Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journa.
A Journal of Nursing Values.
Innovation.
Collaboration, and Global Impact Volume 12.
Issue 2.
April 2026 Published by STIKep PPNI Jawa Barat ISSN 2354-8428, e-ISSN 2598-8727 Original Article Evaluating the Effectiveness of Benson Relaxation on Dysmenorrhea Pain Intensity: A Pre-Experimental Study Among Indonesian Female University Students Febriana Febriana1.
Indah Lestari2 1,2Department of Nursing.
Faculty of Nursing.
Universitas Cendekia Abditama.
Tangerang.
Indonesia Abstract This is an Open Access article distributed under the terms of the Creative Commons Attribu tionNonCommercial 4.
0 International License Background: Dysmenorrhea is a prevalent menstrual disorder among young women that can impair daily functioning and quality of life.
Although pharmacological treatments are commonly used, they may cause side effects, leading to increased interest in nonpharmacological approaches such as Benson relaxation.
Objective: This study aimed to evaluate the effectiveness of Benson relaxation in reducing dysmenorrhea pain intensity among female university students.
Methods: A quantitative pre-experimental study with a one-group pretestAeposttest design was conducted involving 35 female students selected through purposive Participants received a 15-minute Benson relaxation session in a quiet and comfortable Pain intensity was measured before and after the intervention using the Numeric Rating Scale (NRS).
Data were analyzed using the Wilcoxon SignedRank Test.
Results: The findings showed a statistically significant reduction in dysmenorrhea pain intensity following the intervention (Z = -5.
p < 0.
The median pain score decreased from 6 to 3.
Before the intervention, most participants experienced moderate and severe pain, whereas after the intervention, pain levels shifted to mild and moderate categories.
Conclusion: Benson relaxation is an effective, simple, and low-cost non-pharmacological intervention for reducing dysmenorrhea pain intensity.
It can be applied in nursing practice and self-care, although further research using controlled designs is recommended p-ISSN : 2354 8428 e-ISSN: 2598 8727 Keywords: Benson relaxation, dysmenorrhea, pain non-pharmacological Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journa.
Volume 12 .
, 183-188 https://doi.
org/10.
33755/jkk.
Article info Received Revised Accepted Published December 19, 2025 April 19, 2026 April 23, 2026 April 24, 2026 Corresponding author Febriana* Faculty of Nursing.
Universitas Cendekia Abditama Jl.
Islamic Raya.
Kelapa Dua.
Tangerang.
Banten Phone : 62851-2908-1328 Email: febriana@uca.
Citation Febriana.
, & Lestari.
Evaluating the effectiveness of Benson relaxation on dysmenorrhea pain intensity: A pre-experimental study among Indonesian female university students.
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journa.
, 12.
, 183Ae188.
https://doi.
org/10.
33755/jkk.
Website https://journal.
stikep-ppnijabar.
id/jkk INTRODUCTION to uterine hypercontractility and pain.
Indonesia, the prevalence of dysmenorrhea remains high, exceeding 60%, and significantly affects studentsAo academic performance, daily activities, and quality of life .
Pharmacological treatments such as nonsteroidal antiinflammatory drugs (NSAID.
are widely used to manage dysmenorrhea.
however, long-term use Dysmenorrhea is one of the most common menstrual disorders experienced by adolescents and young adult women worldwide, with prevalence estimates ranging from 50% to 90% .
The condition is primarily associated with increased prostaglandin production, which leads Jurnal Keperawatan Komprehensif.
Volume 12 Issue 2.
April 2026 Evaluating Benson Relaxation Effectiveness on Dysmenorrhea Pain may lead to adverse effects, including .
Consequently, non-pharmacological approaches have gained increasing attention as safer and more sustainable alternatives .
Despite this growing interest, current evidence on nonpharmacological fragmented, with variability in intervention comparability and generalizability of findings.
