Comparison of the effect of teaching coping skills and acupressure on premenstrual stress: a randomized controlled trial

Background Premenstrual syndrome (PMS) refers to significant clinical physical and psychological manifestations during the luteal phase of the menstrual cycle, leading to significant distress and impaired functional capacity. Given the side effects caused by pharmacotherapy, it seems logical to use non-pharmacological methods that can reduce symptoms such as menstrual stress. Thus, this study has been conducted to compare the effect of teaching coping skills and acupressure on premenstrual stress in undergraduate students of the Medical School of Azad University of Sanandaj-Iran. Method This study is an experimental study that was designed in the form of three groups (two acupressure and coping strategy groups and one control group). The participants by moderate or severe degree based on the Symptoms Premenstrual Screening Tool entered the study. Students in the coping skills training group received intervention for 5 weeks and every week for 60 min. The second intervention group received acupressure intervention for 3 months and twice a day for 60 s each time, in a sitting position, with pressure on the 6th spleen point (SP6). Data collection tools included socio-demographic and obstetric characteristics questionnaire, as well as premenstrual stress questionnaire and stress coping styles questionnaire, which were completed before and 3 months after the intervention. ANCOVA test was used for comparing the variables of premenstrual stress and coping strategy between the investigated groups, controlling the scores of premenstrual stress and coping strategy before the intervention, as well as controlling those socio-demographic variables that had a significant difference between the two groups. Results Based on the ANCOVA test adjusted based on the age of first menstruation and pre-intervention premenstrual stress scores, the mean post-intervention premenstrual stress scores in the acupressure group [adjusted mean difference (AMD): - 20.6; 95% Confidence Interval (95% CI): - 23.1 to - 17.1; P < 0.001] and coping strategy group [AMD: - 20.5; 95% CI - 23.4 to - 16.7; P < 0.001] were significantly lower than that of the control group. Also, based on the post-hoc test, there was no statistically significant difference in terms of the mean post-intervention PMS scores between the two acupressure and the coping strategy groups [AMD: - 0.1; 95% CI - 3.5-2.9; P = 0.995]. Also, the mean post-intervention scores of task-oriented coping subscale [AMD: 30.8; 95% CI 25.6-36.1; P < 0.001] as well as avoidance-oriented coping subscale [AMD: 18.2; 95% CI 14.6-21.8; P < 0.001] were significantly higher than those of the control group, yet in terms of the emotion-oriented coping subscale [AMD: - 26.9; 95% CI - 31.1 to - 22.7; P < 0.001], the scores were significantly lower than those of the control group. Conclusion Considering the effect of learning coping strategies and applying acupressure in reducing the symptoms of premenstrual stress, it seems that equipping people with coping skills allows them to cope with stressful situations such as premenstrual syndrome and show a better and more logical response and feel less anxiety, depression, physical problems, and social problems. Furthermore, acupressure can also be used as a non-invasive method alone or as a complementary medicine in reducing the symptoms of premenstrual stress in young girls.