2

2.1 (Dysmenorrhea)
2.1.1
2.1.2
2.1.3
2.1.4
2.1.5
2.1.6
2.1.7
2.1.7.1
2.1.7.2
2.1.7.3
2.1.7.4
2.2 (Symptom Self-Management)
2.3
 9

2.1 (Dysmenorrhea)

2.1.1
( , 2544)

( , 2548)

( , 2548)

( , 2549)

( , 2551)

2.1.2

(Proctor & Faquhar, 2004; Jamieson & Steege, 1996)
48.4 84.2 17 (Burnett MA.,et al,
2005) 48.4 (Mario IO.,et al, 2009) 61.27 (Sule & Ukwenya, 2007)
64.3 (Osuga Y, 2005) 68.7 (Chan SC, 2009) 69.4 (Lee LK,
2006) 72 (Desalegn TZ, 2009) 89.5 (Saadutu TT, 2007)
84.2 (Tongchai K, 2004)
 10

10 21.1
(Sharma P, 2008; Cakir
M, 2007; Lee LK, 2006; Tongchai K, 2004)
(Saadatu & Josephine, 2007)
(Sharma P, 2008; Cakir M, 2007)
21.1 63.6
1.8 (Tongchai K, 2004)
(Burnett
MA, 2005) (Patel V, 2006)
2.1.3
2 (primary
dysmenorrhea) (secondary dysmenorrhea)
6
12 (menarche) (menarche)
40
20 2 20
3 20 4 6 2
spasmodic dysmenorrhea (lower abdomen)
(low back) (inner thighs)
congestive dysmenorrhea (dull aching)
(premenstrual
syndrome; PMS) (lethargy) (depression)
(irritability) (nausea) (vomiting)
(headache) (syncope) (Kulig JW, 1990; Chesney & Tasto,
1975)
1 2 48 72 12
 11

3
18 24

endometriosis, adenomyosis, pelvic congestion pelvic adhesion

(cervical stenosis)
(gynecologic malignancy)
endometriosis
24
(Johnson N, 2006)
2.1.4

(infertility) (endometriosis)
(chronic pain syndrome)
(Johnson N, 2006)

(emotional/psychological problems)
(anxiety) (emotional instability)

(imitation of patients mothers negative feelings about menstruation)
29.6
6

(faulty outlook on sex) (Ylikorkala & Dawood, 1978; Jeffcoate N, 1975;
 12

Redlich & Freedman, 1966) (quality of life)

(earlier age at menarche)
(long menstrual periods) (heavy menstrual flow)
(smoking)
(Proctor & Farquhar, 2004) (obesity)
(Parazzin F.,et al, 1994)

(Golomb LM., et al, 1988 cited in LattheP, 2006)
(Mergler & Vezina N, 1985 cited in LattheP, 2006)

(adrenergic)
(menopause) (Sundell
G.,et al, 1990)
2.1.5


2.1.5.1 Prostaglandin F2 alpha (PGF2alpha)
F2 alpha (PGF2alpha)
(PG) (phospholipids)
2 ( phospholipase A2) (arachidonic
acid) (cyclooxygenase) 2
(PGF2alpha)
(PG) 2 (PGF2 alpha)
(secretory)
 13

(proliferative) PG
(secretory) (PG)
( proliferative)
(PG) (PG)
(secretory) (proliferative) 3

2 (PGF2alpha) 2
(PG) 2 (PGF2alpha
PGE2) (myometrium)
(ischemia)
(PG)
(PG)
(Eden JA, 1998; Dawood MY, 1990)
(Secondary dysmenorrhea)
(Smith RP, 1993)
2.1.6
2.1.6.1
-





(sexual abuse)

(Jamieson & Steege, 1997)
 14

2.1.6.2

(Rapkin AJ, 1998)

(prolapsed submucous myoma)
2.1.6.3
(laparoscopy)


(laparoscopy)
(endometriosis) (pelvic adhesion)