In addition, previous studies have rarely quantified the magnitude of intervention effects using standardized effect size measures, nor have they adequately addressed the clinical relevance of pain reduction.
This represents an important clinical gap, as statistically significant findings do not always translate into meaningful improvements in patient experience.
Therefore, this study aims to address these gaps by evaluating the effectiveness of Benson relaxation in reducing dysmenorrhea .
pain intensity among Indonesian female university students using a structured and standardized intervention protocol.
The novelty of this study lies in three key aspects: .
the focus on a highrisk under-researched .
niversity students in a low- and middleincome country contex.
, .
the application of a standardized Benson relaxation protocol with controlled implementation conditions, and .
the inclusion of both statistical and clinical interpretations of outcomes, including effect size By doing so, this study contributes to strengthening the evidence base for nonpharmacological, accessible, and culturally adaptable pain management strategies for One of the non-pharmacological interventions that has shown promise is Benson relaxation, a mindAebody technique that combines controlled breathing, cognitive focus, and repetition of calming words to induce a relaxation response .
Previous studies have demonstrated that Benson relaxation can effectively reduce pain intensity among adolescents and women with dysmenorrhea .
However, most of these studies have been conducted in small-scale settings, often without rigorous control of intervention delivery, thereby limiting the strength of causal inference.
Physiologically, this technique is believed to reduce sympathetic decreased stress hormone levels and increased endorphin release, which contribute to pain reduction .
Additionally, psychological factors such as stress, anxiety, and individual pain perception play a role in the severity of dysmenorrhea .
Nevertheless, the interaction mechanisms in the context of mindAebody particularly in young adult populations.
METHODS
Study Design A quantitative pre-experimental design with a one-group pretestAeposttest approach was employed in this study.
This design was chosen due to limited feasibility in implementing a control group, considering ethical and practical constraints in withholding a potentially beneficial intervention.
The design allows researchers to evaluate changes within the same participants before and after the intervention, providing preliminary evidence of effectiveness.
Several critical gaps can be identified in the existing literature.
First, from a methodological perspective, many studies rely on quasiexperimental or descriptive designs with limited internal validity, making it difficult to establish robust evidence for effectiveness.
Second, from a population-specific perspective, there is a lack of targeted research focusing on university students, who experience unique academic pressures, irregular lifestyles, and heightened stress levels that may exacerbate dysmenorrhea symptoms .
Third, from a practical and implementation perspective, there is insufficient evidence regarding simple, scalable, and selfadministered interventions that can be feasibly integrated into studentsAo daily routines without requiring clinical supervision.
Sample Participants in this study were 35 female university students who met specific inclusion dysmenorrhea, being within the reproductive age range, and being willing to participate.
Students who used analgesics during the data collection period, had a history of reproductive disorders, or were unable to complete the intervention were excluded.
The sampling technique used was purposive sampling.
The sample size was determined based on feasibility.
however, post hoc effect size analysis indicated Jurnal Keperawatan Komprehensif.
Volume 12 Issue 2.
April 2026 Febriana et al.
adequate statistical power significant differences.
Rank Test was applied to compare pretest and posttest scores, with a significance level of p < Instrument Ethical Consideration Pain intensity was assessed using the Numeric Rating Scale (NRS), a validated and reliable instrument widely used in clinical and research The NRS has shown strong validity and reliability in previous studies assessing pain intensity, with a CronbachAos alpha > 0.
The scale ranges from 0 .
o pai.
to 10 .
orst possible pai.
, making it suitable for measuring subjective experiences such as dysmenorrhea.
This study adhered to ethical research Informed consent was secured from all participants, with confidentiality and anonymity maintained, and the right to withdraw at any time without penalty was The intervention posed minimal risk and was considered safe.
RESULTS
Intervention A total of 35 female university students participated in this study, and all participants The analysis demonstrated a consistent and substantial reduction in dysmenorrhea pain intensity following the Benson relaxation intervention.
