INTRODUCTION:

The female reproductive system is a complex, because it involves many external and internal structure that are under hormonal control. The menstrual cycle is a process involving the reproductive and endocrine systems^1.

Dysmenorrheal is defined as abdominal cramping or discomfort associated with menstrual flow. It involves uterine pain with menstruation and its commonly called menstrual cramps².

Menstrual cramps (dysmenorrhea) are pains in the lower abdomen that are throbbing or cramping. Many women experience menstrual cramps just before and during their period. For some women, the discomfort is simply irritating. For others, menstrual cramps can be severe enough to disrupt daily activities for a few days after every movement. Menstrual cramps can be caused by conditions such as endometriosis or uterine fibroids. The key to reducing pain is to treat the underlying cause. Menstrual cramps that aren't caused by another condition tend to fade with age and frequently improve after childbirth.

A comprehensive review was performed on longitudinal or case-control or cross-sectional studies with large community-based samples to accurately determine the prevalence and/or incidence and risk factors of dysmenorrhea. Fifteen primary studies, published between 2002 and 2011, met the inclusion criteria. The prevalence of dysmenorrhea varies between 16% and 91% in women of reproductive age, with severe pain in 2%-29% of the women studied. Women's age, parity, and use of oral contraceptives were inversely associated with dysmenorrhea, and high stress increased the risk of dysmenorrheal³.

Chitra Nayek et al., (2022) conducted an experimental study on effectiveness of planned teaching programme on pelvic rocking exercises in reducing dysmenorrhea in terms of knowledge and practice among 1st year general nursing and midwifery students in selected school of nursing, Kolkata, West Bengal. The sample consists of 60 students. Simple random sampling technique was used. The data were collected by s. structured knowledge questionnaire and observation check list. The results showed that the mean difference of post- test knowledge and practice scores are statistically significant for calculated t value t58 = 2.05, p < 0.05.The study concluded that the planned teaching programme of pelvic rocking exercises were effective⁴.

Das J (2022) conducted a quasi-experimental pretest and post-test design to assess the effectiveness of pelvic rocking exercise on dysmenorrhea among nursing students in Selected College, Bangalore. The sample consists of 140 dysmenorrhea students. Purposive sampling technique was used. The data were collected by baseline performance, numerical pain rating scale. The results showed that the mean pain score in the experimental group pre-test was 6.243 with S.D of 1.6280 and the mean post-test pain score was 4.257 with S.D of 1.5102. The calculated paired ‘t’value is 18.959 at the level of 0.05 level of significant⁵.

OBJECTIVES:

1. To assess the pretest and posttest level of dysmenorrhoea among the college students in experimental and control group.

2. To evaluate effectiveness of pelvic rocking exercise on dysmenorrhoea among college students in experimental and control group.

3. To compare the posttest level of dysmenorrhea among college students in experimental and control group.

HYPOTHESES:

H1: There will be a significant difference between the pre test and post test level of dysmenorrhea among college student in experimental and control group

H2: There will be a significant difference between the posttest level of dysmenorrhea among college student in experimental group and control group

MATERIALS AND METHODS:

Quasi- experimental non randomized control group design was used in this study.

Setting of The Study:

The study was conducted in selected Nursing colleges, Thanjavur District. The Investigator selected Our Lady of Health College of Nursing, Thanjavur for the experimental group. It is affiliated to The Tamil Nadu Dr.M.G.R Medical University, Chennai. The total strength of the college was 400. Among these 120 college students have dysmenorrhea. 30 students were selected under inclusion criteria for experimental group. The investigator had selected Manni Narayanasamy college of Nursing, Mathur, Thanjavur district for the control group which is 18 km away from our lady health college of nursing. The total strength of the college was 200. Among these 80 students have dysmenorrhea. 30 students for were selected control group.

Sample and Sample Size:

The sample comprised of Nursing College students with dysmenorrhea. The sample size comprised of 60.

Inclusion Criteria:

Nursing students

1. Who were willing to participate in the study.

2. Who can understand instruction either Tamil or English

Exclusion Criteria:

Nursing students

1. Who were taking any other medical treatment for dysmenorrheal.

2. Who had any other gynecological disorder.

Sampling technique:

Non-probability purposive sampling technique was used for this study.

Description of the Tool:

Part-1: Demographic and obstetric variables such as age in year, onset of menarche, history of menstrual cycle, number of days of menstrual flow, number of pads used in a day, Pain characters, characteristic of menstrual bleeding, family history of dysmenorrhea, remedy were used to relief dysmenorrhea, premenstrual syndrome.

Part-2: Used Pain Assessment Scale (Modified Mc Gill Pain Questionnaire) to assess the intensity of the pain indicating the nature of the pain such as jumping, pricking, squeezing, and killing etc. the pain indicating words were given to students and asked them what nature of pain they have.

