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Volume 13, Issue 3 (12-2023)
cmja 2023, 13(3): 56-66 |
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kharghani R, MortaghyGhasemy M, musavi S, Naseri R. The effect of motivational interview focused on some principles of Hefz – Alsehe in Iranian medicine on the physical and psychological symptoms of premenstrual syndrome. cmja 2023; 13 (3) :56-66
URL: http://cmja.arakmu.ac.ir/article-1-950-en.html
URL: http://cmja.arakmu.ac.ir/article-1-950-en.html
1- Assistant Professor, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Iran
2- Instructor, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Iran
3- MSc, Clinical Psychology, Ensan Department, Tehran, Iran
4- Department of Midwifery, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences. Iran , naseri.robab@yahoo.com
2- Instructor, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Iran
3- MSc, Clinical Psychology, Ensan Department, Tehran, Iran
4- Department of Midwifery, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences. Iran , naseri.robab@yahoo.com
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INTRODUCTION
Premenstrual syndrome (PMS), as one of the common menstrual disorders, includes a large set of physical and mental symptoms in the premenstrual periods, which disappear with the onset of menstruation. The cause of this disorder is unknown. PMS affects the quality of life, family relationships and social functioning of women. Several methods have been suggested for the relative control of PMS symptoms, and one of these methods is self-care behaviors, including lifestyle modification. Persian medicine focuses on preventing diseases by teaching a healthy lifestyle. One of the challenges of health care providers is to help people change unhealthy behaviors and replace them with healthy behaviors. One of the methods of counseling that can create relatively stable changes by creating internal motivation in a person is motivational interviewing. Considering the high prevalence of PMS in Iran and its many complications, the present study was conducted with the aim of determining the effect of motivational interview with the content of principles of Hefz – Alsehe in Persian medicine on premenstrual physical and psychological symptoms
METHODS
A randomized controlled trial was started on 21/01/2022 in selected medical centers in Zanjan, Iran. Women who had premenstrual symptoms according to the premenstrual symptoms screening tool were included in the study after obtaining informed written consent with the convenience method. Inclusion criteria was the age between 18 to 42 years, regular menstruation, body mass index of 18.5 to 29.9 kg/m2, access and ability to use social network, physical and mental health, not taking medicine or hormones to relieve the symptoms, no smoking and alcohol use, the absence of stressful factors including the death of loved ones within three last months, not doing sports professionally, not working at night shifts. Exclusion criteria were unwillingness to continue cooperation, presence of stressors including the death of a loved person during the study, and pregnancy. The sample size was 25 people for each control and intervention group. Allocation of people in the intervention (A) and control (B) groups was done by randomly selecting 13 four-person blocks from six AABB or BBAA or ABAB or BABA or ABBA or BAAB blocks. This study did not have post-allocation concealment. The data was collected using the demographic and fertility checklist and the premenstrual syndrome screening tool which were completed in person and self-reported. The validity and reliability of the tools have been confirmed in Iran. At first, the content of teaching the principles of Hefz–Alsehe in the subjects of physical activity, eating and drinking, and sleep and wakefulness, based on the book "maintaining health from the perspective of Persian medicine" was provided to the intervention group in the form of a training package in a face-to-face meeting, so that they could read it alone or with a friend at the appropriate time and evaluate the need to change these behaviors in their lives. One week after that, five weekly sessions of motivational interviews based on the principles of Hefz-Alsehe in Persian medicine were held individually and virtually for the intervention group. The first meeting included the definition of norms, determining the rules and the stages of change. The second session included empathy and removing doubts by normalizing behavior and describing a normal day in life. In the third session, a positive and negative review of the lack of attention and personal values and the discovery of the conflict between values and behaviors have been done. In the fourth session, with the confidence/importance ruler technique, the change talk was called, and the participants' self-efficacy was strengthened while reviewing previous successes, strengths and capabilities. In the fifth session, the goal and program of changes in physical activity, nutrition and sleep were defined. In the fifth session, the change started with determining the goal and change plan in the subjects of physical activity, nutrition and sleep. Control group did not receive any intervention. The premenstrual symptoms screening tool was completed by the participants in two stages immediately after the intervention and three months follow-ups and sent to the researcher. Data were analyzed by independent t-test, chi-squared test, repeated measurement test and Benferroni's post hoc test with the SPSS software.
