IN THE NAME OF THE MOST MERCIFUL GOD

Transcription

1 IN THE NAME OF THE MOST MERCIFUL GOD

2 Compiled by : Laaya Hamedanian Professor A. Nadjarzadeh

3 Article Title : Rose Tea for Relief of Primary Dysmenorrhea in Adolescents A Randomized Controlled Trial in Taiwan

4 Journal Title : Journal of Midwifery & Women s Health The American College of Nurse-Midwives Impact Factor: 1.067

5 Authors: Ying-Fen Tseng RN, MSN Chung-Hey Chen RN, PhD Yi-Hsin Yang PhD The study was funded by the National Science Council, Taipei, Taiwan Issue published online: 24 DEC 2010 Article first published online: 24 DEC 2010

6 KEYWORDS pain dysmenorrhea rose tea complementary therapies

7 Abstract Primary dysmenorrhea is the most common gynecological symptom reported by women. Complementary and alternative medicine treatment options are of interest to patients and health care providers. The use of rose tea to alleviate menstrual pain has long been a part of folk knowledge around the world but has not been studied scientifically. Findings suggest that drinking rose tea is a safe, readily available, and simple treatment for dysmenorrhea

8 Introduction Primary dysmenorrhea can be defined as painful menstruation without pelvic abnormalities, and may be accompanied by vomiting, fatigue, back pain, headaches, dizziness, and diarrhea. In traditional Chinese medicine, women's bodies were considered cold and emotionally irritable during menstruation, postpartum, and menopause, so flower tea and red tea were recommended during those periods. The purpose of this study was to investigate the effects of drinking rose tea for alleviating the pain and psychophysiologic distress experienced by adolescents with primary dysmenorrhea in Taiwan.

9 Methods Participants were adolescent female nursing students. They were randomly assigned into control and experimental groups (cluster randomization). The Visual Analog Scale for Pain (VASP) was distributed to 950 female adolescents from recruited schools. The VASP consists of a 10-cm horizontal scale with the descriptors no pain on the left and worst possible pain on the right.

10 The criteria for participating in the study included : 1) 15 to 18 years of age. 2) dysmenorrhea with pain scoring higher than 3 on the VASP (range 0 10). 3) agreement to participate with parental consent after reading an informed consent document.

11 Intervention: Participants in the experimental group were taught how to make rose tea and were asked to drink rose tea from 1 week before their menstrual period to the fifth menstrual day, for a total of 6 cycles. The participants drank 2 teacups of rose tea (i.e., 6 dry rosebuds steeped for 10 minutes in 300 ml of hot water per teacup) for 12 days every month. Our study provided the teapots and dry rosebuds to each of the rose teadrinking participants. Participants in the control group did not receive any intervention until after the final data had been collected.

12 Measurement of Outcome Variables the following five instruments were used to measure the outcome variables: 1.The Short-Form McGill Pain Questionnaire (SF-MPQ) 2.The Menstrual Distress Questionnaire Short Form(MDQ-SF) 3.Visual Analogue Scales for Anxiety (VASA) 4.Perceived Stress Scale (PSS) 5.The Psychophysiologic Life Adaptation Scale (PLAS)

13 Procedure: The two schools were randomly assigned to an experimental or a control group. random sampling from students who had dysmenorrhea pain scoring higher than 3 on the VASP. The two groups were asked to complete the MPQ, MDQ, VASA, and PSS questionnaires after a menstrual cycle at each of 4 time periods (before intervention and 1, 3, and 6 months after intervention). Participants completed most questionnaires individually in a private area, but the second posttest was completed by mail because it coincided with Taiwanese students' annual 1-month winter vacation. consent form were given to each subject and her parents by the primary researcher.

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15 Data Analysis: By applying Dunn's method for multiple comparisons of means, statistically significant differences between the experimental and the control group for the MPQ, MDQ, VASA, and PLAS at the four different time points were determined by P <.017. The accepted level of significance for all other analyses was P <.05. The mixed procedure with the repeated option of SAS V8.0 was used to conduct the statistical analysis.

16 Using the general linear mixed model analysis allows more flexibility than traditional multivariate regression analysis, because it allows subjects who are missing some outcome data to be included in the analysis. Power analysis was used to determine the sample size. Extrapolating for a medium size effect of 0.50, a minimum sample of 63 per group was needed to achieve a power of 0.80 with an alpha of.05. Therefore, 79 experimental subjects and 70 control subjects were randomly selected and approached for the study; this allowed for 20% and 10% attrition rates, respectively.

17 Result: The female adolescents who drank rose tea during their menstrual period reported having lower MPQ, MDQ, VASA, and PSS scores and higher psychophysiologic well-being scores than the control group during the posttests at 1 month, 3 months, and 6 months. The findings suggest positive effects of rose tea on alleviating menstrual pain, menstrual distress, anxiety, and perceived stress among participants in the experimental group after 1 month.

18 Results suggest further improvement in psychophysiologic well-being 3 months after intervention. The experimental group perceived lower menstrual pain, distress, and anxiety as well as higher psychophysiologic well-being over time, and they presented the lowest MPQ, MDQ, and VASA scores and the highest psycho-physiologic well-being scores at the 6-month posttest. They had significantly lower PSS scores than the control group from the 1-month posttest, and they perceived the lowest stress at the 3-month posttest.

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22 DISCUSSION AND IMPLICATION: I. The results of this randomized trial suggest that rose tea may be an effective nonpharmacologic alternative for adolescents with primary dysmenorrhea, with evidence of symptom improvement 1 month after beginning the treatment. II. III. A possible explanation is that rose tea prevents the stagnation of blood inside the uterus by facilitating blood circulation. Rose tea is purported to regulate hormone secretion and alleviate dysmenorrhea, but rigorous scientific testing is needed to determine its effect on specific hormones. IV. Rose calyx contains vitamins A, B, C, E, K, and P. Vitamins B 1 and B 6 were more effective than placebo in reducing dysmenorrhea pain.

23 study's limitations: The study's outcomes were largely subjective and measured by self-report questionnaires, it is possible that rose tea has only a placebo effect on menstrual discomfort. The participants in the experimental group were in contact with a research assistant once a week for a 6-month period. the attention or social bonding participants received from the research assistant may, in itself, have made them feel better. we cannot exclude the possible ameliorative effects of warm water on dysmenorrhea.

24 Participants in the control group may have known about this form of herbal medicine and used rose tea themselves during the follow-up period. During the 6-month follow up period, only two participants complained of mild diarrhea after drinking the first course of rose tea. One quit the study; the other decided to continue and experienced no further diarrhea.

25 SUGGESTION: This study only included Taiwanese adolescents, who may have a cultural predisposition to drinking rose tea. Thus, duplication of the study in other countries is recommended to test the feasibility and effectiveness of rose tea therapy.

26 CONCLUSION: This study contributes to the development of knowledge in nursing and midwifery by having tested an intervention that female adolescents with dysmenorrhea may take advantage of, using readily available resources that they can manage themselves. Although duplication studies are needed, this is the first controlled study to provide evidence that rose tea (steeped rosebuds) may be an effective and safe nonpharmacologic strategy for the treatment of primary dysmenorrhea.

27 Thank you