(Husby GK.,et al, 2003)

(endometriosis) (pelvic adhesion)

0.5 1.3 (Chapron C.,et al, 1998; Harkki-Siren P.,et al, 1999)
(complete
blood count erythrocyte sedimentation rate)

 15

2.1.7



2.1.7.1 (Traditionally established drug treatment)
(analgesic)
paracetamol, aspirin paracetamol-opiate
(Proctor & Faquahar CM, 2004) PGF2alpha (prostaglandin synthetase inhibitors)
(Non-steroidal anti-inflammatory drugs: NSAIDs)
cyclo-oxygenase PG
80
(Dawood & Khan-Dawood, 2007)


NSAIDs

48
PG PG

PG
NSAIDs
NSAIDs (FDA)
diclofenac, ibuprofen, ketoprofen, meclofenamate, mefenamic acid naproxen
aspirin paracetamol (Zhang & Li Wan
Po, 1998)
 16

NSAIDs 30 - 60

NSAIDs
indomethacin cyclooxygenase-2 inhibitors (COX-2)
rofecoxib 25 mg valdecoxib 40 mg
naproxen
NSAIDs
(Morrison BW.,et al, 1999)
2.1.7.2

(combined oral contraceptive pill; combined OCP)
(ovulation)
PG late luteal phase
(atrophic)
90 (Silem M,
2003; Vercellin P.,et al, 2003)




(FDA)
2.1.7.3


laparoscopic uterine nerve ablation presacral neurectomy (Rapkin AJ, 1998)
 17

2.1.7.4 (Complementary and alternative

medicine)

2.1.7.5 (nutrition)











(
, 2549)

(randomize control trial; RCT) black cohosh, chastetree, dong quai

blackhaw crampbark
(Low Dog T, 2001) blackhaw
(oxalic acid) (kidney stones)
(Dennely CE, 2006)
 18

3 (niacin)
90
3 2 2 - 3 3
(flushing) (Hudgin AP, 1954 cited in Dennely CE, 2006)
RCT
1 (vitamin B1)
(Magnesium) (Fish oil) (vitamin E)
1 (vitamin B1)
556 ( 12 21 )
spasmodic dysmenorrheal 1
90 1
(Gokhale LB, 1996)
(Magnesium)
21 50 3

(Proctor & Murphy, 2001)
(Fish oil) - 3 (omega 3 fatty acids)
-6 (,
) -3 (, canola oil wheat germ)
-6 PGF2alpha, thromboxane A2
leukotriene B4 -3 eicosapentanoic acid docosahexanoic acid
PGE3, thromboxane A3 leukotriene B5
-3
(Saldeen & Saldeen, 2004) 42
(fish oil)
(placebo) (Proctor & Murphy, 2001) -3
 19

(antiplatelet)
(anticoagulants)
(supplements) (Dennehy CE, 2006)
(vitamin E)

PG chidonic acid (Ziaei S.,et al, 2005)
100 278 150 IU 500 IU 2-3
(Zeaei S.,et al, 2005;
Ziaei S.,et al, 2001; Blanche Butter & McKnight, 1955 Dennely CE, 2006)

(antiplatelet proporties)
(anticoagulants)
400 IU 400 IU
(Dennely CE, 2006)
(Herbal)




saffron, celery seed anise (SCA)
3 3
3 SCA mefenamic
acid (NSAIDs) (placebo) (Nahid K.,et al, 2009)


 20

(Tsen Y-F.,et
al, 2005)
2.1.7.6 (total body modification)

(nervous system dysfunction)
(Hitchcock ME, 1976)


(Kokjohn K.,et al, 1992; Rosette P, 2004;
, 2552)

2
()



 21

2 - 3 3
2 ()


2
1

: http://www.nursing.siam.edu/data1/Gmail/skeletal51.doc
2.1.7.7 (acupressure)



