Premenstrual Syndrome And Its Related Factors In Female Nursing Students

Objectives:The purposes of this study were to investigate the occurrence of premenstrual syndrome(PMS)and the network characteristics of PMS symptoms in female nursing students;to explore the demographic,physiological,psychological and sociological factors related to the occurrence of PMS and construct a network model between PMS symptoms and related factors.Methods:This study was a cross-sectional survey.A total of 3458 female nursing students who met the inclusion criteria were selected from 9 nursing colleges and universities from June to December 2020,and they were asked to conduct a questionnaire survey.The survey tools included the General Data Questionnaire,the Premenstrual Syndrome Scale,the Big Five Inventory-Neuroticism,Emotion Regulation Questionnaire,Mindful Attention Awareness Scale,Childhood Trauma Questionnaire-Short Form.SPSS 25.0 and R 4.0.0 software were used for statistical analysis.Statistical methods included independent sample t test,chi-square test,binary logistic regression analysis and network analysis.Results:1.Epidemiological characteristics of PMS in female nursing students PMS was determined according to the premenstrual syndrome scale score ≥6.Among 3458 female nursing students,1479(42.8%)students were in the PMS group Excitable,bloating and diarrhoea,and lethargy were the most common and severe symptoms of the PMS2.Network analysis of PMS symptoms in female nursing students In the PMS group,the results of gaussian graphical model showed that most of the symptoms in the network were correlated,the strongest correlations were between nervousness and fidgeting(0.42),and between depression and anxiety(0.39),followed by migraine and insomnia(0.31),irritability and anxiety(0.26),hand and foot swelling and neuroticism(0.26);there were associations between hand and foot swelling and insomnia(0.22),hand and foot swelling and migraine(0.21).Anxiety was the most centrality in the whole network,followed by fidgeting and hand and foot swelling.The results of network stability test showed that PMS symptom network had good stability(correlation stability coefficient=0.75).3.Differences in related factors among female nursing students with or without PMSThe results of univariate analysis showed that,among demographic factors,nursing students who had older age,higher educational level,higher grades,irregular eating,smoking,and drinking alcohol had a higher incidence of PMS(Ps<0.05);among physiological factors,nursing students who had irregular menstruation,menorrhagia,often dysmenorrhea,using acesodyne,and later chronotype had a higher incidence of PMS(Ps<0.001);among psychological factors,nursing students in the PMS group had higher scores on neuroticism and expression suppression than those in the non-PMS group,but lower scores on cognitive reappraisal and mindfulness compared to those in the non-PMS group(Ps<0.05);among social factors,the incidence of physical neglect,emotional neglect,sexual abuse,physical abuse,and emotional abuse in the PMS group were higher those in the non-PMS group(Ps<0.001).4.Binary logistic regression analysis on related factors affecting PMS in female nursing studentsWhether there is PMS was taken as the dependent variable,and the demographic,physiological,psychological and sociological factors which had statistical significance in univariate analysis were included into the binary logistic regression model as independent variables.The results of stepwise regression showed that,older age(OR=1.08),smoking(OR=1.98),menorrhagia(OR=1.53),occasionally or often dysmenorrhea(OR=2.13 and 4.15,respectively),occasionally or often using acesodyne(OR=1.51 and 1.55,respectively),later chronotype(OR=1.20),neuroticism(OR=2.46),expression suppression(OR=1.04),physical abuse(OR=1.44),and physical neglect(OR=1.46)were significantly associated with increased odds of PMS(Ps<0.05);cognitive reappraisal(OR=0.99)and mindfulness(OR=0.91)were significantly associated with decreased odds of PMS(Ps<0.05)5.Network analysis of PMS symptoms and related factors in female nursing students with PMSIn the PMS group,the network analysis method was used to construct the mixed graphical model including the related factors screened by regression analysis and PMS symptoms.In the model,dysmenorrhea among physiological factors and bloating and diarrhoea among PMS symptoms had a strong direct connection(0.21),neuroticism among psychological factors and depressive symptoms(0.27),neurotic symptoms(0.21),and hand and foot swelling(0.16)among PMS symptoms had strong connections;physical abuse among social factors and excitable(0.17)and neurotic symptoms(0.14)among PMS symptoms had direct connectionsConclusions:1.The incidence of PMS in female nursing students was high(42.8%),and the symptoms were mainly mild to moderate2.Among the PMS symptoms,most of the symptoms were interrelated,and anxiety was the most core symptom of the symptom network.3.Demographic,physiological,psychological and sociological factors were correlated with PMS symptoms to varying degrees among female nursing students.In particular,dysmenorrhea,neuroticism,and physical abuse were strongly associated with PMS symptoms.