Scoring Procedure:

Level of pain	score
No pain	0
Mild pain	1
Discomforting	2
Distressing	3
Horrible	4
Excruciation	5

Method of Data Collection:

The main study was conducted in Our Lady of Health College of Nursing, Thanjavur and Mannai Narayanasamy College of Nursing The formal permission was obtained from head of the Institutional authorities. Oral consent was obtained from the participants prior to the study. 30 samples were selected from Our Lady of Health College of Nursing for experimental group and 30 samples were selected from Manni Narayanasamy College of Nursing for control group by using Purposive method after explaining the objectives of the study. On day 1^st, demographic and obstetric variables were collected and the level of dysmenorrhea were assessed by modified McGill pain Questionnaire in both experimental and control group. The investigator collected the sample for experimental group in our lady hostel new auditorium and demonstrated pelvic rocking exercise under the direct observation of investigator, the sample were doing the pelvic rocking exercise for 20 minutes in both morning and evening for 21 days. After 21 days posttest was conducted with the same scale(modified McGill pain Questionnaire).The collected data were entered in a coding sheet and analyzed statistically.

Plan for Data Analysis:

S.No	Data analysis	Methods	Remark
1	Descriptive statistics	Frequency and percentages	To describe the demographic variables
1		Mean and standard deviation	To assess the pretest and posttest level of dysmenorrhea among college students in experimental and control group.
2	Inferential statistics	Paired ‘t’ test	To evaluate the effectiveness of pelvic rocking exercise on dysmenorrhea among college students in experimental and control group
		Un paired ‘t’ test	To determine the comparison between the posttest level of dysmenorrhea among college students in experimental and control group
		Chi-square test	To determine the association between the posttest level of dysmenorrhea with their selected demographic variables

RESULTS:

Table no 1: Frequency and percentage wise distribution of pretest and posttest of the level of dysmenorrhea among the college students in experimental group. N=30

Level of Dysmenorrhoea	Pretest		POSTTEST
Level of Dysmenorrhoea	f	(%)	f	(%)
No pain	0	0	6	20
Mild	0	0	24	80
Discomforting	3	10	0	0
Distressing	16	53.3	0	0
Horrible	11	36.7	0	0
Excruciating	0	0	0	0
Total	30	100	30	100
Mean+Standard deviation	17+3.151		7.57+3.875

Table no 1 shows that frequency and percentage wise distribution of pretest and posttest of the level of dysmenorrhea among the college student in experimental group.In pretest, Majority of college students16(53.3%) had distressing,11(36.7%) had horrible and 3(10%) had discomforting level of dysmenorrhea and the mean and standard deviation the level of dysmenorrhea among the college students in experimenal group (17+3.151) respectively.

In posttest, Majority of college students 24(80%) had mild, and 6(20%) had no pain level of dysmenorrhea and the mean and standard deviation the level of dysmenorrhea among the college students in experimental group (7.57+3.875) respectively.

Table no 2: Frequency and percentage wise distribution of pretest and posttest of the level of dysmenorrhea among the college students in control group. N=30

Level of Dysmenorrhoea	Pretest		Posttest
Level of Dysmenorrhoea	f	(%)	f	(%)
No pain	0	0	0	0
Mild	2	6.7	3	10
Discomforting	19	63.3	18	60
Distressing	5	16.7	4	13.333
Horrible	4	13.3	5	16.667
Excruciating	0	0	0	0
Total	30	100	30	100
Mean+Standard deviation	14.40+5.001		14.96+5.014

Table no 2 shows that frequency and percentage wise distribution of pretest and posttest of thelevel of dysmenorrhea among the college student in control group.In pretest, Majority of college students 19(63.3%) had Discomforting, 5(16.7%) had Distressing, 4(13.3%) had Horrible and 2(6.7%) had mild level of dysmenorrhea and the mean and standard deviation the level of dysmenorrhea among the college students in control group (14.40+5.001) respectively.

In posttest, Majority of college students 18 (60%) had Discomforting, 5(16.667) had Horrible 4(13.333) had distressing, and 3(10%) had mild level of dysmenorrhea and the mean and standard deviation the level of dysmenorrhea among the college students in control group (14.96+5.014) respectively.

Table no 3: Effectiveness of pelvic rocking exercise on dysmenorrhea among the college students in experimental and control group. N=60

Group	Pretest		Posttest		Paired -t test	Table value
Experimental Group	Mean	SD	Mean	SD	8.433 (S)	2.05
Experimental Group	17	3.151	7.57	2.875	8.433 (S)	2.05
Control Group	14.40	5.001	14.96	5.014	1.140 (NS)	2.05

Table no 3 shows that, the mean score of effectiveness of pelvic rocking exercise on dysmenorrhea among the college students in experimental group, the mean and standard deviation score was pretest 17±3.151and the posttest 7.57±2.875. The calculated paired t’ test value of t=8.433 shows statistically significant difference of effectiveness of pelvic rocking exercise on dysmenorrhea among the college students in experimental group.

