Korean J Women Health Nurs.  2020 Sep;26(3):231-239. 10.4069/kjwhn.2020.09.10.

Do depression, fatigue, and body esteem influence premenstrual symptoms in nursing students?

• Lee EJ
• Yang SK

• KMID: 2506898
• DOI: http://doi.org/10.4069/kjwhn.2020.09.10

Abstract

Purpose
The purpose of this study was to investigate factors affecting premenstrual symptoms among nursing students, focusing on depression, fatigue, and body esteem.
Methods
The participants were 145 nursing students at a university located in Kyungnam, Korea. Data were collected from November 2 to November 30, 2019 using self-reported structured questionnaires, and analyzed using descriptive statistics, the independent t-test, analysis of variance, Pearson correlation coefficients, and multiple regression analysis.
Results
The mean item score for premenstrual symptoms was 2.52±0.92, indicating a low level. The mean score for depression was 16.05±7.72, and 58.6% of participants were found to be non-depressed, 16.6% to be mildly depressed, 15.2% to be moderately depressed, and 9.7% to be severely depressed. The mean item score for fatigue was 4.84±0.84, indicating a moderate level, and that for body esteem was 2.94±0.44, indicating a moderate level. The premenstrual symptoms of nursing students showed a statistically significant correlation with depression (r=–.58, p<.001), fatigue (r=.33, p<.001), and body esteem (r=–.28, p<.001). The factors impacting the premenstrual symptoms of nursing students were depression (β=.47, p<.001), dysmenorrhea (β=–.18, p=.009), menstrual cycle regularity (β=.17, p=.013), and body esteem (β=–.14, p=.038). The total explanatory power of these variables was 41.0%.
Conclusion
The results suggest that intervention programs to relieve the premenstrual symptoms of nursing students should focus on depression, menstrual cycle regularity, dysmenorrhea, and body esteem.

Keyword

Body image; Depression; Fatigue; Premenstrual syndrome; Nursing students

Reference

References

1. The American College of Obstetricians and Gynecologists. Premenstrual syndrome [Internet]. Washington, DC: Author;2015. [cited 2020 Jun 17]. Available from: https://www.acog.org/patient-resources/faqs/gynecologic-problems/premenstrual-syndrome.

2. Direkvand-Moghadam A, Sayehmiri K, Delpisheh A, Kaikhavandi S. Epidemiology of premenstrual syndrome (PMS)-a systematic review and meta-analysis study. J Clin Diagn Res. 2014; 8(2):106–109. https://doi.org/10.7860/JCDR/2014/8024.4021.

3. Lim H, Park Y. Differences in dietary intake and life-style of female college students in seoul with and without premenstrual syndrome. J Menopausal Med. 2010; 16(3):153–161.

4. Kim MJ, Nam YS, Oh KS, Lee CM. Some important factors associated with premenstrual syndrome influence of exercise, menarche, and age on PMS. Korean J Growth Dev. 2003; 11(2):13–26.

5. Lee SR, Lim JY, Lee EJ, Jo YT, Ra CR. Preconception care and policy recommendations for unmarried women of childbearing age: focusing on medical service use and online reproductive health information. Sejong, KR: Korea Institute for Health and Social Affairs;2014.

6. Jang HJ, Sung MH. Impact of menstrual attitudes, premenstrual syndrome, and stress response on quality of life among nursing students. Korean J Women Health Nurs. 2018; 24(4):346–354. https://doi.org/10.4069/kjwhn.2018.24.4.346.

7. Rapkin AJ, Akopians AL. Pathophysiology of premenstrual syndrome and premenstrual dysphoric disorder. Menopause Int. 2012; 18(2):52–59. https://doi.org/10.1258/mi.2012.012014.

8. Lee JY, Kim SM, Kang SH, Chung HG, Choi JH, So HS et al. Association of premenstrual syndrome and premenstrual dysphoric disorder with depression, sleep quality and sleep pattern in the Korean female high-school students. Anxiety Mood. 2016; 12(2):113–118.

9. Jung GS, Oh HM, Choi IR. The influential factors on premenstrual syndrome college female. J Korea Acad Ind Coop Soc. 2014; 15(5):3025–3036. https://doi.org/10.5762/KAIS.2014.15.5.3025.

