of women from puberty to menopause. PMS may effect at any stage of reproductive life.7 There’s a wide range of estimates of how many women suffer from PMS. The American College of Obstetricians and Gynecologists estimates that at least 85 percent of menstruating women have at least 1 PMS symptom as part of their monthly cycle. Most of these women have fairly mild symptoms that don’t need treatment. Others (about 3 to 8 percent) have a more severe form of PMS, called premenstrual dysphoric (dis-FOHR-ik) disorder (PMDD). PMS occurs more often in women who are between 20-40 years and family history of depression.8

A Study was conducted from April 2002 to October 2004 reported that the symptoms were severe. The commonest symptom was mastalgia or heaviness of breasts. Women reported anger attacks and depression.9 In India 30-40% women suffer some impairment of daily activity; 75% women have some symptoms; 3-8% women have severe PMS. The 35 million women in the US suffering from PMS. By the year 2007 among the total Indian women population 159,760,591 women are suffering from premenstrual symptoms.10

According to statistics, three out of ten women suffer from Premenstrual Syndrome (PMS) is a group of symptoms sometimes very annoying to appear until 2 weeks before your period and can last until the second day rule. It is important to realize that this condition is serious and should be treated as nuisances in some cases the woman gets to experience can be disabling. Among the most common symptoms are apparent in this stress syndrome: abdominal pain, fluid retention, irritability, mood swings, anxiety and severe headache. In more severe cases can be seen depression, sleeping problems and even memory loss.11

Several studies have been done to evaluate the effectiveness of using essential oils in the treatment of pain. Although they are not absolutely conclusive, they do show a definitive benefit as a complementary therapy in treating patients with pain.12

A study was conducted to assess the effects of premenstrual disorders on work productivity and absenteeism in the multinational impact study. Based on the Daily Record of Severity of Problems (DRSP) questionnaire, symptoms were assessed prospectively over 2 months. Work productivity impairment and absenteeism were assessed retrospectively using the Premenstrual Symptoms Screening Tool (PSST) and a modified version of the Work Productivity and Activity Impairment (WPAI) questionnaire. Employed women with moderate-to-severe PMS/PMDD had higher rate of productivity impairment on the modified version of the WPAI questionnaire (values ≥7) relative to those with no perceived symptoms/mild PMS Similar outcomes were obtained for impairment of working productivity or efficiency using the PSST scale (value 4). Women with moderate-to-severe PMS/PMDD had a higher rate of absenteeism Moderate-to-severe PMS/PMDD seems to be

associated with work productivity impairment and increased absenteeism, and thus poses a potential economic burden.13

As investigator has own experience of premenstrual symptoms and by the contact of other students having premenstrual symptoms have several days of absence in college. The investigator selected the problem for her own benefit and also for the benefit of all the college girls who are suffering from PMS.

6.2 REVIEW OF LITERATURE:-

Reviewing the literature is an important step in the research process. It is essential that a researcher has to build on the existing knowledge. The two types of literature used are the theoretical and empirical literature. A well organized review of literature will definitely help the researcher to develop a good context for the research study.14

Researcher has presented the reviewed literature under the following headings.

1. Literature related to the prevalence of premenstrual symptoms (PMS).

2. Literature related to effectiveness of aromatherapy to reduce PMS.

1. Literature related to the prevalence of premenstrual symptoms:-

An observational study was conducted to find out the frequency of premenstrual syndrome in young college girls and to describe the severity of emotional, physical and behavioral symptoms by convenient sampling on 384 young girls. The frequency of premenstrual syndrome was 53% which 42% was mild 18.2% moderate and 31.7% severe . Premenstrual syndrome is a common problem in young girls . Doctors should adopt comprehensive measure to reduce its incidence and improve the quality of life.15

A population based cross-sectional health survey was carried out to study the prevalence of premenstrual syndrome and the factors associated with this by comparing the obtained frequency with the self reported frequency involving 1,395 women aged 15-49 years old. The obtained prevalence was 25.2% and the self reported prevalence was 60.3%. the principal premenstrual symptoms found were: Irritability, abdominal discomfort, nervousness, headache, fatigue and breast pain.16

A study was conducted to determine the prevalence of premenstrual cyclic symptoms in premenopausal age. Among 2 00 women (38.3%) had 3 or more symptoms (14.0%) had 5 or more cyclic symptoms. (4.7%) reported that the symptoms were severe. eleven women had seeked treatment for premenstrual tension syndrome. The commonest symptom was mastalgia or heaviness of breasts.17