The mean score of Effectiveness of pelvic rocking exercise on dysmenorrhea among the college students in control group , the mean and standard deviation score was pretest 14.40±5.001 and the posttest 14.96±5.014. The calculated paired t’ test value of t = 1.140 shows statistically non significant difference of effectiveness of pelvic rocking exercise on dysmenorrhea among the college students in control group.

Table no 4: Comparison of pelvic rocking exercise on dysmenorrhea among the college students in experimental group and control group. N=60

Group

Experimental Group

Control Group

Unpaired ‘T’test

Value

Table Value

Post test

Mean

(S)

2.00

7.57

2.875

14.96

5.014

Table no 4 This table shows that the mean and standard deviation score of Comparison of pelvic rocking exercise on dysmenorrhea among the college students in posttest of experimental group was 7.57±2.875 and the control group was 14.96±5.014. The calculated unpaired t’ test value of t=14 and the table value 2.00. shows statistically significant difference between pelvic rocking exercise on dysmenorrhea among the college students in experimental group and control group of posttest.

DISCUSSION:

The first objective was to assess the pretest and posttest level of dysmenorrhea among the college students in experimental and control group.In the experimental group pretest level of dysmenorrhea revels that college students 16(53.3%) had distressing, 11(36.7%) had horrible and 3(10%) had discomfort.In the control group pretest level of dysmenorrhea college students 19(63.3%) had Discomforting, 5(16.7%) had Distressing, 4(13.3%) had Horrible and 2(6.7%) had mild level of dysmenorrhea.The assessment of posttest level of dysmenorrhea revels that college students 24(80%) had mild, and 6(20%) had no pain level of dysmenorrhea in experimental group. While in the control group posttest level of dysmenorrhea, college students 18(60%) had discomforting, 5(16.667%) had horrible 4(13.333) had distressing, 3(10%) had Mild level of dysmenorrhea in control group.

The second objective of the study was to evaluate effectiveness of pelvic rocking exercise on dysmenorrhea among experimental and control group.The mean value 17 with standard deviation 3.151 of the pretest was significance to the posttest mean value 7.57 with standard deviation 3.875 and the ‘t’ value was (calculated value) 8.43 and the table value 2.05 (CV>TV) which is significant at 0.05 level for experimental group. Where as in the control group the analysis is revealed that the mean value 14.40 with standard deviation 5.001 of pre test had no significance to the post test mean value 14.96 with the standard deviation 5.014 and the ‘t’ value was (calculated value) 1.140 and table value 2.05(CV<TV) which is not significant at 0.05 level.The above findings shows that in experimental group there was significant difference in pre test and post test level of dysmenorrhea among college students, It reveals that the pelvic ^{rocking exercise
intervention was effective. Hence H}1 ^{was accepted.}

The third objectives of the study to determine the comparison between the posttest level of dysmenorrhea among college student in experimental and control group.There was significant difference in posttest level of dysmenorrheal among college students in experimental group and control group. The study result revealed that the mean value 7.57 with standard deviation 2.875 in experimental group and the mean value 14.96 with standard deviation 5.014 in control group. And the ‘t’ test value (calculated value) 14 and table value 2.00CV>TV which is significant at 0.05 level.The statistical analysis reveals that there was significant difference in posttest level of dysmenorahea in college students in experimental group the comparison with control group. so the given pelvic rocking exercise intervention was effective in reduce the dysmenorrhea ^{level in the
experimental group.}^Hence,^H2 ^{was
accepted.}

^CONCLUSION:

The statistical analysis reveals that there was significant difference in posttest level of dysmenorahea in college students in experimental group the comparison with control group. so the given pelvic rocking exercise intervention was effective in reduce the dysmenorrhea level in the experimental group.

REFERENCES:

1 Brunners and suddarth’s, text book of medical surgical nursing volume 2 13^th edition, published by wolters kluwer pvt ltd, new delhi. 1624- 1627.

2 Bt. Basavanthpa essentials of medical surgical nursing edition 2011, pub by jp brothers medical publishers pvt ltd bengaluru, 306.

3 Ju, H., Jones, M., and Mishra, G. (2014). The prevalence and risk factors of dysmenorrhea. Epidemiologic reviews, 36, 104–113.

4 ChitraNayek and Anita Paul Samanta. (2022). Effectiveness of Planned Teaching Programme on Pelvic Rocking Exercises in Reducing Dysmenorrhoea in Terms of Knowledge and Practice Among 1st Year General Nursing and Midwifery Students in Selected School of Nursing, Kolkata, West Bengal. Acta Scientific Gastrointestinal Disorders, 5(1): 27-30.

5 Das J et al. A Study to assess the effectiveness of pelvic rocking exercise on dysmenorrhea among nursing students in selected College’s, Bangalore. IOSR Journal of Nursing and Health Science (IOSR-JNHS). 2022; 11(1): 20-29.

Received on 15.09.2023 Modified on 06.10.2023

A and V Pub Int. J. of Nursing and Medical Res. 2023; 2(4):150-154.

DOI: 10.52711/ijnmr.2023.35