Relationship of adolescent physical and sexual abuse to perimenstrual symptoms (PMS) in adulthood

Research is lacking regarding adolescent physical and sexual abuse and perimenstrual symptoms (PMS). This study examined the relationship between adolescent physical and sexual abuse and PMS in adult women. Secondary data analysis of a longitudinal study of a community sample of 568 women (35% underrepresented ethnicities), using the database "Nursing Assessment of PMS: Neurometric Indices," was performed. History of both adolescent physical abuse and sexual abuse was significantly associated with PMS in adulthood. Women with a history of adolescent physical and sexual abuse had significantly more severe PMS patterns with more dysphoria than women without abuse.     

Living with chronic illness: a phenomenological study of the health effects of the patient-provider relationship.

PURPOSE: To understand the patient-healthcare provider (HCP) relationship from the lived experience of women with chronic disease and determine how this relationship affects women's health. DATA SOURCES: Narrative accounts of 25 women's relationships with HCPs in repeated group and individual interviews were audio-taped and transcribed verbatim. Interpretive phenomenology was used to explore the data using three interconnected modes of paradigm cases, exemplars, and themes. CONCLUSIONS: Women with chronic disease believed their health was significantly affected by their relationships with HCPs. They experienced a greater sense of well-being and security in connected relationships and had more confidence and motivation to manage their illness. IMPLICATIONS FOR PRACTICE: This research suggests that for women with chronic disease, relationships with HCPs that are connected, and characterized by partnership, and personableness result in the women feeling better in many dimensions. The context of today's healthcare system often pushes the nurse practitioner (NP) to provide care more attuned to medical issues, leaving little time for the development of connected relationships. In spite of this pressure, NPs need to strive to develop relationships with patients that are intersubjective/connected.     

Evaluation of an electronic diary as a diagnostic tool to study headache and premenstrual symptoms in migraineurs

OBJECTIVE: To evaluate an electronic diary as a tool to evaluate the occurrence and relationship of headaches and premenstrual syndrome (PMS) symptoms throughout the menstrual cycle in women with migraine. BACKGROUND: Menstrually related headache and PMS significantly impact the quality of life of many women. The time relationship of these 2 menstrually related problems is not well understood and not well described. METHODS: Twenty women with migraine experiencing regular menstrual cycles were enrolled in a prospective study designed to date- and time-stamp data, both self- and computer-prompted, headache and PMS symptoms, for 3 consecutive months. A previously validated PMS score was calculated by grading 23 PMS criteria on a scale of 0 to 3 (0 = no symptoms, 3 = severe symptoms). RESULTS: The total number of data entries recorded was 2009, composed of 56 menstrual cycles in 20 migraineurs. Five hundred forty-four entries reported a current, prodromal, or previous headache. The mean daily occurrence of headache increased beginning on cycle day -5, peaked on days +1 to +5, and returned to baseline by day +7. Mean daily PMS scores ranged from 2.4 to 12. Mean daily PMS scores peaked on days -6 to +2 and returned to baseline by day +8. CONCLUSIONS: An electronic diary may have potential as a diagnostic tool in studying headaches and PMS symptoms throughout the menstrual cycle. The occurrence of headache and PMS symptoms in migraineurs follows similar time courses.     

Emotion Regulation in Women with Premenstrual Syndrome (PMS): Explicit and Implicit Assessments

Psychological factors, such as cognitive-emotional processes, are proposed to play an important role in the etiology of premenstrual syndrome (PMS). Our aim was to determine whether there are differences in emotion regulation between women with PMS and non-PMS controls. The study included 54 women who suffered from PMS (confirmed by prospective daily ratings during two menstrual cycles), as well as 52 non-PMS controls. All participants completed the Cognitive Emotion Regulation Questionnaire (CERQ) as an explicit and the affect misattribution procedure (AMP) as an implicit measure of emotion regulation. Each participant conducted the self-report as well as the experimental assessments twice, once during the follicular phase and once during the luteal phase of the menstrual cycle. The AMP was conducted with neutral and negative picture and facial stimuli. Three different interstimulus intervals (100, 500, 1500 ms) were used to examine implicit emotion regulation processes. Women with PMS reported a significantly higher use of three dysfunctional emotion regulation strategies in the CERQ (p values < .001). In the AMP with picture stimuli, women with PMS showed stronger implicit negative affective reactions compared to non-PMS women, independent of menstrual cycle phase (p = .008). In the AMP with facial stimuli, this stronger negative affect misattribution appeared in women with PMS compared to the control group only in the luteal phase and only for medium interstimulus intervals of 500 ms (p = .050). The results suggest that PMS is associated with alterations in the processes of emotion regulation, as assessed both on an explicit and on an implicit level. Further research on the etiology of PMS should focus more on cognitive-emotional processing and its interaction with biological changes relating to the menstrual cycle.     