A study was conducted about the prevalence of premenstrual dysphoric disorder among Indian women at AIIMS DELHI. (6.4%) fulfilled the criteria of PMDD. The prevalence of PMDD. The prevalence and symptoms of premenstrual syndrome (PMS) were studied in a survey using a random selection of fertile women (n=1,852). The prevalence of PMS was 72.8%. 7.5% of the women with PMS and felt they needed to see a physician. Oral contraceptives do not seem to affect premenstrual symptoms in this group. The result suggests that severe premenstrual symptoms of predominantly depressive nature are probably a manifestation of an underlying depressive disorder.18

A study was conducted to determine the prevalence and the impact of premenstrual symptoms among Japanese adolescent girls, a total of 618 high school students were assessed. Of them, 64.6% were found to suffer from premenstrual symptoms, which is lower

than that in adult women. On the other hand, the rates of prevalence of moderate to severe PMS and PMDD in girls were higher than those in adult women. Premenstrual symptoms could have significant consequences by interfering with the daily functioning of adolescent girls.19

A cross sectional study was conducted to evaluate health related quality of life in a sample of Iranian adolescents with premenstrual disorders. Health-related quality of life was measured using the Short Form Health Survey. In all 602 female students all students reported at least one premenstrual symptom. Of these, 224 (37.2%) met the diagnostic criteria for premenstrual dysphoric disorder (PMDD).It was found that there were significant differences between these two groups in all measures (P < 0.001) except for physical functioning (P = 0.274). These differences were more evident on role emotional, role physical, social functioning and bodily pain. The study findings affirm the fact that adolescents with premenstrual disorders suffer from poor health-related quality of life. In order to improve quality of life in female adolescent’s appropriate support should be provided for this population especially for those who suffer from more severe premenstrual disorders.20

A study was conducted to survey the prevalence and severity of premenstrual symptoms and compare premenstrual symptom clusters of younger (13–15-year-old) and older (16–18-year-old) adolescents, based on both chronological and gynecological age. Physical, emotional, and behavioral premenstrual symptoms were assessed by self-report using the Premenstrual Assessment Form (PAF), in a sample of 75 adolescents. All participants reported at least one premenstrual symptom of minimal severity. Many reported symptoms that they considered moderate (88%), severe (73%), or extreme (56%). The symptoms most commonly reported were food cravings, breast swelling, abdominal discomfort, mood swings, stressed feeling, and dissatisfaction with appearance. Other symptoms, such as missing time at school, becoming violent with people or things, and “thinking of what it would be like to do something to self” (such as crash the car), wishing to go to sleep and not wake up, or having thoughts of death or suicide, were less frequently reported. The younger teens (13–15 years old) had significantly less intense symptoms than the older teens (16–18 years old). Premenstrual symptoms reported as being moderate or greater in severity were found to be quite prevalent (88%) in this sample of adolescents.21

A study was conducted to investigate the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), and the frequency and severity of the symptoms in a population-based sample of Chinese women of reproductive age. Women aged 18-45 years were screened for suspected PMS and PMDD). For those who were consistent with PMS diagnostic criteria, the daily record of severity of problems (DRSP) questionnaire was used to assess the symptoms prospectively over 2 months. Participants were then categorized as having no perceived symptoms, mild PMS, moderate PMS, and PMDD. Among the study group, the incidence of PMDD was 2.1% and PMS was 21.1%. The most common symptoms were irritability (91.21%), breast tenderness (77.62%), depression (68.31%), abdominal bloating (63.70%) and angry outbursts (59.62%).The prevalence of PMS/PMDD and the frequency and severity of the symptoms have their own characteristics in Chinese women.22

2. Effectiveness of aromatherapy to reduce premenstrual symptoms:

A study was conducted on 80 students suffering from premenstrual syndrome. The students were randomly divided into two groups and received, either 10 drops of citrus essence or placebo drops, three times a day during the luteal phase for two cycles. Questionnaire and a daily symptom rating form, had been evaluated for content validity and their reliability had been measured by Cronbach's Alpha Reliability Coefficient (0.080). A p-value of 0<0.5 was considered statistically significant. The group on citrus essence witnessed a significant reduction of 46.08% in the symptoms compared to the group on placebo 14.21%, (p<0.001). After the intervention, there were also significant decreases in the severity of physical and psychological symptoms in both citrus essence (respectively, 24.3% and 21.78%) and placebo groups (respectively, 2.07% and 9.21%), (p<0.001). The study showed that citrus essence could reduce the severity of premenstrual syndrome. The essence is suggested to be taken during the luteal phase in two consecutive cycles.23 