10. Park BY, Shim OS. Predictors of quality of life in nursing students and general college students. J Learn Cent Curric Instr. 2016; 16(11):811–830. https://doi.org/10.22251/jlcci.2016.16.11.811.

11. Kim KH, Yoon HS. Factors influencing sleep quality in nursing students and non nursing students. J Korean Acad Psychiatr Ment Health Nurs. 2013; 22(4):320–329. https://doi.org/10.12934/jkpmhn.2013.22.4.320.

12. Park MH, Hwang EH. Comparison of sleep quality, fatigue and depression among nursing students between school lessons and clinical practicum term. J Korean Soc Sch Community Health Edu. 2016; 17(3):103–116.

13. Park SJ, Choi JY. Factors affecting clinical practice-related fatigue among nursing students. J Korea Content Assoc. 2016; 16(2):456–466. https://doi.org/10.5392/JKCA.2016.16.02.456.

14. Gim WS. Korean overall body esteem scale(KOBES): development, validation, and gender differences. Korean J Psychol Woman. 2007; 12(2):231–253. http://doi.org/10.18205/kpa.2007.12.2.009.

15. Hong M, Park Y, Chen EY, Yun JW, Oh MH. Body esteem, stress, and health promoting behavior among korean adults in a community. Korean J Rehabil Nurs. 2017; 20(1):61–68. https://doi.org/10.7587/kjrehn.2017.61.

16. Ussher JM, Perz J. “I feel fat and ugly and hate myself": self-objectification through negative constructions of premenstrual embodiment. Fem Psychol. 2020; 30(2):185–205. https://doi.org/10.1177/0959353519900196.

17. Lee SJ, Lee EJ, An K. A relationship on body esteem, self esteem and eating behavior of nursing students. Asia-pacific J Multimed Serv Convert Art Humanity Social. 2019; 9(6):527–539. https://doi.org/10.35873/ajmahs.2019.9.6.051.

18. Yoon JW. Effects of perceived stress, ego-resilience on premenstrual syndrome in female college students. J Korean Content Assoc. 2019; 19(3):405–415. https://doi.org/10.5392/JKCA.2019.19.03.405.

19. Moos RH. The development of a menstrual distress questionnaire. Psychosom Med. 1968; 30(6):853–867. http://doi.org/10.1097/00006842-196811000-00006.

20. Kim HW, Kwon MK. Study on the validity and reliability of MMDQ (Moos Menstrual Distress Questionnaire) among middle school students. Korean Parent Child Health J. 2004; 7(2):111–120.

21. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977; 1(3):385–401. http://doi.org/10.1177/014662167700100306.

22. Cho M, Kim K. Diagnostic validity of the CES-D(Korean version) in the assessment of DSM-III-R major depression. J Korean Neuropsychiatr Assoc. 1993; 32(3):381–399.

23. Chon KK, Choi SC, Yang BC. Integrated adaptation of CES-D in Korea. Korean J Psychol Health. 2001; 6(1):59–76.

24. Schwartz JE, Jandorf L, Krupp LB. The measurement of fatigue: A new instrument. J Psychosom Res. 1993; 37(7):753–762. https://doi.org/10.1016/0022-3999(93)90104-N.

25. Byeon YS, Lee JI. Reliability and validity tests for the Fatigue Assessment Instrument (FAI). J Korean Acad Fund Nurs. 2004; 11(2):220–225.

26. Gim WS, Cha JH. Body-related values and consumer behavior: an exploratory study for scale development. Korean J Consumer Advert Psychol. 2006; 7(3):455–485.

27. Jeon JH, Hwang SK. A structural equation modeling on premenstrual syndrome in adolescent girls. J Korean Acad Nurs. 2014; 44(6):660–671. http://doi.org/10.4040/jkan.2014.44.6.660.

28. Kang DH. Influencing factors in premenstrual syndrome(PMS) among nursing students. J Digit Converg. 2017; 15(3):277–286. https://doi.org/10.14400/JDC.2017.15.3.277.

29. Wang HJ, Kang MS, Oh SM. Influential factors on premenstrual syndrome in female college students. Korean Parent Child Health J. 2018; 21(1):1–10.

30. Choi HJ, Kim BM, Kim JW, Kim JH, Oh HJ, Lee GE, et al. Factors associated with stress and menstrual attitude with premenstrual syndrome among nursing students. J Kyungpook Nurs Sci. 2018; 22(2):26–34.