INTRODUCTION:

Women hood is the period in females’ life after she has passed through childhood and adolescence, generally age 18. Puberty generally begins at about age 10 followed by menarche or onset of menstruation. There are various words used to refer to the quality of being a woman. The term 'womanhood' is merely means the state of being a woman having passed the menarche, the first appearance of menstruation.

Dysmenorrhoea or painful menstruation presents with or shortly after the menarche. It may start within six months after menarche because it occurs during ovulatory cycles, which may not always be evident at menarche. Although it may occur are as late as a year after menarche. It is characterized by fluctuating "spasmodic menstrual cramps some time referred to as labor like pains that begin only a few hours before or with the onset of menstrual flow the symptoms of dysmenorrhoea lasts only 2-3 days

Dysmenorrhoea is a leading cause of short term school absentism and it is associated with negative impact on social, academic and sports activities of many females.

A total of 706 Hispanic females in grade 9 though 12 completed a 31 item questionnaire about presence, duration, severity treatment and limitation of dysmenorrhoea at a local urban school. among participants who had period in previous 3 months (85%) reported dysmenorrhoea. Of these 8% reported missing classes to dysmenorrhoea during 3 months prior to survey and 33% reported, missing individual classes, (Banikarim. C , et.. al 2000)

A study conducted by American Botanical Council, gives significant effect of gingerols in pain reduction in dysmenorrhoea. A double blind trial was conducted on 450 students 18 years older with dysmenorrhoea, The experimental group received (Zinziber officinal) rhizome powder capsule 250mg four time away for three days starting day one of their menses A baseline pain severity and menstrual characteristic were assessed by a self administered questionnaire assessment was performed after the menstrual period. At the end of the treatment the level of dysmenorrhoea significantly reduced in 175/450 women in the experimental group.

Ginger rhizome powder is prepared by, drying the cleaned, cut, skin peeled ginger rhizome, then make it in to fine powder form under a blender. The moisture content in this ginger rhizome powder will be 0.01% 250 mg of ginger rhizome powder four time daily for three days starting first day of the menstrual period. provide significant pain relief and satisfaction. The finding suggest intake of gingerols as ginger rhizome powder has beneficial effect on pain relief. (Tori 2009)

NEED FOR THE STUDY:

In a women, menarche signifies the transition from girlhood to womanhood. This transitional period is characterized by so many physical changes and often associated with irregular menstruation, excessive bleeding and dysmenorrhoea. Thus in order to lead a healthy, responsible and fulfilling lives and protect themselves from reproductive health problems young female need to be knowledgeable about them, need sound information about the major physiological changes that takes place in the reproductive system..

According to some international reports, the prevalence of dysmonorrhoea is very high and at least 50% of women experience this problem throughout this years. This problem not only cause fear in approximately one fifth of the female population but also causes many social physical, physiologic and economic problem for women around the world. The result of recent studies shown that, nearly 10% of females with dysmenorrhoea experienced an absence rate of 1-3 days per month from work or where unable to do their regular / daily tasks due to their severe pain.

The investigator in her personal experiences come across the situation during her hostel life that most of the students staying in the hostel are suffering with dysmenorrhoea.. The researcher has reviewed so many literatures which explained the benefits of ginger rhizome powder in this aspect with less side effect compared to allopathic management. Hence research is interested to apply their knowledge of indigenous system of medicine in nursing care management are a part of pain management and selected this present study.

STATEMENT OF THE PROBLEM:

Effectiveness of ginger rhizome powder to manage dysmenorrhoea among selected hostel students, Coimbatore.

OBJECTIVES:

1 To assess the severity of menstrual pain

2 To administer ginger rhizome powder to selected students with dysmenorrhoea

3 To assess the effect of ginger rhizome powder on dysmenorrhoea

OPERATIONAL DEFINITIONS:

Effect It is the state of reduction of cramping menstrual pain after the administration of ginger rhizome powder.

GINGER RHIZOME POWDER:

It is a herbal powder which is prepared from dried ginger rhizome, branched with small limbs and light brown skin and with a fragrant pungent smell and mild spicy in taste.

DYSMENORRHOEA:

It is gynecological medical condition of pain during menstruation that interferes with daily activities of a women.

CONCEPTUAL FRAMEWORK:

Widenbach's Helping Art Of Clinical Theory, 1964 was adopted for developing conceptual frame work for this experimental study. According to Widen Bach, this theory views nursing as an art based on goal directed care. WIDEN BACH'S vision of Nursing practice, closely parallel to the assessment, implementation and evaluation step of Nursing process.