A study was conducted to evaluate the effectiveness of evening primrose oil (EPO) for the treatment of the premenstrual syndrome (PMS). Only seven placebo-controlled trials were found but only in five trials was randomization clearly indicated. Inconsistent scoring and response criteria made statistical pooling and hence a rigorous meta-analysis inappropriate. The two most well-controlled studies failed to show any beneficial effects for EPO, although because the trials were relatively small modest effects cannot be excluded. Nonetheless, on current evidence EPO is of little value in the management of premenstrual syndrome.24

A study was conducted to evaluate the effectiveness of Neptune Krill Oil (NKO) for the management of premenstrual syndrome and dysmenorrhoea and to compare the effectiveness of NKO for the management of premenstrual syndrome and dysmenorrhoea with that of omega-3 fish oil. Treatment period of three months with either NKO or omega-3 fish oil. In 70 patients with complete data, a statistically significant improvement was demonstrated among baseline, interim, and final evaluations in the self assessment questionnaire (p<0.001) within the NKO group as well as between-group comparison to fish oil, after three cycles or 45 and 90 days of treatment. Data analysis showed that Neptune Krill Oil can significantly reduce dysmenorrhoea and the emotional symptoms of premenstrual syndrome and is shown to be significantly more effective for the complete management of premenstrual symptoms compared to omega-3 fish oil.25

A study was conduct to combat symptoms of Premenstrual Syndrome by an aromatherapy compound consisting of "essential oils" (highly concentrated oils extracted from plant cells for use in natural, therapeutic applications). The compound preferably comprises equal proportions of essential oil of geranium, essential oil of clary sage, and essential oil of orange. The compound can be used "neat" (directly on the skin), however, the preferred embodiment is to add the compound to a "carrier" (a base for diluting the Aromatherapy compound) such as lotion or vegetable oil. The preferred formula is approximately 3 milliliters essential oil (1milliliter of geranium, 1 milliliter of clary sage, and 1 milliliter of orange) blended in 120 milliliters of carrier.26

A study was conducted to evaluate the therapeutic effectiveness of evening primrose oil in the relief of 10 symptoms associated with PMS as well as menstrual

symptoms was studied in 38 women,. The prospective trial was randomized, double-blind and placebo controlled and was crossed over after three cycles. Although the result showed an improvement in symptoms of PMS during the trial, no significant difference in the scoring between the active and placebo groups were found over six cycles. No carry over effect of active medication was observed, the beneficial effect on all symptoms was rapid, the scoring decreasing in the first cycle but increasing slightly at the change over period after the third cycle, irrespective of whether the active and placebo medication was next given. These findings indicate that the improvement by the women with moderate PMS was solely a placebo effect.27

PROBLEM STATEMENT:-

“A study to evaluate the effectiveness of aromatherapy to reduce premenstrual symptoms among college girls in a selected college Bangalore, Karnataka”.

OBJECTIVES OF THE STUDY:-

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1. To assess the problems of premenstrual symptoms among College girls.

2. To evaluate the effectiveness of aromatherapy to reduce premenstrual symptoms among college girls.

3. To associate the level of premenstrual symptoms among college girls with their selected demographic variables.

OPERATIONAL DEFINITION

1. Effectiveness:- It refers to determine the extent to which aromatherapy has reduced PMS as determined by the differences between pretest and post test score. 2. Aromatherapy :- In this study aromatherapy is the practice of using the lavender oil for abdomen and back massage two times a day for 10minutes over 1week (from 14days-21days of menstrual cycle) to reduce premenstrual symptoms.

3. Premenstrual symptoms:- Premenstrual symptoms are those which occur before the menses and subside with the onset of menstrual flow. Common Symptoms include- headache, fatigue, painful breasts, feeling of Abdominal fullness, behavioral and emotional symptoms like irritability, mood swings, anxiety.

4. College girls:- In this study college girls refers to the girls between18-23 yrs old staying in hostel.

HYPOTHESIS :-

(H1) There will be a significant reduction of premenstrual symptoms among college girls after administration of aromatherapy. (H2) There will be significant association between the level of premenstrual symptoms and their selected demographic variables among College girls.

RESEARCH VARIABLES:-

Independent variable:- In this study the independent variable is the essential oil of aromatherapy.

Dependent variable:- Dependent variable is the premenstrual symptoms among college girls.

ASSUMPTION:-

1. Premenstrual symptoms are different from individual to individual. 2. The college girls who receive aromatherapy will experience a reduction of

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7.7.17.1.1

7.1.27.1.3

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premenstrual symptoms.3. Aromatherapy will improve the sense of well being during premenstrual period.

