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Sacca L, Lobaina D, Knopf E, Burgoa S, Jimenez S, Okwaraji G, Etzel M, Vardanyan V, Tharp M, Rao M, Jhumkhawala V, Sohmer J, Densley S, Linzer N, Meka P, Diaz D, Knecht M, Hopkins DK, Kitsantas P, Mejia M, Wilson C. Assessment of the Validity and Quality of Polycystic Ovarian Syndrome (PCOS) Screening Tools Available for Women Globally: A Systematic Review. Clin Pract 2024; 14:1625-1649. [PMID: 39311281 PMCID: PMC11417729 DOI: 10.3390/clinpract14050131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 08/16/2024] [Accepted: 08/19/2024] [Indexed: 09/26/2024] Open
Abstract
Background: This systematic review has the following aims: (1) to identify measurement tools used globally by healthcare providers to diagnose PCOS in women at elevated risk; (2) to assess the comprehensiveness of these tools regarding mental health and chronic pain; (3) to list strategies for validating, disseminating, and implementing these tools; and (4) to provide future recommendations for experts in healthcare settings. Methods: This review utilized the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and the Arksey and O'Malley York methodology. Studies were sourced from the PubMed, Embase, and Cochrane Library databases, with inclusion criteria focusing on peer-reviewed articles addressing PCOS diagnosis and associated comorbidities. Data extraction and analysis followed the Joanna Briggs Institute (JBI) recommendations. Results: A total of 63 studies met the inclusion criteria. Findings indicate that current screening tools for PCOS often lack comprehensive integration of mental health and chronic pain assessments. Tools like the PCOSQ and its updated version, PCOSQ-50, inadequately address pain-related symptoms, highlighting a gap in holistic patient evaluation. This review identified significant associations between PCOS and mental health disorders, including anxiety and depression, emphasizing the need for mental health screenings as part of PCOS management. Conclusions: There is a critical need for validated PCOS screening tools that encompass both physical and psychological aspects of the condition. Educating healthcare providers on the cultural and social determinants influencing PCOS can improve diagnosis and patient outcomes. Future research should focus on developing holistic screening tools and culturally relevant educational resources, aiming to enhance the overall quality of life for women with PCOS.
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Affiliation(s)
- Lea Sacca
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Diana Lobaina
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Elisheva Knopf
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Sara Burgoa
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Samantha Jimenez
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Goodness Okwaraji
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Madison Etzel
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Vartiter Vardanyan
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Madison Tharp
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Meera Rao
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Vama Jhumkhawala
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Joshua Sohmer
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Sebastian Densley
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Niko Linzer
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Pranav Meka
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Daniella Diaz
- Charles E. Schmidt College of Science, Boca Raton, FL 33431, USA;
| | - Michelle Knecht
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Dawn Kimberly Hopkins
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA;
| | - Panagiota Kitsantas
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Maria Mejia
- Department of Population Health and Social Medicine, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA; (D.L.); (E.K.); (S.B.); (S.J.); (G.O.); (M.E.); (V.V.); (M.T.); (M.R.); (V.J.); (J.S.); (S.D.); (N.L.); (P.M.); (M.K.); (P.K.); (M.M.)