REVIEW OF LITERATURE:

A cross sectional survey conducted in primary health centre in Goa, India, The objective was to describe the prevalence and determinants of dysmenorrhoea. Three thousand women aged 18-45 years were randomly selected. A total of 2494 women consented to participate. The participants were asked standardized question regarding menstrual complaints over the past 12 months especially the social, demographic and reproductive risk factors. Vaginal urine specimens were collected for diagnosis of reproductive tract infections. A total of 2262 women were eligible. The result of the study shows that 755 participants had moderate to severe dysmonorrhoea was associated with experience of violence, somatic complaints gynecological complaints (non menstrual pain) menorrhagia and illiteracy. The study concluded that the burden of dysmenorrhoea is greater than any other gynecological complaint and is associated with significant impact. (Wikipedia Cited 2008)

A cross sectional study was conducted in a public secondary school with an objective to determine prevalence of primary dysmenorrhoea. Its associated factors and its effect on school activities among adolescent girls in a secondary school in rural district on Selangor Malaysia A stratified random sampling of 300 female students (12-17years) was selected A self administered questionnaire consisting 20 items was used to collect the socio demographic and menstrual data. Pain intensity for dysmenorrhoea was measured by numerical rating scale. The prevalence of dysmenorrhoea was 62.3% It was significantly high in the middle adolescence 15-17 years old age group. Girls with regular menstrual cycle and positive family history. (Smith R. P et al 2006)

METHODS AND MATERIALS:

RESEARCH DESIGN:

Experimental design, post test control group was adopted in this study.

SETTING :

The study was conducted in selected Ladies Hostel, which was located in Coimbatore. It was started for the accommodation of Paramedical students and Arts and Science College students of institutions. The hostel has appropriate facilities for the accommodation of around 800-1000 students.

POPULATION :

The students who are residing in the hostel, who are identified with dysmenorrhoea.

SAMPLING TECHNIQUE:

Convenient sampling technique was used with sample size 18 students with dysmenorrhoea were selected for the study.

CRITERIA FOR SELECTION OF SAMPLE :

Inclusive Criteria :

• Students those who are residing in selected Ladies Hostel, and who are having dysmenorrhoea.

• Students those who are menstruating in the data collection period.

Exclusive Criteria:

• The students those who are not willing to participate in the study.

• Students, those who are not an inmate of selected Ladies Hostel.

VARIABLES OF STUDY:

TOOLS FOR DATA COLLECTION:

Demographic Data :The tool was constructed for the study contain sample number, age, weight, age at menarche, regularity of menstrual cycle, number of days of menstrual flow, any history of large amount of bleeding, duration of menstrual pain, experience of painful menstruation at first, any symptoms, associated with dysmenorrhoea, any home remedies and any medication taken for dysmenorrhoea and their expected date of menstruation.

Numerical Pain Intensity Scale:

Numerical rating scale is an assessment scale, a linear line with marks spaced 1 cm apart ranging from ‘0’ (no pain) to ‘10’ (worst possible pain – imaginable) and the samples are asked to mark a point of line indicating the intensity of pain. It is widely preferred by National and International Investigators for its applicability and clarity in determining the pain intensity. The validity and reliability of Numerical Pain Intensity Scale were taken by Duncan, Bushnell and Lavigne (1989).

Effectiveness of ginger rhizome powder on dysmenorrhoea is assessed using the obtained score. Independent 't' test is used to test the significance in mean difference among two group post test scores The calculated ‘t’ value is 3.074. Thus the calculated value is greater than the table value at 0.05 (2.353) level of significance at 3 degrees of freedom . Thus the null hypothesis is rejected and this shows that there is significant evidence that oral administration of ginger rhizome powder 250 mg four time a day, up to three days starting from first day of menstrual period helps in lowering level of pain in dysmenorrhoea.

RESULTS AND DISCUSSION:

Table reveals that the mean value of experimental group is 2.33 and control group is 0.44. The calculated ‘t’ value for experimental group is ‘7’. Thus the calculated ‘t’ value for the experimental groups is higher than the table value at 0.05 level of significance at 8 degrees of freedom. Thus the null hypothesis is rejected.

An independent ‘t’ test was used to assess the effectiveness of ginger rhizome powder on dysmenorrhoea. The calculated ‘t’ value is 3.074. Thus the calculated ‘t’ value is higher than the table value at 0.05 = 2.353. Thus the calculated value is higher than the table value at 0.05 level of significance at 3 degrees of freedom. Thus the null hypothesis is rejected and this shows that there is significant evidence that oral administration of ginger rhizome powder 250 mg four times a day, up to three days starting from first day of menstrual period helps in lowering severity of dysmenorrhea.

