title: A path analysis of stress and premenstrual symptoms in Korean international and Korean domestic students.
abstract: OBJECTIVE
  To identify the relationships between perceived stress, acculturative stress and premenstrual symptoms, among other associated factors (e.g. depressive symptoms, coping self-efficacy, perceived social support) of premenstrual symptoms suggested in the literature by testing the conceptual framework of the 'Stress and Premenstrual Experience Model: Women in Cultural Transition'.
  
  
  BACKGROUND
  Level of perceived stress has been cited as a major influencing factor for women's premenstrual symptoms; however, how these two elements are related, including possible mediators and moderators, remains unclear.
  
  
  METHODS
  A longitudinal causal-comparative web-based study design.
  
  
  METHODS
  Data collection occurred between November, 2014 - February, 2015. The convenience sampling method was used to recruit 98 Korean international students and 89 Korean domestic students. Weekly surveys were conducted for 10 weeks to capture women's levels of perceived stress, acculturative stress and premenstrual symptoms from two menstrual cycles. The survey data collected during the premenstrual phase was analysed using path analyses.
  
  
  RESULTS
  The hypothesized pathways based on the conceptual model were partially supported in the study. Depressive symptoms were a partial mediator between perceived stress and premenstrual symptoms and between acculturative stress and symptoms in Korean international students. The perceived social support was a moderator between perceived stress and premenstrual symptoms in Korean domestic students.
  
  
  CONCLUSIONS
  This study proposes a revised conceptual model that will contribute to the understanding of stress and premenstrual symptom severity in women in the acculturation process and concludes with suggestions and implications for future nursing practice and research.
authors.affiliation: Yeouido St. Mary's Hospital, Seoul, Korea.
authors.forename: Yaelim
authors.identifier: http://orcid.org/0000-0003-4200-8011
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Duke University School of Nursing, Durham, NC, USA.
authors.forename: Eun-Ok
authors.initials: EO
authors.lastname: Im
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D038622:Internationality; D011293:Premenstrual Syndrome / Q000523:psychology*; D056910:Republic of Korea; D012944:Social Support; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: reproductive health; stress; survey designs; transcultural nursing; women's health