Polycystic ovary syndrome: implications for the advanced practice nurse in primary care

Contributions of Advanced Practice Nursing to Primary Health Care: A Scoping Review

Objective: To map the contributions and strategies to implement advanced practice nursing in primary health care. Materials and methods: This scoping review was carried out following the guidelines of the Joanna Briggs Institute in six databases, namely: LILACS, MEDLINE, WoS, Embase, CINAHL, and Scopus, in addition to a bibliographic repository. A total of 3,076 studies were found, from which 12 were selected. Results: The contributions mentioned by the studies regarding advanced practice nursing were divided into three subcategories, as follows: care, educational or management, and preventive practices. They concern autonomy, specialized clinical skills, therapeutic counseling, and patient-centered interaction. Some strategies to implement advanced practice are related to continuing education, practice management, self-care, and disease management. Conclusions: There is a need to improve strategies for advanced practice nursing, especially in primary care, to address gaps in specialized care, the development of indicators, and therapeutic objectives.

Gut microbiota dysbiosis in polycystic ovary syndrome: Mechanisms of progression and clinical applications

Polycystic ovary syndrome (PCOS) is the most common endocrine diseases in women of childbearing age that leads to menstrual disorders and infertility. The pathogenesis of PCOS is complex and has not yet been fully clarified. Gut microbiota is associated with disorders of lipid, glucose, and steroid hormone metabolish. A large body of studies demonstrated that gut microbiota could regulate the synthesis and secretion of insulin, and affect androgen metabolism and follicle development, providing us a novel idea for unravelling the pathogenesis of PCOS. The relationship between gut microbiota and the pathogenesis of PCOS is particularly important. This study reviewed recent research advances in the roles of gut microbiota in the occurrence and development of PCOS. It is expected to provide a new direction for the treatment of PCOS based on gut microbiota.

Maladaptive coping with illness in women with polycystic ovary syndrome

OBJECTIVE

To investigate associations between active and passive coping, psychiatric symptoms of depression and anxiety, and quality of life in women with polycystic ovary syndrome (PCOS). To assess the relative contribution of these coping strategies to reduced quality of life in an attempt to clarify the possible relevance of coping for impaired psychosocial well-being in PCOS.

DESIGN

Internet-based survey.

PARTICIPANTS

448 German women with PCOS.

METHODS

Coping (Freiburg Questionnaire of Coping-with-Illness), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), and quality of life (Short Form 12 Health Survey [SF-12]) were assessed in an Internet-based survey. Correlation and regression analyses were conducted.

RESULTS

In women with PCOS, passive coping was significantly associated with greater anxiety (r= .65; p < .001), depression (r= .61; p < .001), and reduced psychological quality of life (r=-.64, p < .001). In stepwise multiple regression analyses, passive coping, together with depression, anxiety and body mass index (BMI), explained 50.1% of the SF-12 psychological sum score, while active coping did not enter any regression model.

CONCLUSION

Data suggested that faced with the diagnosis of PCOS, passive coping may constitute a maladaptive strategy associated with anxiety and depression symptoms and compromised quality of life. Hence, efforts to incorporate psychosocial aspects into counselling and care for women with PCOS should take coping strategies into consideration. Nurses and other health care providers may help to improve coping strategies through education and psychosocial support in women with PCOS.

Diagnosis and management of endometriosis: the role of the advanced practice nurse in primary care

PURPOSE

To discuss the etiology, clinical presentation, diagnosis, and management of endometriosis for the advanced practice nurse (APN) in primary care.

DATA SOURCES

Selected research, clinical studies, clinical practice guidelines, and review articles.

CONCLUSIONS

Commonly encountered by the APN in primary care, endometriosis is a chronic, progressive inflammatory disease characterized by endometrial lesions, cysts, fibrosis, or adhesions in the pelvic cavity, causing chronic pelvic pain and infertility in women of reproductive age. Because of its frequently normal physical examination findings, variable clinical presentations, and nonspecific, overlapping symptoms with other conditions, endometriosis can be difficult to diagnose. As there currently are no accurate noninvasive diagnostic tests specific for endometriosis, it is imperative for the APN to become knowledgeable about the etiology, clinical presentation, diagnosis, and current treatment options of this disease.

IMPLICATIONS FOR PRACTICE

The APN in primary care plays an essential role in health promotion through disease management and infertility prevention by providing support and much needed information to the patient with endometriosis. APNs can also facilitate quality of care and manage treatments effectively to improve quality of life, reduce pain, and prevent further progression of disease. Practice recommendations include timely diagnosis, pain management, infertility counseling, patient education, and support for quality of life issues.

HER LIFESTYLE: a mneumonic for addressing polycystic ovary syndrome in adolescents

PCOS affects up to 10 percent of women of childbearing age, including adolescents. The emotional and physical consequences of PCOS can be significant. Early diagnosis and initiation of lifestyle changes can have a positive impact on risk for long-term sequelae.

The Lived Experience of Women Diagnosed With Polycystic Ovary Syndrome

OBJECTIVE

To uncover the meaning of living with polycystic ovary syndrome.

DESIGN

Phenomenology.

SETTING

A women's health care practice in northeast United States.

PARTICIPANTS

A purposive sample consisting of 12 women, ages 21 to 48 years, who had been previously diagnosed with polycystic ovary syndrome.

DATA COLLECTION

Semistructured interviews.

RESULTS

Analysis of the participants' responses revealed the following themes: (a) identifying differences, (b) wanting to be normal, (c) searching for answers, (d) gaining control, (e) attempting to achieve femininity, (f) letting go of guilt, and (g) dealing with it.

CONCLUSIONS

Polycystic ovary syndrome is a syndrome that impacts women both physically and psychosocially. Nurses can play a key role in assisting women afflicted with this hormonal disturbance through education and support.