RESULTS
There was no significant difference between the mean and standard deviation of the demographic and fertility variables of the intervention and control groups. There was no significant difference in the mean scores of premenstrual mental and physical symptoms and daily life activities between the two intervention and control groups in the pre-test phase. In the intervention group, the mean (standard deviation) of psychological symptoms in pre-test was 22.57 (8.053), post-test was 16.95 (7.406) and follow-up was 11.67 (5.893) and the effect of symptoms on daily life activities in the pre-test was 05. 10 (2.356), post-test was 5.24 (2.624) and follow-up was 4.52 (2.694), respectively. Repeated measurements test showed that in different phases of the study, the changes of premenstrual psychological symptoms and the effect of symptoms on daily life activities were significant between the control and intervention groups (P<0.001). Although, the mean score of premenstrual physical symptoms of the intervention group was reduced compared to the control group, the changes in physical symptoms between the control and intervention groups were not significant.
CONCLUSIONS
According to the findings of the study, motivational interviewing focused on principles of Hefz – Alsehe in Persian medicine is recommended to improve the psychological symptoms of PMS and the impact of symptoms on daily life activities.
Ethical Considerations
This article is a part of the master's thesis that was approved by ethics committee of Zanjan University of Medical Sciences (ethics code: IR.ZUMS.REC.1400.213) and Persian Registry of Clinical Trials (identifier: IRCT202107040511787N1). Before any interventions, formal informed consent was obtained from each participant.
Funding
This study was conducted with the support of the Research Deputy of Zanjan University of Medical Sciences.
Authors’ Contribution
Study conception and design: Kharaghani. R, Naseri. R; The intervention protocol design: MortaghyGhasemy. M, Musavi. S, Naseri. R; Drafting and data collection: Naseri. R; Data analysis and interpretation of results: Kharaghani. R, Naseri. R; Editing, final approval, control and supervision: Kharaghani. R, MortaghyGhasemy. M, Musavi. S; being accountable for the work: Naseri. R
Conflict of Interest
Authors report no conflict of interests.
Acknowledgments
The researchers are thankful to participants in this study and all who helped us in conducting the study.
Premenstrual syndrome (PMS), as one of the common menstrual disorders, includes a large set of physical and mental symptoms in the premenstrual periods, which disappear with the onset of menstruation. The cause of this disorder is unknown. PMS affects the quality of life, family relationships and social functioning of women. Several methods have been suggested for the relative control of PMS symptoms, and one of these methods is self-care behaviors, including lifestyle modification. Persian medicine focuses on preventing diseases by teaching a healthy lifestyle. One of the challenges of health care providers is to help people change unhealthy behaviors and replace them with healthy behaviors. One of the methods of counseling that can create relatively stable changes by creating internal motivation in a person is motivational interviewing. Considering the high prevalence of PMS in Iran and its many complications, the present study was conducted with the aim of determining the effect of motivational interview with the content of principles of Hefz – Alsehe in Persian medicine on premenstrual physical and psychological symptoms
METHODS
A randomized controlled trial was started on 21/01/2022 in selected medical centers in Zanjan, Iran. Women who had premenstrual symptoms according to the premenstrual symptoms screening tool were included in the study after obtaining informed written consent with the convenience method. Inclusion criteria was the age between 18 to 42 years, regular menstruation, body mass index of 18.5 to 29.9 kg/m2, access and ability to use social network, physical and mental health, not taking medicine or hormones to relieve the symptoms, no smoking and alcohol use, the absence of stressful factors including the death of loved ones within three last months, not doing sports professionally, not working at night shifts. Exclusion criteria were unwillingness to continue cooperation, presence of stressors including the death of a loved person during the study, and pregnancy. The sample size was 25 people for each control and intervention group. Allocation of people in the intervention (A) and control (B) groups was done by randomly selecting 13 four-person blocks from six AABB or BBAA or ABAB or BABA or ABBA or BAAB blocks. This