DELIMITATION:-

The study will be delimited to –

1. College girls between age group of 18-23 yrs.2. A sample size of 60 subjects.3. A study period of 4 weeks only. 4. College girls who faced premenstrual symptoms for at least one year.

PROJECTED OUTCOME:-

The study will provide relief from premenstrual symptoms to the college girls (18-23 yrs) and helps the individual to cope from premenstrual symptoms and perform a healthy lifestyle.

METERIAL AND METHOD:-

Source of data:- Young college girls ( 18-23 yrs) from a selected college, Bangalore.

Research design:- experimental research design.

Setting :- The study will be conducted at Garden city college hostel Vidyanagar Bangalore.

Population :-

The target population for the study will be the college girls between 18-23 yrs of age studying in Garden City College.

SAMPLE PROCEDURE:-

Sample:

The college girls who will be present in the selected college within the period of study and who will fulfill the sampling criteria.

Sample size

The sample size of the study will be 60 college girls, in which 30 experimental group and 30 control group will be selected by simple random technique.

Sample Technique:

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Non-purposive sampling.

Inclusion Criteria College girls who have premenstrual symptoms. College girls age group between 18-23 yrs. College girls are willing to participate. College girls who have regular menstrual cycle.

Exclusion criteria

College girls who have other disease condition. College girls who are taking other treatment. College girls who have allergy to aroma oils.

INSTRUMENTS INTENDED TO BE USED:- The tool will consists of two sections

Sec-I

The section will include the demographic variables like age, marital status and dietary habit, qualification.

Sec-II

This section include questionnaire related to premenstrual symptoms with visual analogue scale (VAS) rating scale will be used.

METHOD OF DATA COLLECTION:-

Permission will be obtained from the college and consent will be taken from the college and participants. The pretest on premenstrual symptoms will be assessed by administering questionnaire and visual analogue scale (VAS) and rating scale. The lavender oil massage in abdomen and back two times a day for 10 minutes over one week (from 14days-21days of menstrual cycle) will be applied to reduce premenstrual symptoms. At last in the 22nd days of menstrual cycle post test will be done.

METHOD OF DATA ANALYSIS AND PRESENTATION:-

The data will be analyzed with the help of descriptive and inferential statistical analysis.

◊ Statistical analysis such as standard deviation, percentage and paired ‘t’ test will be used to

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determine the effectiveness of aromatherapy to reduce premenstrual symptoms.

◊ Chi-square analysis will be done to associate the premenstrual symptoms and demographic variable.

DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS.

Yes, the study requires implementation of lavender oil massage in abdomen and back two times a day for 10 minutes over 1weeks (from 14dayS-21days of menstrual cycle) to the college girls (18-23yrs) in a selected college, Bangalore.

HAS ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF PREVIOUS.

Ethical clearance is obtained from the research committee of Garden City College Of Nursing.

Permission will be obtained from the selected college, Bangalore.

Consent will be obtained from the college girls having premenstrual symptoms who are willing to participate in the study.

List of references:-

.1 Aromatherapy essential oils available from www.oswalsyndicate.com/Aromatherapy/index.html

9 2 Aromatherapy-The balance and harmony of body and mind available from http://www.aromatherapy.com/

3. Benefits of aromatherapy,2010 available from http://www.umm.edu/altmed/articles/aromatherapy-000347.htm

4. Peter Filinovich, 14 effective natural remedies for premenstrual syndrome available from http://ezinearticles.com/?14-Effective-Natural-Remedies-for-PMS-Premenstrual-Syndrome&id=5950806.

5. Cathy Wong, Natural remedies for PMS, oct 4, 2011 available from http://altmedicine.about.com/cs/womenshealth/a/PMS.htm

6. Actively trying for a baby available from http://www.babycenter.com.my/preconception/activelytrying/pms, 2006

7. Premensrual symptoms, oct 2011 available fromhttp://www.endotext.org/female/female10/femaleframe10.htm

8. http://www.womenshealth.gov/publications/our-publications/fact-sheet/premenstrual-syndrome.cfm

9. S.N Pandey, Prevalence of premenstrual symptoms- preliminary analysis and brief review of management strategies available from http://www.researchgate.net/publication/51531040

10. Prevalence and incidence of premenstrual syndrome available from http://www.rightdiagnosis.com/p/premenstrual_syndrome/prevalence.htm

11. How to fight Premenstrual symptoms available from http://www.elephpantworldtour.com/page/60

12. Studies of aromatherapy in treatment of pain available from http://altmed.creighton.edu/Aromatherapy/Studies.htm

13. Lothar A.J. Heinemann et al, Explorative Evaluation of the impact of severe premenstrual disorder on work absenteeism and productivity, 29 sep 2009 available from http://www.ncbi.nlm.nih.gov/pubmed/20123176

14. Vathsala Sadan, Indian Journal of continuing nursing education, vol-12, no-1, jan-june

2011, p-28.

