title: The relationship between occupational stress and dysmenorrhea in midwives employed at public and private hospitals and health care centers in Iran (Mashhad) in the years 2010 and 2011.
abstract: BACKGROUND
  According to the biopsychosocial model, menstrual symptoms are caused not only by a combination of biological factors such as hormonal disorders and lifestyle, but also by psychological and social factors such as working environment. This study aimed to determine the relation between occupational stress and dysmenorrhea in Iranian midwives.
  
  
  METHODS
  This prospective correlational study was performed on 150 midwives at public and private hospitals and health care centers of Mashhad, Iran. The subjects were selected through two-stage cluster sampling during 2010-2011. At the beginning of the study, participants completed questionnaires containing demographic information, work circumstances, the 21-item Depression, Anxiety, and Stress Scale, and the Job Content Questionnaire. They then completed the short form of daily Menstrual Distress Questionnaire during three consecutive menstrual cycles. Independent Student's t-test, one-way analysis of variance, Kruskal-Wallis, Mann-Whitney, and chi-square tests, correlation coefficients, and linear regression analysis were used to analyze the data collected data in SPSS11.5.
  
  
  RESULTS
  Dysmenorrhea was observed in 63.3% of the participants. Among these individuals, 15.7%, 45.2%, and 38.9% had mild, moderate, and severe symptoms, respectively. Moreover, 59.3% of the studied midwives had severe occupational stress. There was a significant positive correlation between occupational stress and severity of dysmenorrhea (P = 0.002, r = 0.82).
  
  
  CONCLUSIONS
  Occupational stress is associated with increased risk of severe dysmenorrhea. This finding can be used to guide preventive measures to eliminate or decrease occupational stress and dysmenorrhea among Iranian midwives. However, identification of sources of occupational stress and related workloads is necessary.
authors.affiliation: School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Kordi
authors.affiliation: School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Soheila
authors.initials: S
authors.lastname: Mohamadirizi
authors.affiliation: School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohamad Taghi
authors.initials: MT
authors.lastname: Shakeri
keywords: Dysmenorrhea; Iran; midwifery; occupations