Interference and Impact of Dysmenorrhea on the Life of Spanish Nursing Students

Abstract

Dysmenorrhea is a cause of absenteeism in universities which, in the context of nursing studies, may affect mandatory attendance. Moreover, presenteeism is associated with medication errors, patient falls, and a reduced quality of patient care. This study sought to identify the degree of interference of dysmenorrhea on daily life and its impact on academic performance among Spanish nursing students, and to explore the reasons for presenteeism. A cross-sectional descriptive study was conducted on 261 nursing students. Data were collected using a self-administered questionnaire. The chi square tests, chi-square linear trend, Student’s t-test, one-way analysis of variance of polynomial contrasts, and post hoc tests for the bi-variate analysis were used to compare the participants’ responses regarding their type of dysmenorrhea and pain intensity. In addition, a multivariate regression was performed to predict absenteeism. The answers to the open questions were analyzed using thematic content analysis techniques. We observed 62.8% of absenteeism and 92.7% of presenteeism due to dysmenorrhea. Absenteeism was observed to be 3.079 (confidence interval (CI): 95%1.724–5.499; p < 0.001) times more likely among women with severe menstrual pain, 2.513 (CI 95%1.314–4.807; p = 0.005) times more in those suffering from menstrual nausea and 1.936 (CI 95%1.098–3.411; p = 0.022) times more frequent in those suffering from diarrhea. The reasons for presenteeism were grouped into five categories: the pain was bearable, it is not a reason to be absent, others don’t consider it a reason to be absent, responsibility and guilt, and academic consequences. Dysmenorrhea can have a significant impact on academic performance. The concern among students about the academic repercussions and even feelings of guilt and incomprehension from others leads to high rates of presenteeism with potentially negative consequences for patient care.

Living with Restrictions. The Perspective of Nursing Students with Primary Dysmenorrhea

“…Our findings regarding restrictions on daily activities and sports coincide with the results of Abreu-Sánchez et al [2], who found that menstrual pain accounted for 62.8% of absenteeism among Spanish female university students and that certain daily activities caused or intensified their menstrual pain. These included siting down, walking and having a full bladder.…”

“…In the field of nursing, presenteeism has been identified as a risk to patient safety due to possible errors in the administration of medication [50,51]. The motives for presenteeism when suffering from menstrual pain may include [2]: students considering menstrual pain as an insufficient reason to be absent, thinking that others do not consider it a valid justification to be absent, anxiety about the negative academic impact of being absent, believing that attending class despite feeling unwell is most responsible, and feelings of guilt when being absent. In Spain, nursing students displayed a 92.7% level of presenteeism due to dysmenorrhea [2].…”

“…Iacovides et al and Al Jefout et al [14,15] reported that dysmenorrhea can significantly decrease the quality of life of women. Previous studies have also shown [1,2,[16][17][18] that dysmenorrhea can negatively impact academic performance. Moreover, it has been related to decreased concentration, among other symptoms, as well as greater absenteeism during menstruation and presenteeism, understood as the practice of attending classes or clinical placements when suffering from severe menstrual pain.…”

“…Menstrual pain is a very common problem among young women, estimated to afflict between 67 and 74% of young women worldwide [1]. In Spain, up to 75% of female university students suffer from this condition [2]. Dysmenorrhea is defined as chronic spasmodic pelvic pain associated with menstruation and often accompanied by other symptoms such as nausea, vomiting, diarrhoea, dizziness, headache, irritability, and depressive symptoms [3].…”

“…Chen et al [19] reported that the effects of dysmenorrhea can include difficulty in sitting and walking, the need to adopt antalgic positions (sleeping in foetal position), absenteeism from university classes and/or work, abandonment of family responsibilities (accompanying children to school) and recreational activities. A study by Abreu-Sánchez et al [2] showed how dysmenorrhea interferes with the academic life of university students, to the point of being absent from class or clinical placements. The study also noted that women feel misunderstood and worry about the repercussion that dysmenorrhea may have on their academic performance.…”