15. Tabassum S et al, Premenstrual syndrome: frequency and severity in young college girls, 2005 Dec, 55(12): 546-9 available from http://www.ncbi.nlm.nih.gov/pubmed/16438276.

16. Celena Maria Longo da silva et al, Population study of premenstrual syndrome available from http://www.scielo.br/scielo.php?pid=S0034-89102006000100009&script=sci_arttext&tlng=en

17. J.V Joshi et al, Journal of mid-life health, vol-1, 2010,p-30-34, available from http://www.jmidlifehealth.org/article.asp?issn=0976-7800;year=2010;volume=1;issue=1;spage=30;epage=34;aulast=Joshi.

18. Hallman J, The premenstrual syndrome- an equivalent of depression? 1986, Apr, 73(4): 403-11 available from http://www.ncbi.nlm.nih.gov/pubmed/3728066

19. Takashi Takeda et al, Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in Japanese high school students available from http://www.mendeley.com/research/yaz-in-the-treatment-of-premenstrual-dysphoric-disorder/

20. Mahin Delara et al, Health related quality of life among adolescents with premenstrual disorders: a cross sectional study available from http://www.hqlo.com/content/10/1/1

21. Janet A Grossman et al, Premenstrual symptoms, vol-22, may 1998, p-403-408 available from http://www.jahonline.org/article/S1054-139X(97)00239-5/abstract

22. Mingqi Qiao et al, Prevalence of premenstrual syndrome and premenstrual dysphonic disorder in a population based sample in china available from http://www.sciencedirect.com/science/article/pii/S0301211512000607

23. Gity Ozgoli et al, Essential oil of citrus sinensis for the treatment of premenstrual syndrome; a Randomized placebo-controlled trial, vol-12, issue-2, 2011,no-47 available from http://www.jri.ir/Documents/Abstract/En/454.pdf

24. J.C. dornan, vol-17, issue-1, Feb-1996 p-60-68 Is evening primrose oil of value in the treatment of premenstrual syndrome? Available from http://www.ncbi.nlm.nih.gov/pubmed/8721802

25. Sampalis F, Evaluation of the effects of Neptune Krill oil on the Management of premenstrual syndrome and dysmenorrhoea available from http://www.ncbi.nlm.nih.gov/pubmed/12777162

26. PMS Defense: An Aromatherapy compound for the relief of symptoms of premenstrual syndrome available from http://www.docstoc.com/docs/50644671/PMS-Defense-An-

Aromatherapy-Compound-For-The-Relief-Of-Symptoms-Of-Premenstrual-Syndrome---Patent-6322823

27. Khoo S.K et al, Evening primrose oil and treatment of premenstrual syndrome, Med J Aust, 1990; 153(4): 189-92 available from http://www.ncbi.nlm.nih.gov/pubmed/2201888

10 SIGNATURE OF THE CANDIDATE

11REMARKS OF THE GUIDE

The study aims to investigate the effectiveness of aromatherapy on PMS relief. Most of the college students are taking leave due to PMS problem every month which can be reduced or avoided by using aromatherapy.

12 NAME AND DESIGNATION OF THE GUIDE

PROF.PERIADURACHI KUMAR.M.SC.NURSING.PHDCOMMUNITY HEALTH NURSINGPRINCIPAL,GARDEN CITY COLLEGE OF NURSING.BANGALORE

12.1 SIGNATURE

12.2 CO.GUIDE

12.3 SIGNATURE

12.4 HEAD OF THE DEPARTMENT

PROF.PERIADURACHI KUMAR.M.SC.NURSING.PHDCOMMUNITY HEALTH NURSINGPRINCIPAL,GARDEN CITY COLLEGE OF NURSING.BANGALORE

12.5 SIGNATURE

13 REMARKS OF THE PRINCIPAL

Aromatherapy is one of the alternative medical disciplines and practices outsides standardized medicine. Many women would like to follow herbal medicines to avoid side effects.This study will help the youngsters to turn into herbal treatment when they have not found relief.

13.1 SIGNATURE