NURSING APPRAISAL, STRESS & ENDOCRINE DYNAMICS IN PMS

护理评估、压力

• 批准号: 2257221
• 负责人: LINDA L LEWIS
• 金额: $ 12.26万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-01-01 至 1997-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2257221
• 关键词: blood pressure; body temperature; corticotropin releasing factor; epinephrine; female; heart rate; hormone regulation /control mechanism; human subject; hypothalamic pituitary axis; luteinizing hormone; muscle tension; neuroendocrine system; nursing research; patient care management; premenstrual syndrome; stress

Approximately 2.5 million U.S. women experience severe symptoms of premenstrual syndrome (PMS) which contribute to dysfunctional social relationships and, in some, depression with suicidal ideation. Women with PMS report a heightened responsiveness to stress during their symptom days, but not in their non-symptom days. Physiologically, there is a common stress-response link in reproductive and adrenal hormonal pathways: cortisol releasing factor (CRF). The effects of increased CRF on these pathways can be examined by applying a stress challenge and measuring the responses in selected hormone pulsatile release patterns. If transient, episodic alterations in the reproductive or adrenal hormonal pathways are demonstrated in response to a stress challenge, our knowledge of the physiology of PMS will be advanced and nursing therapeutic strategies directed at symptom management can be explored. The purpose of this study is to provide evidence for a significantly greater responsiveness to an applied stress challenge, compared to rest conditions, in the luteal phase of the menstrual cycle in women with PMS (n=20), compared to normal controls (n=20), using a repeated measures, between group design. Specific aims of the study are to determine whether women with PMS as compared to controls demonstrate 1) heightened stress-challenge responsiveness in the pulsatile release patterns of serum luteinizing hormone (reproductive pathway), cortisol (adrenal pathway), and somatic stress indicators (e.g. heart rate, urinary epinephrine), 2) relationships among the indicators of stress-challenge responsiveness, and 3) heightened perception of stress in the luteal phase. Hormone release patterns will be evaluated through frequent blood sampling (every 10 minutes for 12 hours) on two luteal phase days; on stress challenge day the Stroop Color Word Test will be applied, on rest conditions day, restful reading). Somatic stress indicators will be measured before, during, and after stress challenge conditions and rest conditions. Daily Likert-format ratings of stress will be used to assess perceived stress.

大约250万美国妇女经历严重的症状， 经前综合征（PMS），导致社会功能失调， 在某些情况下，抑郁症与自杀意念。 妇女 经前综合症患者报告说，他们在治疗过程中对压力的反应会增强， 症状日，但不是在他们的非症状日。 生理上， 是生殖和肾上腺激素中常见的应激反应环节 途径：皮质醇释放因子（CRF）。 CRF增加的影响 可以通过施加压力挑战来检查这些途径， 测量所选激素脉冲释放模式的响应。 如果是短暂的，生殖或肾上腺的偶发性改变， 激素途径被证明是对压力挑战的反应，我们的 经前综合症的生理学知识将是先进的和护理 可以探索针对症状管理的治疗策略。 这项研究的目的是提供证据， 与休息相比，对施加的压力挑战的反应更强 条件下，在月经周期的黄体期与PMS妇女 （n=20），与正常对照组（n=20）相比，使用重复测量， 组设计之间。 研究的具体目的是确定 与对照组相比，经前综合症女性是否表现出1） 脉冲释放模式中的应激-挑战反应性 血清黄体生成素（生殖途径）、皮质醇（肾上腺皮质激素） 途径）和躯体压力指标（例如心率、尿 肾上腺素），2）应激-挑战指标之间的关系 反应性，和3）在黄体压力的感知增强 相位 激素释放模式将通过频繁的血液检查进行评估。 在两个黄体期日采样（每10分钟，持续12小时）; 压力挑战日将应用Stroop颜色词测试，休息时 条件日，宁静阅读）。 身体压力指标将是 在应激挑战条件和休息之前、期间和之后测量 条件 每日Likert格式的压力评级将用于评估 感知压力