MAJOR FINDINGS OF THE STUDY:

· Among eighteen samples, around 56% of participants were in 19-21 years of Age in both experimental and control group, and around 11% were in the age group of 25-27 years in control group.

· In weight distribution, around 33% members were in 52-57 kg Weight in both experimental and control group and around 22% of participants of experimental group and 11% of control group were in 40-45 years age.

· Around 89% of participants attained Menarche at the age of 12-14 years and around 11% were attained menarche at the age of 14-16 years.

· In experimental group 110% participants having regular Menstrual Cycle and in control 78% having regular menstruation and 22% were having menstrual irregularities.

· Around 33% and 22% of participants had history of excessive menstrual bleeding in both experimental % control group respectively.

· Among 18 samples around 89 percentage of participants had Menstrual Pain duration for 3-5days and in control group it was 67%.

· Around 33% of and 67% percentage of participants lad associated symptoms in dysmenorrhoea among experimental and control group respectively.

· Around 78% of participants does not have habit of taking Home Remedies for dysmenorrhoea in each group.

· Around 22% and 11% of participants in each group are having a habit of taking Medication for dysmenrrhoea .

LIMITATIONS:

· The study was conducted among selected students with dysmenorrhoea.

· The duration of data collection was limited for 2 weeks.

· The study was conducted in the students of selected ladies Hostel.

· Administration of ginger rhizome powder was limited to 3 days.

· The study was conducted among students, those who are having painful menstrual period during the data collection.

RECOMMENDATIONS:

· Similar study can be conducted in a large group of girls with dysmenorrhoea.

· The study can be conducted in different settings.

· The study can also be done in community settings.

· Education can be provided regarding natural remedies to control dysmenorrhoea.

· Education can be provided regarding ill effects of pharmacological treatments for reducing dysmenorrhoea.

SUMMARY:

The main purpose of the study was to assess the effect of ginger rhizome powder to manage dysmenorrhoea among selected students of 18 students with dysmenorrhoea was selected for the study. The investigator first introduced herself, and explained about the effect of ginger rhizome powder on dysmenorrhoea. The research provided 250 mg of ginger rhizome powder orally 4 times a day, for 3 days of menstruation, starting from the first day of menstruation and monitored the pain level at sequential intervals of four hours. An experimental study was adopted for this study. Convenient sample collected were analysed and interpreted.

CONCLUSION:

The study was undertaken to assess the effect of ginger rhizome powder to manage dysmenorrhoea among selected students of Ladies Hostel. Among 18 samples nine were in experimental groups and nine were in control group. The results showed that the calculated ‘t’ value in independent ‘t’ was 3.074. Thus the calculated ‘t’ value of post test of both groups is higher than the table values at 0.05 level of significance at 3 degrees of freedom. And this shows that there is significant evidence that oral administration of ginger rhizome powder 250 mg four times a day for 3 days starting from the first day of menstruation helps in lowering severity of pain in dysmenorrhoea.

REFERENCES :

BOOKS:

Lowdermilk, Perry, Bobak. “Maternity and Womens Healthcare” 6^th edn, London Mosby Publications, 1997.

Howkins and Bourne.”Show’s Textbook of Gynecology” 15^th edn, New Delhi, Elsevier Publication, 2008.

D.C. Dutta.”Textbook of Obstetrics including Perinatology and Contraception” 6^th edn, Calcutta, Central Publications, 2009.

Gupta, S. P. “Statistical Methods” 11^th edition, New Delhi, Sulthan Chand and Sons Publications, 2007.

Burns N and Grove S. ”Understanding Nursing Research” 3^rd edn. W.B. Saunders Publications, London, 2002.

Linona B. “Research Methods” 4^th edn, Lohre’s Publications, Philadelphia, 2010.

Basvanthappa, B.T. “Nursing Research” 2^nd edn. Jaypee Brothers Publications, New Delhi, 2007.

Mudaliar A.L., M.K. Krishna Menon, “Clinical Obstetries 9^th edition. Hyderabad. Orient Longman Publication 202.

Krishna Moorthy. V., “Bach flower Remedies” 3^rd edition, New Delhi. B.Jain Publications 2003.

Polit, Denice. F, and Hungler; Benedette; “Essentials of Research 8^thedition. Philadelphia. J.B. Lippincott company 2002.

Chris Matzen, Mcquriston Adele. A. Webb 2^ndediton, “Foundation of Nursing Theory London, Sage Publication 1995.