(Cho & Hwang, 2009)
3 2-3
1

 22

: http://www.guashathai.com/image/mypic_article/Untitled-3.jpg
2.1.7.8 (acupuncture)


4,000




(Witt CM.,et al, 2008; Maciocia and Kaptchuk, 1998 Jun E-J.,et al, 2007)
2.1.7.9 (transcutaneous electrical nerve
stimulation; TENS)

( Milsom I., et al, 1994; Dawood & Ramos, 1990) 42 60
NSAIDs
 23

(2552)

2.1.7.10


40
(, 2549)
1









3 4 20 40

 24

(analgesic) paracetamol, aspirin, paracetamol-opiate
PGF2alpha (prostaglandin synthetase inhibitors)
(Non-steroidal anti-inflammatory drugs: NSAIDs) diclofenac, ibuprofen, naproxen
(combined oral
contraceptive pill; combined OCP) PG late luteal phase


(TENS)

2.2 (Symptom Self -Management)

(Eryilmaz & Ozemir,
2009; Zegeye., et al, 2009; S. Ohde., et al, 2008; French, 2005; David., et al, 2004)

(Symptom Self Management)
(Dodd., et al, 2001)
(Dodd)


Symptom Self Management Model 1)
(Symptom experience)
2) Symptom management strategies
Who What
 25

How Whom When Why How

much 3) Outcomes
Functional status, Emotional status, Symptom status, Mortality, Morbidity & co-morbidity,
Quality of life, Cost, Self-care (Dodd) /
1) (Person) /
(Demographic) (Physical) (Psychological)
(Pathological) 2) (Environmnent)/
(Physical) (Social support)
(Culture) 3) (Health/Illness) /
(Health status) (Disease & Injury)

(Knowledge & Beliefs)
(Individual and Family Self-Management Theory)
Ryan & Sawin (2009) 3
( Context ) (Process)(Outcomes)
(Risk & Protective Factors)
(Condition Specific) (Physical & Social Environment)
(Individual&Family)
(Social Facilitation) (Self-Regulation)
Self-Management Model (Bandura,1986
, 2552) (Social Facilitation)


(Self-Regulation)

(Self
Regulation) (Self-
Management Behaviors) (Health Status)
(Quality of Life)
 26

Context Condition Specific Physical & Social Individual & Family

Risk&Protective Complexity of condition Environment Developmental stages
Factors Complexity of treatments Access to care, Setting Perspectives, Literacy,
trajectory and provider transitions, Information processing,
Transportation, Culture, Social Capabilities
captital
Process Knowledge & Beliefs Self- Regulation Social Facilitation:
of self-management Self-efficacy Skill & Abilities Influence
Outcome expectancy Goal Setting, Self-monitoring and Support
Goal congruence Reflective thinking, Decision Collaboration
making, Planning and Action,
Self-evaluation, Emotional
Control
Outcomes Self-Management Behaviors: Cost of Healthcare
Proximal Condition Specific Services
Outcomes Health Status Quality of Life or Well Cost of Health
Distal Being
Figure 2.1 Model of the Individual and Family Self-Management Theory

(Self - Management Behaviors)

(Health Quotient)
(Health consciousness) (Health knowledge)
(Lee Earn chang, 2001:17)
(Hoeger and Hoeger, 2005)

9

(Health
Quotient)

 27

2.3



17 (Burnett MA., et al, 2005) 48.4 (Mario IO., et al,
2009) 61.27 (Sule & Ukwenya, 2007) 64.3 (Osuga Y, 2005)
68.7 (Chan SC, 2009) 69.4 (Lee LK, 2006) 72 (Desalegn TZ,
2009) 89.5 (Saadatu TT, 2007) 2004 84.2
(Tongchai K, 2004) 2008 84.9 ( , 2008)

(Eryilmaz & Ozemir, 2009; Zegeye., et al, 2009; S.
Ohde., et al, 2008; French, 2005; David., et al, 2004)




2 10




(Self management behavior)


(
, 2549)
 28

( , 2549)