| | - Candy Wilson
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL 33431, USA;
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Zaman R, Ehsan S, Fatima A, Obaid S, Shahzadi J. Translation and psychometric analysis of urdu version of modified polycystic ovary syndrome health related quality of life questionnaire (MPCOSQ-U). BMC Womens Health 2024; 24:413. [PMID: 39039453 PMCID: PMC11265378 DOI: 10.1186/s12905-024-03266-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 07/15/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome is a metabolic disorder prevalent among females of reproductive age. The symptoms of PCOS profoundly affect the quality of life of these females. Outcome measures specific to PCOS are crucial to the management of these patients. The MCPOSQ is a validated tool to measure the health-related quality of life specific to PCOS. The purpose of this study was to translate the modified polycystic ovary syndrome quality of life questionnaire (MPCOSQ) and to determine the reliability and validity of the modified polycystic ovary syndrome quality of life questionnaire Urdu version (MPCOSQ-U). METHODOLOGY This cross-sectional study was conducted in Islamabad/Rawalpindi. The MPCOSQ was translated to Urdu and validated by expert gynaecologists. The MPCOSQ-U and SF-36 were administered to one hundred eighty females with PCOS. The MPCOSQ-U was evaluated for internal consistency, test-retest reliability, factor analysis, face validity, content validity and construct validity. RESULTS The average age (years) of the females was 25.27(1.83). The MPCOSQ-U showed excellent test-retest reliability and internal consistency (ICC2,1=0.95, Cronbach's α = 0.97). The content validity index (CVI) was 0.92. There was a statistically significant but weak positive correlation between MPCOSQ-U and SF-36 (r = .186, p = .012). CONCLUSION The Urdu version of the modified version of the polycystic ovarian syndrome quality of life questionnaire is a validated and reliable tool to assess the quality of life of Pakistani females with PCOS. This is an important step to cover the language barrier, which influences the outcome assessment in PCOS.
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Affiliation(s)
- Rabbiya Zaman
- Department of Physical Therapy, Zohra Institute of Health Sciences, Rawalpindi, Pakistan
| | - Sarah Ehsan
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan.
| | - Abeer Fatima
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Sumaiyah Obaid
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Javeria Shahzadi
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
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Alghadeer S, Algarawi A, Abu-Rkybah F, Alshebly MM, Alruthia Y. The translation and validation of the Arabic Version of the Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (AR-PCOSQ). BMC Womens Health 2020; 20:244. [PMID: 33121466 PMCID: PMC7596927 DOI: 10.1186/s12905-020-01108-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 10/22/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Polycystic ovarian syndrome (PCOS) is a hormonal disorder that is prevalent in females of reproductive age with signs and symptoms that significantly reduce self-esteem and have a negative impact on their quality of life. The management of PCOS signs and symptoms should result in an improvement in the health-related quality of life (HRQoL) of patients. Polycystic ovarian syndrome questionnaire (PCOSQ) is a disease-specific scale. The PCOSQ has been translated into different languages and assessed in different populations. The validity and reliability of PCOSQ varied depending on the ethnicity and culture of the respondents. The objective of the study was to establish a valid and reliable version of the PCOSQ (AR-PCOSQ) in Arabic. METHODS A cross-sectional study using the translated and validated AR-PCOSQ questionnaire was conducted by interviewing 117 women with PCOS. RESULTS The mean age (years) and BMI (kg/m2) of subjects were 29.90 ± 6.33 and 27.21 ± 5.54, respectively. Most of the patients had ≥ 1-year long history of PCOS (73.5%) and a post-school degree (64.96%). The content validity index (CVI) for the AR-PCOSQ from 10 gynecologists was 0.9, indicating satisfactory validity content. The internal consistency for reliability confirmation measured by Cronbach's alpha coefficient was applied. Alpha coefficients for all items together was 0.863, indicating good reliability. The intraclass correlation coefficients for each item for 30 participants were also acceptable, ranging from 0.911 to 0.986 with p value < 0.001. As far as the factor analysis is concerned, the overall Kaiser-Meyer-Olkin sampling adequacy measure was 0.772. The Bartlett sphericity test was significant (p ≤ 0.001), Indicating that there were interrelated variables. CONCLUSION Our results demonstrated the initial reliability and validity of the Arabic version of the PCOSQ as a measure of specific HRQoL in Saudi women with PCOS. This will fill an important gap in measuring the HRQoL for patients with PCOS in research and community settings in Saudi Arabia. The AR-PCOSQ can be used to help prioritize health-related concerns from the patient's perspective.