Kothari. R. “Research Methodology” 2^ndedition, New Delhi. Viswaprakashan publication 1990.

JOURNALS

Ozgoli G., Goli M., Moatlar F. “Comparison of effects of ginger, mefenamic acid and ibuprofen on pain in women with primary dysmenorrhoea.” J Altern and Complement Medicine 2009, Feb: 15(2): 129-320.

Litiwati et al. “Effects of dysmenorrhoea on school activities” Medihealth 2007; 2(1): 42-47.

Sun L.H., Ge J.J., Yang J.J., She Y.F., Li W.L., Li X.H., et al “Randomized controlled clinical study on ginger practitioned moxibustion for patient with primary dysmenorrhoea” Zhen Ci-2009, Dec; 34(6) 398-402.

Ganguli S.K. Adolescent Health. Indian Journal of Public Health, 2003; 47(3): 5-15.

Agarwal A. “A study of dysmenorrhoea among adolescent girls.” Indian J. Community Medicine 2010 January 35(1) 159-164.

Nafstad P. Stray – Pedersen B. Solvberg M. et al “Menarche and Menstruation Problems Among Teenagers in Oslo.” Tiksskr Nor Leageforne 1995; 115(5): 604-606.

Dagwood M.Y. Dysmenorrhoea J Report Medihealth, 1995; 30(3), 154-167.

Jerry R.K., Tris F.L., “Epidemiology of Adolescent Dysmenorrhoea.” Official of American Paediatrics, 1980 Dec 5; 68, Page no. 661-64.

Smith R.P., Power R.J. “Level of knowledge among adolescent girls regarding effective treatment for dysmenorrhoea in Malaysia BIOG: An International Journal of Obstetrics and Gynaecology (ACOG) 2006 April: 113(4) Page no: 453-463.

Dhingra R., Kumar A., “Knowledge and Practices Related to Menstruation among Tribal (Gujjar) Adolescent girls. Ethno-Medicine 2009, 3(1) Page 43-48.

Received on 20.05.2016 Modified on 30.06.2016

Int. J. Adv. Nur. Management. 2016; 4(4): 417-422.

DOI: 10.5958/2454-2652.2016.00092.5

Distribution of age in years	Experimental Group		Control Group
Distribution of age in years	No. of participants	Percentage (%)	No. of participants	Percentage (%)
16-18	3	33	2	22
19-21	5	56	5	56
22-24	0	-	2	22
25-27	1	11	0	-

Distribution of age in years	Experimental Group		Control Group
Distribution of age in years	No. of participants	Percentage (%)	No. of participants	Percentage (%)
10-12	-	-	3	33
12-14	9	89	4	44
14-16	1	11	2	22

Regularity of Menstrual cycle	Experimental Group		Control Group
Regularity of Menstrual cycle	No. of participants	Percentage (%)	No. of participants	Percentage (%)
Regular	9	100	7	78
Irregular	-	-	2	22

Heavy bleeding	Experimental Group		Control Group
Heavy bleeding	No. of participants	Percentage (%)	No. of participants	Percentage (%)
Yes	3	33	2	67
No	6	22	7	78

Duration of Menstrual Pain in days	Experimental Group		Control Group
Duration of Menstrual Pain in days	No. of participants	Percentage (%)	No. of participants	Percentage (%)
0-2	1	11	3	33
3-5	8	89	6	67

Distribution of Weight	Experimental Group		Control Group
Distribution of Weight	No. of participants	Percentage (%)	No. of participants	Percentage (%)
40-45	2	22	1	11
46-51	2	22	2	22
52-57	3	33	3	33
58-63	2	22	3	33

Dysmenorrhoea experienced at first year	Experimental Group		Control Group
Dysmenorrhoea experienced at first year	No. of participants	Percentage (%)	No. of participants	Percentage (%)
10-12	-	-	1	11
13-15	6	67	2	22
16-18	3	33	6	67

Symptoms associated with Dysmenorrhoea	Experimental Group		Control Group
Symptoms associated with Dysmenorrhoea	No. of participants	Percentage (%)	No. of participants	Percentage (%)
Yes	3	33	6	67
No	6	67	3	33

	Pretest		Posttest		''t' value
	Mean	S.D.	Mean	S.D.
Experimental group	7	1.11	4.66	0.99	7
Control group	6.55	1.23	6.11	1.053	4.89

Group	Test	Mean	Standard Deviation	‘t’ value
Experimental group	2.33	25.8	1	+3.074
Control group	0.44	4.88	0.277	+3.074