The intervention applied in this study was Benson relaxation, a non-pharmacological technique designed to elicit a relaxation response through controlled breathing and repetition of calming words.
Participants received a 15-minute session conducted in a quiet, distraction-free environment to optimize During the session, participants were instructed to sit comfortably, close their eyes, and engage in slow, rhythmic breathing while focusing on inhalation and exhalation.
With each exhalation, they silently repeated a calming word .
AutenangA.
to enhance concentration and promote relaxation.
If distracting thoughts arose, participants were guided to gently refocus on their breathing and repeated word without The intervention was delivered individually by trained research assistants following a standardized protocol (SOP), with session fidelity ensured through checklist-based Before the intervention, the median pain score was 6 (IQR: 5Ae.
, indicating moderate pain.
After the intervention, the median pain score decreased to 3 (IQR: 2Ae.
, reflecting mild pain.
The mean pain score also decreased from 6.
(SD = 1.
14 (SD = 0.
, representing a mean reduction of 3.
15 points on the Numeric Rating Scale (NRS) (Table .
The descriptive analysis demonstrates a substantial reduction in dysmenorrhea pain intensity following the intervention.
The mean pain score decreased from 6.
29 (SD = 1.
indicating moderate pain, to 3.
14 (SD = 0.
corresponding to mild pain.
Similarly, the median score declined from 6 (IQR: 5Ae.
to 3 (IQR: 2Ae.
, resulting in a median reduction of 3 points (Table .
Data Collection Data were collected through face-to-face Participants first received a clear explanation of the study and provided written informed consent.
Baseline pain intensity .
was assessed using the Numeric Rating Scale (NRS).
Participants then underwent the Benson relaxation intervention, after which posttest pain intensity was measured using the same instrument.
All documented using coded data forms to maintain participant confidentiality.
Data Analysis The Wilcoxon Signed-Rank Test demonstrated a dysmenorrhea pain intensity following the intervention (Z = -5.
257, p < 0.
, with a very large effect size .
= 0.
Rank distribution analysis further revealed that 94.
3% of participants experienced a reduction in pain intensity, with no participants reporting increased pain and only 5.
7% showing no change (Table .
Data were analyzed using SPSS software.
Descriptive statistics were used to present participant characteristics and pain scores.
The normality test indicated non-normal data therefore.
The Wilcoxon Signed- Bootstrap analysis confirmed that the reduction in pain intensity was robust, with the 95% confidence interval not crossing zero, indicating a stable and reliable intervention effect under non-parametric (Table Jurnal Keperawatan Komprehensif.
Volume 12 Issue 2.
April 2026 Evaluating Benson Relaxation Effectiveness on Dysmenorrhea Pain Table 1.
Distribution of Pain Intensity Before and After Intervention .
= .
Pain Level Mild .
Ae.
Moderate .
Ae.
Severe .
Ae.
Pretest n (%) 0 .
Posttest n (%) 20 .
Table 2.
Descriptive Statistics of Pain Scores (PreAePost Interventio.
Variable Pretest Pain Score Posttest Pain Score Mean Difference Mean A SD 29 A 1.
14 A 0.
Median (IQR) 6 .
Ae.
Ae.
Ai MinAeMax 4Ae9 1Ae5 Ai Table 3.
Wilcoxon Signed-Rank Test and Rank Distribution of Pain Intensity .
= .
Zvalue Variable Pain Intensity 257 <0.
(PreAePos.
Note: Effect size .
calculated as Z/OoN.
Effect Size .
Negative Ranks n (%) Positive Ranks n (%) Ties n (%) 33 .
Table 4.
Bootstrap Estimation of Median Difference .
,000 Resample.
Statistic Median Difference (PreAePos.
Estimate 95% Confidence Interval 50 Ae 3.
dysmenorrhea, where uterine hypercontractility driven by prostaglandins plays a central role in pain generation .
DISCUSSION