The Effectiveness of Self-Compassion Training and Positive Thinking on Sleep Quality and Decrease of Pain Intensity in Girl With Primary Dysmenorrhea

* Corresponding Author: Abbas Abolghasem. PhD. Address: Department of Psychology, Faculty of Humanities, University of Guilan, Rasht, Iran. Tel: +98 (914) 3535482 E-mail: abolghasemi_44@yahoo.com 1. Department of Psychology, Faculty of Humanities, Rasht Branch, Islamic Azad University, Rasht, Iran. 2. Department of Psychology, Faculty of Humanities, University of Guilan, Rasht, Iran. Karameh Saghebi Saeedi1 , *Abbas Abolghasem2 , Bahman Akbary1


Introduction
rimary dysmenorrhea is known as a feminine problem that affects the quality of life of women of all ages. Primary dysmenorrhea medications are associated with dissatisfaction in the affected girls and their families, while non-pharmacologic therapies enhance pain adapta-P tion, reduce pain perception, and make it tolerable for the patient. These methods also increase the effectiveness of painkillers and reduce the drug dosage. Studies show that psychological factors influence perception of pain severity, and self-kindness and positive attitude training have been effective on one's health and perception of pain. Positive psychology offers a new way of cognitive processing and emotion regulation and reduces interpersonal and psychological problems. Self-kindness is positively associated with health-promoting behaviors and strongly predicts a healthy attitude toward psychological development.

Results
After collecting the questionnaires, the data were analyzed by SPSS software. The mean age of the students was 16.52±0.70 with the age range of 14 to 18 years. Shapiro-Wilk test was used to investigate the normal distribution of variables in pre-test and post-test, which was not significant for sleep quality and pain intensity in pre-test and post-test stages. Therefore, the distribution of variables was normal and parametric methods were used. Due to non-establishment of MANCOVA's assumptions, univariate Analysis Of Covariance (ANCOVA) was used to analyze the data. In the positive attitude, self-kindness and control groups, the F-test was used to examine the assumption of homogeneity of pre-test and post-test of sleep quality and pain intensity, which was not significant (P>0.05). Levene's test was used to compare homogeneity of experimental and control groups in post-test of sleep quality, and this difference was also not significant.
Results of ANCOVA analysis to investigate the difference between the experimental and control groups in post-test sleep quality and pain intensity, with the pre-test control of this variable (Table 1), showed that there was a significant difference in sleep quality between the experimental and control groups (F=7.16, P<0.005). Eta squared showed that the difference between the three groups in the post-test vari- able was significant with respect to the pre-test statistical control.
Modified means (Table 2) show that experimental conditions had 95% confidence in improving sleep quality and decreasing pain intensity in students with primary painful menstruation.

Discussion
The results showed that positive attitude and self-kindness training were effective in improving sleep quality in girls with primary dysmenorrhea, and positive attitude was more effective than self-kindness. In explaining the impact of self-kindness on improving sleep quality in affected girls, it can be deduced that: People with insomnia have a constant mental discomfort about sleeping during the day or night, which results in physical and emotional arousal. Mindfulness exercises related to self-kindness help insomnia patients to modify their sleep-related internal and external symptoms by guiding attention, careful review, and selective attention. People with higher self-kindness appear to have more self-acceptance and are less involved in these thoughts. However, people with less mental involvement are less likely to engage in bedtime thoughts, the most important cause of insomnia. So a person who has higher selfcompassion has a higher quality of sleep.
The results showed that positive attitude training was effective in decreasing pain severity in girls with primary dysmenorrhea but self-kindness was not effective in reducing pain severity. In general, positive emotions can have a great impact on one's health, well-being, and life expectancy by making them more prepared to face different activities. Training how to close the gates will stop the transmission of more pain messages to the brain, thereby reducing pain. Training relaxation techniques, introducing automatic thoughts and cognitive reconstruction, pleasant activity planning, as well as scheduled activity training will lead to appropriate activity and balance between work, rest and social activity, which -according to the gate control theory of pain -reduces the severity of pain.