Application of psycho-educational intervention to reduce menstrual-related distress among adolescent girls: a randomized controlled trial.

Abstract

Objectives: The objective of the present study was to investigate the effect of psycho-educational intervention on severity of menstrual distress symptoms among adolescents with primary dysmenorrhea.

Methods: A randomized controlled trial was conducted from August 2019 to April 2020 comprising 120 adolescent girls. The study settings were high schools in Qazvin City. Participants were randomly assigned to intervention (n=60) and control groups (n=60) using a cluster randomization method. The intervention included three 60- to 90-min group psycho-educational sessions based on Leventhal's self-regulatory method. The sessions took place over three consecutive weeks with each group comprising 8-10 individuals. Menstrual distress (as the primary outcome), and illness perception and severity of dysmenorrhea (as the secondary outcomes), were assessed at four time points (pre-intervention, and three post-intervention assessments [one month, two months, and three months]).

Results: A total of 54 individuals from the intervention group and 60 from the control group completed all follow-up measurements. Menstrual distress in the pre-menstruation phase significantly decreased among the intervention group at the three follow-ups (-5.41, -5.45, -4.97; all p<0.001). Menstrual distress in the menstruation phase significantly decreased among the intervention group at the three follow-ups (-11.75, -12.49, -12.38; all p<0.001). Dysmenorrhea pain intensity significantly decreased among the intervention group at the three follow-ups (-2.90, -3.49, -3.30; all p<0.001). Illness perception of dysmenorrhea significantly decreased among the intervention group. Mean differences of between group comparison (intervention vs. control) through follow-ups were -19.74, -22.56, -22.71 (all p<0.001). Based on the result of the RM ANOVA-ANCOVA model, the group effect was significant (p<0.001) with the intervention explaining 36.3 % of variance for change in menstrual distress in the pre-menstruation phase, 75 % of change in mean scores of menstrual distress in the menstruation phase, 78.5 % of variance for change in mean scores of dysmenorrhea, and 74.8 % of variance for change in mean scores of illness perception.

Conclusions: This intervention improved adolescent girls' menstrual distress, severity of dysmenorrhea, and illness perception regarding dysmenorrhea.