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Affiliation(s)
- Sultan Alghadeer
- Basic Sciences Department, Prince Sultan College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P. O. Box 2457, Riyadh, 11451 Saudi Arabia
| | - Alhanouf Algarawi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P. O. Box 2457, Riyadh, 11451 Saudi Arabia
| | - Faten Abu-Rkybah
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P. O. Box 2457, Riyadh, 11451 Saudi Arabia
| | - Mashael M. Alshebly
- Obstetrics and Gynecology Consultant, King Saud University Medical City, Riyadh, Saudi Arabia
- Department of Obstetrics and Gynecology, College of Medicine, King Saud University, P. O. Box 2925, Riyadh, 11461 Saudi Arabia
| | - Yazed Alruthia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P. O. Box 2457, Riyadh, 11451 Saudi Arabia
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Alur-Gupta S, Chemerinski A, Liu C, Lipson J, Allison K, Sammel MD, Dokras A. Body-image distress is increased in women with polycystic ovary syndrome and mediates depression and anxiety. Fertil Steril 2019; 112:930-938.e1. [PMID: 31395311 DOI: 10.1016/j.fertnstert.2019.06.018] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/17/2019] [Accepted: 06/11/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate differences in body-image distress (BID) scores between women with polycystic ovary syndrome (PCOS) and controls and whether BID mediates anxiety and depression. DESIGN Cross-sectional study. SETTING Academic institution. PATIENT(S) Reproductive-aged women with PCOS (n = 189) and controls (n = 225). INTERVENTION Administering the Multidimensional Body-Self Relations-Appearance Subscale (MBSRQ-AS), Stunkard Figure Rating Scale (FRS), Hospital Anxiety and Depression Scale (HADS), and PCOS quality of life survey (MPCOS-Q). MAIN OUTCOME MEASURE(S) BID, depression, and anxiety scores and mediation of depression and anxiety scores by BID. RESULT(S) Women with PCOS had worse BID scores on all five MBSRQ-AS subscales adjusted for age, body mass index, race, pregnancy history, income, and employment, and larger differences on the FRS compared with the control women. In multivariable regression models, the prevalence of depressive (28% vs. 19.2%) and anxiety (76.5% vs. 56.5%) symptoms were also statistically significantly higher in women with PCOS compared with the controls. Most MBSRQ-AS subscale scores statistically significantly correlated with depression, anxiety, and quality of life scores. The association between PCOS/control status and higher anxiety and depression scores was completely mediated by the appearance evaluation and body areas satisfaction subscales and partially mediated by overweight preoccupation, appearance orientation, and self-classified weight. CONCLUSION(S) Women with PCOS have increased BID and depressive and anxiety symptoms. In our study different aspects of BID either fully or partially mediated the association between PCOS/control status and depression and anxiety scores, suggesting that therapeutic interventions targeted at improving body image may decrease depressive and anxiety symptoms.
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Affiliation(s)
| | - Anat Chemerinski
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Chang Liu
- University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jenna Lipson
- Pennsylvania Hospital, Philadelphia, Pennsylvania
| | - Kelly Allison
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mary D Sammel
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anuja Dokras
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Tai chi for overweight/obese adolescent and young women with polycystic ovary syndrome: study protocol for a randomized controlled trial. Trials 2018; 19:512. [PMID: 30236149 PMCID: PMC6149209 DOI: 10.1186/s13063-018-2893-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 08/31/2018] [Indexed: 11/10/2022] Open
Abstract
Background Tai Chi is a moderately intense exercise that dates back to ancient China. It has been reported that Tai Chi not only has beneficial effects on metabolic disorders, such as diabetes, cardiovascular diseases and obesity, but also has favorable effects on psychological well-being. Since these conditions are quite closely associated with polycystic ovary syndrome (PCOS), we hypothesis that Tai Chi could be a potential treatment option for PCOS patients. We aim to determine the feasibility and effectiveness of Tai Chi on overweight/obese adolescent and young women with PCOS. Methods A total of 50 patients will be randomized into two arms: (1) Tai Chi or (2) self-monitored exercise. Both groups will exercise for 3 months. The primary hypothesis is that Tai Chi results in a significantly lower Body Mass Index (BMI) than self-monitored exercise. The study was approved by the Ethics Committee of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine. Discussion This is the first study to determine the feasibility and effectiveness of Tai Chi in treating overweight/obese adolescent and young women with PCOS. The trial will provide evidence to assess the feasibility of a future multicenter, randomized controlled trial. Trial registration ClinicalTrials.gov, ID: NCT02608554. Registered on 17 November 2015. Electronic supplementary material The online version of this article (10.1186/s13063-018-2893-z) contains supplementary material, which is available to authorized users.
