A NURSING INTERVENTION FOR PERIMENSTRUAL TURMOIL: A LONGITUDINAL THERAPEUTIC TRIAL.

Description

Perimenstrual symptoms characterized by cyclical feelings of turmoil affect a small proportion of women (4-8%), but disrupt significantly women's personal and social lives. This research represents a trial of a multimodal nursing therapeutic program in which women individualized their therapeutic regimens. Data were collected prior to, during, and after treatment for a total of six menstrual cycles. Daily and weekly measures included endocrine (salivary progesterone and cortisol) lives, symptom experience, personal resources, social demands and resources, and patterns of health behaviors and health practices. An experimental intervention, introduced after a baseline data collection period, was a multi-modal package of treatments (diet, nutritional supplements, exercise, stress-management, esteem-building) administered within the framework of a peer-professional therapeutic network. The therapeutic program produced three response patterns: normalized, regulated and unstable. The normalized response represented attenuation of perimenstrual turmoil and improvement in all other measures whereas the regulated response reflected an initially unstable pattern that reorganized into a regular, predictable, and low intensity cycle of perimenstrual turmoil. The unstable response pattern remained extremely variable across cycle phases and treatment condition. Data analysis included descriptive and autocorrelational time-series analytic strategies. This study represents a first attempt at characterizing perimenstrual symptoms across six menstrual cycles. Moreover, the therapeutic trial represents an innovative multimodal approach in which therapeutic elements were individualized and intensive baseline and outcome measures permitted identification of response patterns over time. In testing a model of nursing intervention, this study has proposed prescriptive theory which includes a practice model and evaluative criteria directed toward an important women's health problem. The prescriptive theory included concepts of self-management, self-modification and caring. Criteria for evaluating patterns of therapeutic response is a unique contribution to nursing therapeutics since individual response patterns are of importance to nursing practitioners.

Subjects