BACKGROUND:

Adequate symptoms assessment is essential in premenstrual syndrome prevention. Assessment scales were designed to support practitioners in identifying adolescents at premenstrual syndrome risk. The Premenstrual syndrome scale is one of the most extensively studied symptoms assessment instruments, although the majority of studies focused on validity rather than reliability.

OBJECTIVES:

· The first aim was to measure the interrater reliability of the Premenstrual syndrome scale and its individual items.

· The second aim was to study different statistical approaches regarding interrater reliability estimation.

DESIGN AND METHODS:

An interrater reliability study was conducted in selected private school, Namakkal District. Samples selected through simple random technique. Adolescents (n = 46) were assessed for menstrual five cycles. Data were analyzed using an overall percentage of agreement and the intraclass correlation coefficient.

VALIDITY AND RELIABILITY:

The ability of the Premenstrual syndrome Scale to predict the development of PUs (predictive validity) has been tested extensively. Inter-rater reliability (Cronbach's Alpha) was 0.97.

The tool has been shown to be equally reliable with adolescent girls. Sensitivity ranges from 83-100% and specificity 64-90% depending on the cut-off score used for predicting PU risk.

CONCLUSIONS:

Although the calculated interrater reliability coefficients for the total Premenstrual syndrome score were high in some cases, several clinically relevant differences occurred between the nurses. The calculation of weighted kappa or intraclass correlation coefficients is the most appropriate interrater reliability estimates.

PREMENSTRUAL SYNDROME SCALE (PMSS)

Each of the symptoms below, circle the number that most closely describes the intensity of your premenstrual symptoms during your last cycle. These are symptoms that would occur during the premenstrual phase of your cycle. This phase begins about seven days prior to menstrual bleeding (or seven days before your period) and ends about the time bleeding starts. Rate each item on this list on a scale from 1 (not present or no change from usual) to 5 (extreme change, perhaps noticeable even to casual acquaintances).

INTERPRETATION:

The premenstrual syndrome scale comprised 40 questions with three sub‑scales (Physiological, Psychological and Behavioural symptoms). This 5‑point Likert‑ type scale consisting of 40 items. The measurements on the scale are set according to the following scoring system: the response Never was scored as “1”, rarely as “2”, sometimes as “3”, very often as “4” and always as “5” points.

S.No	Premenstrual syndrome scale (PMSS)	SCORES
S.No	Premenstrual syndrome scale (PMSS)	Never (1)	Rarely (2)	Sometimes (3)	Very often (4)	Always (5)
	Physiological symptoms
1	Breast tenderness and swelling
2	Abdominal bloating
3	weight gain
4	Headache
5	Dizziness/fainting.
6	Fatigue
7	Palpitations
8	Pelvic discomfort and pain
9	Abdominal cramps
10	Change in bowel habits
11	Increased appetite
12	Generalized aches and pains
13	Food cravings (Sugar/ Salt)
14	Skin changes, rashes, pimples
15	Nausea/vomiting
16	Muscle and Joint pain
	Psychological symptoms
17	Irritability
18	Anxiety
19	Tension
20	Mood swings
21	Loss of concentration
22	Depression
23	Forgetfulness
24	Easy crying/ Crying spells
25	Sleep changes (Insomnia/ hypersomnia)
26	Confusion
27	Aggression
28	Hopelessness
	Behavioural symptoms
29	Social withdrawal
30	Restlessness
31	Lack of self control
32	Feeling guilty
33	Clumsiness
34	Lack of interest in usual activities
35	Poor judgment
36	Impaired work performance
37	Obsessional thoughts
38	Compulsive behavior
39	Irrational thoughts
40	Being over sensitive

Level of symptoms	Actual Scores	Percentage of Scores
No symptoms	1- 40	< 20
Mild symptoms - only slightly apparent	41 - 80	21 -40
Moderate symptoms - aware of symptom, but it doesn’t affect daily activity at all	81 – 120	41 60
Severe - continuously bothered by symptoms	121 - 160	61 -80
very severe - symptom is overwhelming and /or interferes with daily activity	161 -200	> 80