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Böttcher B, Fessler S, Friedl F, Toth B, Walter MH, Wildt L, Riedl D. Health-related quality of life in patients with polycystic ovary syndrome: validation of the German PCOSQ-G. Arch Gynecol Obstet 2018; 297:1027-1035. [PMID: 29249009 PMCID: PMC5849657 DOI: 10.1007/s00404-017-4623-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 12/06/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE Patients with polycystic ovary syndrome (PCOS) report a decreased health-related quality of life (HRQOL) and higher levels of psychological distress. Validated questionnaires are necessary to assess the impact of PCOS on patients' lives. The aim of the present study was to evaluate the German "Polycystic Ovary Syndrome Questionnaire" (PCOSQ-G). METHODS The psychometric properties of the PCOSQ-G were investigated in PCOS patients with item-total correlation, internal consistency and test-retest reliability. Correlations with the Short-Form-36 Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS-D) were calculated to evaluate the validity of the PCOSQ-G. Discriminatory validity was investigated through a receiver operating characteristic curve and independent sample t tests compared with healthy controls. RESULTS Good psychometric properties were found for most items. Acceptable to high internal consistency was found for the total score (α = 0.94-0.95) and all subscales (α = 0.70-0.97). High test-retest reliability was found for the total score (0.86) and all subscales (0.81-0.90). The validity analyses showed that the PCOSQ-G total score was positively correlated with both SF-36 summary scales and was negatively correlated with both HADS subscales. Patients reported significantly lower values for the PCOSQ-G total score (p < 0.001) and all subscales, and the PCOSQ-G discriminated well between patients and healthy controls (AUC = 0.81, p < 0.001). CONCLUSIONS PCOSQ-G is a reliable and valid tool to assess the HRQOL in patients with PCOS and can be used in future clinical research. Patients with PCOS exhibited an impaired HRQOL, which indicates the need for psychosomatic counseling.
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Affiliation(s)
- B Böttcher
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - S Fessler
- Department of Psychology, University of Innsbruck, Bruno-Sander-Haus, Innrain 52f, 6020, Innsbruck, Austria
| | - F Friedl
- Department of Psychology, University of Innsbruck, Bruno-Sander-Haus, Innrain 52f, 6020, Innsbruck, Austria
| | - B Toth
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - M H Walter
- Department of Psychology, University of Innsbruck, Bruno-Sander-Haus, Innrain 52f, 6020, Innsbruck, Austria
| | - L Wildt
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - D Riedl
- University Clinic of Medical Psychology, Medical University Innsbruck, Schöpfstr. 23a, 6020, Innsbruck, Austria.
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Skevington SM, Epton T. How will the sustainable development goals deliver changes in well-being? A systematic review and meta-analysis to investigate whether WHOQOL-BREF scores respond to change. BMJ Glob Health 2018; 3:e000609. [PMID: 29379649 PMCID: PMC5759710 DOI: 10.1136/bmjgh-2017-000609] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 11/26/2022] Open
Abstract
Introduction The Sustainable Development Goals (SDGs) 2015 aim to ‘…promote well-being for all’, but this has raised questions about how its targets will be evaluated. A cross-cultural measure of subjective perspectives is needed to complement objective indicators in showing whether SDGs improve well-being. The WHOQOL-BREF offers a short, generic, subjective quality of life (QoL) measure, developed with lay people in 15 cultures worldwide; 25 important dimensions are scored in environmental, social, physical and psychological domains. Although validity and reliability are demonstrated, clarity is needed on whether scores respond sensitively to changes induced by treatments, interventions and major life events. We address this aim. Methods The WHOQOL-BREF responsiveness literature was systematically searched (Web of Science, PubMed, EMBASE and Medline). From 117 papers, 15 (24 studies) (n=2084) were included in a meta-analysis. Effect sizes (Cohen’s d) assessed whether domain scores changed significantly during interventions/events, and whether such changes are relevant and meaningful to managing clinical and social change. Results Scores changed significantly over time on all domains: small to moderate for physical (d=0.37; CI 0.25 to 0.49) and psychological QoL (d=0.22; CI 0.14 to 0.30), and small for social (d=0.10; CI 0.05 to 0.15) and environmental QoL (d=0.12; CI 0.06 to 0.18). More importantly, effect size was significant for every domain (p<0.001), indicating clinically relevant change, even when differences are small. Domains remained equally responsive regardless of sample age, gender and evaluation interval. Conclusion International evidence from 11 cultures shows that all WHOQOL-BREF domains detect relevant, meaningful change, indicating its suitability to assess SDG well-being targets.