Effectiveness of professional--peer group treatment: symptom management for women with PMS

The purpose of this intervention study was to determine short- and long-term effectiveness of a symptom management intervention aimed at relieving the distress associated with premenstrual syndrome (PMS). The PMS Symptom Management Program (PMS-SMP), a package of nonpharmacological strategies involving self-monitoring, personal choice, self-regulation, and self/environmental modification, was administered within a group combining peer support and professional guidance to 91 women classified with severe PMS (early treatment groups n = 40; waiting treatment groups n = 51). Repeated behavioral measures (symptom severity and personal resources/demands) were obtained on five occasions: two menstrual cycles prior to treatment and at 3, 6, 12, and 18 months after treatment. A package of symptom management strategies was effective in reducing PMS severity by 75%, premenstrual depression, and general distress by 30-54%, as well as increasing well-being and self-esteem in women experiencing severe PMS. These results compare favorably with antidepressant drug treatment studies that report a 40-52% reduction in PMS severity. The most marked improvement was found in the first 3 months after treatment; however, improvement was maintained or enhanced in the long-term follow-up. Although focused on perimenstrual symptom relief, these strategies are generally health promoting and can be applied to other women's health conditions.     

Arousal and stress response across the menstrual cycle in women with three perimenstrual symptom patterns

The purpose of this study was to compare arousal levels and stress response across menstrual cycle phases in women with three perimenstrual symptom patterns. Women with low symptom severity (LS, N = 28), were compared with those with a premenstrual syndrome (PMS, N = 15) and premenstrual magnification (PMM, N = 19) pattern across postmenses and premenses phases. Each woman was assessed during relaxation and in response to mental task and symptom imaging stressors during a postmenses and premenses day. Results of baseline skin conductance (SCL), electromyogram (EMG), and finger temperature (T) demonstrated arousal premenses in women with the PMS pattern, but not in women with the LS pattern. In addition, women with the PMS pattern experienced increased EMG and SCL response to stressors premenses. Women with the PMM pattern experienced a rise in finger temperature premenses, opposite the pattern of the women with LS or PMS. These results support development of symptom management strategies to reduce arousal and modulate stress response for women with PMS who seek help for their symptoms. In addition, the difference in arousal and stress response observed in women with PMS and PMM support development of different symptom management strategies for these two groups of women.     

Applying the theory of reasoned action to AIDS risk behavior: condom use among black women

This study tested hypotheses regarding attitudinal and normative influences on intentions to use condoms, a practice that would reduce women's risk of sexually transmitted HIV infection. Participants were 103 sexually active unmarried black women undergraduates at an inner-city commuter university, in an area with a high rate of reported AIDS cases among women. Consistent with the theory of reasoned action, multiple regression analysis on women's anonymous responses to a mailed survey revealed that those who registered more favorable attitudes toward condoms and those who perceived subjective norms more supportive of condom use reported firmer intentions to use condoms in the next three months. Key behavioral beliefs related to attitudes centered on the adverse effects of condom use on sexual enjoyment. Key normative influences were respondents' sexual partners and mothers. However, women's own attitudes were a stronger determinant of intentions to use condoms than were their perceptions of normative influences, particularly among women with above-average AIDS knowledge. The results suggest that the theory of reasoned action provides a potentially useful conceptual framework for interventions to change a key AIDS risk behavior among women.     

Ethical concerns in caring for older women in the community

Given the preceding discussion, what can be summarized at this point about the ethical concerns we face in the care of older women? Overall, we have presented a perspective that combines our understanding of women's health and nursing ethics. The essence of much of our concern about caring for older women is that we have views about their care that reflect our understanding of what it means to be professionals who have a social contract with our clients. We have discussed nursing ethics as a process that occurs within a social context that emphasizes working to maximize self-determination and informed choices for older women. We have emphasized autonomy and a perspective that places the nurse in an advocacy position with the patient in a relationship of partners. Arriving at reasoned positions on the ethical issues in the care of older women leads to agreement with Gloria Steinem that women may be the one group that grows more radical with age.     