study did not have post-allocation concealment. The data was collected using the demographic and fertility checklist and the premenstrual syndrome screening tool which were completed in person and self-reported. The validity and reliability of the tools have been confirmed in Iran. At first, the content of teaching the principles of Hefz–Alsehe in the subjects of physical activity, eating and drinking, and sleep and wakefulness, based on the book "maintaining health from the perspective of Persian medicine" was provided to the intervention group in the form of a training package in a face-to-face meeting, so that they could read it alone or with a friend at the appropriate time and evaluate the need to change these behaviors in their lives. One week after that, five weekly sessions of motivational interviews based on the principles of Hefz-Alsehe in Persian medicine were held individually and virtually for the intervention group. The first meeting included the definition of norms, determining the rules and the stages of change. The second session included empathy and removing doubts by normalizing behavior and describing a normal day in life. In the third session, a positive and negative review of the lack of attention and personal values and the discovery of the conflict between values and behaviors have been done. In the fourth session, with the confidence/importance ruler technique, the change talk was called, and the participants' self-efficacy was strengthened while reviewing previous successes, strengths and capabilities. In the fifth session, the goal and program of changes in physical activity, nutrition and sleep were defined. In the fifth session, the change started with determining the goal and change plan in the subjects of physical activity, nutrition and sleep. Control group did not receive any intervention. The premenstrual symptoms screening tool was completed by the participants in two stages immediately after the intervention and three months follow-ups and sent to the researcher. Data were analyzed by independent t-test, chi-squared test, repeated measurement test and Benferroni's post hoc test with the SPSS software.
RESULTS
There was no significant difference between the mean and standard deviation of the demographic and fertility variables of the intervention and control groups. There was no significant difference in the mean scores of premenstrual mental and physical symptoms and daily life activities between the two intervention and control groups in the pre-test phase. In the intervention group, the mean (standard deviation) of psychological symptoms in pre-test was 22.57 (8.053), post-test was 16.95 (7.406) and follow-up was 11.67 (5.893) and the effect of symptoms on daily life activities in the pre-test was 05. 10 (2.356), post-test was 5.24 (2.624) and follow-up was 4.52 (2.694), respectively. Repeated measurements test showed that in different phases of the study, the changes of premenstrual psychological symptoms and the effect of symptoms on daily life activities were significant between the control and intervention groups (P<0.001). Although, the mean score of premenstrual physical symptoms of the intervention group was reduced compared to the control group, the changes in physical symptoms between the control and intervention groups were not significant.
CONCLUSIONS
According to the findings of the study, motivational interviewing focused on principles of Hefz – Alsehe in Persian medicine is recommended to improve the psychological symptoms of PMS and the impact of symptoms on daily life activities.
Ethical Considerations
This article is a part of the master's thesis that was approved by ethics committee of Zanjan University of Medical Sciences (ethics code: IR.ZUMS.REC.1400.213) and Persian Registry of Clinical Trials (identifier: IRCT202107040511787N1). Before any interventions, formal informed consent was obtained from each participant.
Funding
This study was conducted with the support of the Research Deputy of Zanjan University of Medical Sciences.
Authors’ Contribution
Study conception and design: Kharaghani. R, Naseri. R; The intervention protocol design: MortaghyGhasemy. M, Musavi. S, Naseri. R; Drafting and data collection: Naseri. R; Data analysis and interpretation of results: Kharaghani. R, Naseri. R; Editing, final approval, control and supervision: Kharaghani. R, MortaghyGhasemy. M, Musavi. S; being accountable for the work: Naseri. R
Conflict of Interest
Authors report no conflict of interests.
Acknowledgments
The researchers are thankful to participants in this study and all who helped us in conducting the study.
Type of Study: Research |
Subject:
Traditional medicine
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