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Affiliation(s)
- Suzanne M Skevington
- International Hub for Quality of Life Research, Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Tracy Epton
- International Hub for Quality of Life Research, Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, UK
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Panico A, Messina G, Lupoli GA, Lupoli R, Cacciapuoti M, Moscatelli F, Esposito T, Villano I, Valenzano A, Monda V, Messina A, Precenzano F, Cibelli G, Monda M, Lupoli G. Quality of life in overweight (obese) and normal-weight women with polycystic ovary syndrome. Patient Prefer Adherence 2017; 11:423-429. [PMID: 28280314 PMCID: PMC5338969 DOI: 10.2147/ppa.s119180] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is characterized by phenotypic heterogeneity and has a wide variety of consequences. Approximately half of women with PCOS are overweight or obese, and their obesity may be a contributing factor to PCOS pathogenesis through different mechanisms. The aim of this study was to evaluate if PCOS alone affects the patients' quality of life and to what extent obesity contributes to worsen this disease. DESIGN To evaluate the impact of PCOS on health-related quality-of-life (HRQoL), 100 Mediterranean women with PCOS (group A), 50 with a body mass index (BMI) >25 kg/m2 (group A1) and 50 with BMI <25 kg/m2 (group A2), were recruited. They were evaluated with a specific combination of standardized psychometric questionnaires: the Symptom Checklist-90 Revised, the 36-Item Short-Form Health Survey, and the Polycystic Ovary Syndrome Questionnaire. The patients were compared with a normal-weight healthy control group of 40 subjects (group B). Another control group of 40 obese healthy women (group C) was used to make a comparison with PCOS obese patients (A1). RESULTS Our results showed a considerable worsening of HRQoL in PCOS patients (A) compared with controls (B). In addition, patients with PCOS and BMI >25 (A1) showed a significant and more marked reduction in scores, suggesting a lower quality of life, compared with controls (B) and with normal-weight PCOS patients (A2). CONCLUSION PCOS is a complex disease that alone determines a deterioration of HRQoL. The innovative use of these psychometric questionnaires in this study, in particular the PCOS questionnaire, has highlighted that obesity has a negative effect on HRQoL. It follows that a weight decrease is associated to phenotypic spectrum improvement and relative decrement in psychological distress.
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Affiliation(s)
- Annalisa Panico
- Department of Clinical Medicine and Surgery, University of Napoli Federico II, Naples, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
- Correspondence: Giovanni Messina, Department of Clinical and Experimental Medicine, University of Foggia, Via L Pinto, 71122 Foggia, Italy, Tel +39 81 566 5804, Fax +39 81 566 5844, Email
| | - Gelsy Arianna Lupoli
- Department of Clinical Medicine and Surgery, University of Napoli Federico II, Naples, Italy
| | - Roberta Lupoli
- Department of Clinical Medicine and Surgery, University of Napoli Federico II, Naples, Italy
| | - Marianna Cacciapuoti
- Department of Clinical Medicine and Surgery, University of Napoli Federico II, Naples, Italy
| | - Fiorenzo Moscatelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Teresa Esposito
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Ines Villano
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Anna Valenzano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Vincenzo Monda
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Antonietta Messina
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Francesco Precenzano
- Department of Mental and Physical Health, and Preventive Medicine, Child and Adolescent Neuropsychiatry Unit, Second University of Naples, Naples, Italy
| | - Giuseppe Cibelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Marcellino Monda
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Giovanni Lupoli
- Department of Clinical Medicine and Surgery, University of Napoli Federico II, Naples, Italy
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