Factors that affect acceptance of HIV microbicides among women

Globally, women make up more than half of those infected with HIV. For women in nearly every region around the world, the primary mode of HIV transmission is through heterosexual sex. However, over thirty years into the HIV/AIDS epidemic women still lack sufficient means of protecting themselves against HIV. Vaginal HIV microbicides (VHMs) are a promising new method to prevent HIV infection. VHMs are chemical substances that can destroy HIV, block its entry into or fusion with the target cell or inhibit HIV replication once the virus has entered a target cell. They can be applied through various delivery methods intravaginally. VHMs are designed to be used by women and to that end it is crucial to understand women's preferences for formulation, use and other characteristics in order to determine how to increase adherence and acceptability. Of particular consideration is how relationship dynamics will affect microbicide usage. The purpose of this review is to examine the most recent body of literature regarding male and female perceptions of VHMs to prevent male to female transmission of HIV in order to gain a greater understanding of the factors that affect adherence and acceptability of VHM usage among women. A greater understanding of the factors that affect adherence and acceptance of VHMs will have an impact on the uptake of VHMs, allow nurses and other health care providers to counsel clients more effectively about their use and point to new directions needed on the research and development of future microbicides.     

Coping resources of women with premenstrual syndrome.

The purpose of this study was to determine what coping resources are used by women who suffer from premenstrual syndrome (PMS), and to compare the coping resources used with those of a normative population. Two hundred forty-four women volunteered to be in the study. After screening and a 3-month lapse time required for diary completion, 54 subjects remained in the study. A history developed by the researchers, menstrual diaries, and the Coping Resources Inventory (CRIS) were used in data collection. The findings indicate a statistically significant relationship between the dependent variable, severity of PMS, and the independent variables, self-disclosure, stress monitoring, social support, and structure. There was a positive relationship between self-disclosure and stress monitoring with severity of PMS, and an inverse relationship between social support and structuring and severity of PMS.     

Interactive model of women's stressors, personality traits and health problems

Theories have linked various stressors with health problems, and some studies have identified personality traits that enhance health. However, few studies have examined the interaction among women's stressors, personality traits and their health. This retrospective study (1996-1997) analysed the effects of women's major stressors and personality traits on symptoms of health problems, and developed a model of women's health based on the interaction among these factors. A convenience sample of 300 women aged between 18 and 66 years completed a questionnaire that measured three types of stressors, eight personality traits and 40 symptoms of health problems. Principle components and factor analyses identified the best items to measure the stressors, traits and problems. New reduced data subsets were constructed for classification tree analyses to identify the effects of stressors and personality traits on women's health. Women with medium or high stressors and low assertiveness, low hardiness, or the inability to express their feelings, were more likely to report physical symptoms than women who were stronger in these personality traits. Also, women with medium or high stressors and low to medium trust or love relationships were very likely to report high emotional symptoms, as were women with high trust or love, who did not express their feelings. An interactive model of women's health was supported. The amount of women's stressors and their personality traits may increase or diminish their stress response and affect their health. Nurses can identify women with high stressors and unhealthy personality traits that increase their risk for stress-related illnesses, and assist these women to modify their stressors or personality traits to enhance their health.     

Employment, family roles, and mental ill health in young married women

Women are entering the labor force at unprecedented rates, many combining employment with their roles as wives and mothers. The purpose of this study was to determine if the complement of women's roles was associated with negative mental health effects. It was hypothesized that multiple roles would have negative effects on mental health only in the presence of a social context that itself was associated with symptoms of mental ill health. The contextual variables included influence of sex role norms, task-sharing support from the spouse, and support from a confidant. A sample of 140 married women randomly selected from registrants at a family health clinic were interviewed about their roles and mental health. The complement of the women's roles was not associated with mental ill health, nor was there a clear relationship between employment or parenting on mental health. Each of the contextual variables had a moderate influence on symptoms of mental ill health. Women who had traditional sex role norms, little task-sharing support from a spouse, and little support from a confidant had poorer mental health than their counterparts. Thus, in this sample, the context for role performance had a stronger influence on mental health than did the actual roles women performed. In addition, the importance of the social contextual variables was contingent on the woman's complement of roles. For women who were both spouse and parent, confiding support was most important.(ABSTRACT TRUNCATED AT 250 WORDS)     

Symptoms of premenstrual syndrome in female migraineurs with and without menstrual migraine

Background

Menstrual migraine (MM) and premenstrual syndrome (PMS) are two conditions linked to specific phases of the menstrual cycle. The exact pathophysiological mechanisms are not fully understood, but both conditions are hypothesized to be triggered by female sex hormones. Co-occurrence of MM and PMS is controversial. The objective of this population-based study was to compare self-assessed symptoms of PMS in female migraineurs with and without MM. A total of 237 women from the general population who self-reported migraine in at least50% of their menstruations in a screening questionnaire were invited to a clinical interview and diagnosed by a neurologist according to the International Classification of Headache Disorders II (ICHD II), including the appendix criteria for MM. All women were asked to complete a self-administered form containing 11 questions about PMS-symptoms adapted from the Diagnostic and Statistical Manual of Mental Disorders. The number of PMS symptoms was compared among migraineurs with and without MM. In addition, each participant completed the Headache Impact test (HIT-6) and Migraine Disability Assessment Score (MIDAS).

Findings

A total of 193 women returned a complete PMS questionnaire, of which 67 women were excluded from the analyses due to current use of hormonal contraception (n?=?61) or because they did not fulfil the ICHD-criteria for migraine (n?=?6). Among the remaining 126 migraineurs, 78 had MM and 48 non-menstrually related migraine. PMS symptoms were equally frequent in migraineurs with and without MM (5.4 vs. 5.9, p?=?0.84). Women with MM reported more migraine days/month, longer lasting migraine attacks and higher HIT-6 scores than those without MM, but MIDAS scores were similar.

Conclusion

We did not find any difference in number of self-reported PMS-symptoms between migraineurs with and without MM.

     

Latest industry information on the safety profile of levofloxacin in Japan

This paper focuses on the development of four major adverse drug reactions (ADRs) associated with some fluoroquinolones: convulsions, phototoxicity, cardiac effects, and hepatotoxicity. CNS adverse events have been linked to fluoroquinolone administration, including seizures, which are more likely with co-administration of NSAIDs. Only 61 cases of convulsions have been reported with levofloxacin, with 33 of those affected having received NSAIDs. The assumed rate of serious convulsions was as low as 1/65,000 with NSAIDs and 1/260,000 without NSAIDs. Levofloxacin has a very low phototoxicity-inducing potential confirmed by pre-clinical animal studies and the results of post-marketing surveillance (PMS). Pre-clinical results demonstrated that levofloxacin was 20 times less phototoxic than sparfloxacin and PMS data show that serious phototoxicity develops in only 1 in 1.8 million cases treated with levofloxacin. While many fluoroquinolones are associated with cardiac effects, pre-clinical data has shown that compared with sparfloxacin and grepafloxacin, levofloxacin has no effect on myocardial conduction. PMS data further support the safety of levofloxacin in this regard. While trovafloxacin is associated with serious hepatic problems, PMS data demonstrates that levofloxacin has a very low incidence of 1/100,000 hepatic effects. These results were confirmed in a prospective study that confirmed a low 1.3% incidence rate for all ADRs associated with levofloxacin.     

Women and alcohol: misrepresented and misunderstood

Women's use of alcohol has been increasing over the last few decades. The physical, psychological and social effects of alcohol are more severe for women than for men. The underlying causes of women's drinking differ from those of men, which poses a challenge to nurses working in the specialist field of alcohol misuse. This article explored women's relationship with alcohol and treatment services, and identified that these treatment services are not specific to women's needs. To conclude, in order to offer women sensitive services, practitioners need knowledge of gender issues.     

Ovarian steroids and premenstrual symptoms: a comparison of group differences and intra-individual patterns

To examine the relationship of gonadal hormone and symptom patterns across the menstrual cycle, women screened for 2-3 cycles completed an intensive study cycle; 26 had a low-severity symptoms (LS), 20, a premenstrual syndrome (PMS), and 26, a premenstrual magnification pattern (PMM). All completed daily symptom diaries and collected late afternoon urine samples which were assayed for pregnanediol and estradiol for that cycle. The PMS and PMM groups had significantly more positive cross-correlations of pregnanediol and symptoms than the LS group. Women in all groups had similar levels of estradiol and pregnanediol. Women with PMS and PMM patterns responded to progesterone differently than women with LS patterns: thus the former groups may not benefit from hormone therapies.     

Development of the Perceived Multiple Role Stress Scale (PMRS).

Assessment of women's perception of multiple-role stress arising from occupancy of the maternal and student role is crucial if we are to engage in prevention and intervention strategies. Existing measures do not fully address the components of multiple role stress in this population: emotional role ambiguity, person-role and inter-role conflict. This article describes the development of the Perceived Multiple Role Stress Scale (PMRS) which was derived from Kahn, Wolfe, Quinn and Snoek's (1964) systems-based role theory. The 8-item, 3-factor PMRS measures multiple role stress in women who are both mothers and students. Review of the PMRS by role stress and women's roles experts supported content validity. Construct validity was supported in three phases over a five-year period. It is recommended that the three correlated factors be used as one eight-item scale. The internal consistency for the PMRS was .86.