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Percy C, Turner A, Orr C. Developing a Novel Web-Based Self-Management Support Intervention for Polycystic Ovary Syndrome: Mixed Methods Study With Patients and Health Care Professionals. JMIR Form Res 2024; 8:e52427. [PMID: 38451567 PMCID: PMC10958350 DOI: 10.2196/52427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/18/2023] [Accepted: 01/10/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) represents a significant global health burden requiring urgent attention. This common chronic endocrine and cardiometabolic condition affects around 1 in 10 women and individuals assigned female at birth, with significant adverse effects on well-being, quality of life, and mental health, as well as serious and complex long-term health consequences. International guidelines for best health care practice recommend the provision of comprehensive cognitive behavioral interventions to support self-management and improve health outcomes for those living with PCOS. Web-based health interventions have the potential to meet this need in an accessible and scalable way. OBJECTIVE We aim to identify barriers to self-management and psychological well-being in women with PCOS and adapt a web-based self-management program to provide a prototype digital support intervention for them. METHODS We adapted an existing support program (HOPE) for PCOS using the antecedent target measure approach. We conducted qualitative interviews with 13 adult women living with PCOS, 3 trustees of a patients with PCOS advocacy charity, and 4 endocrinologists to identify "antecedents" (barriers) to self-management and psychological well-being. Framework analysis was used to identify potentially modifiable antecedents to be targeted by the novel intervention. At a national conference, 58 key stakeholders (patients and health professionals) voted for the antecedents they felt were most important to address. We used research evidence and relevant theory to design a prototype for the PCOS intervention. RESULTS Voting identified 32 potentially modifiable antecedents, relating to knowledge, understanding, emotions, motivation, and behaviors, as priorities to be targeted in the new intervention. A modular, web-based prototype HOPE PCOS intervention was developed to address these, covering six broad topic areas (instilling HOPE for PCOS; managing the stress of PCOS; feeding your mind and body well; body image, intimacy, and close relationships; staying healthy with PCOS; and keeping PCOS in its place). CONCLUSIONS We identified barriers to self-management and psychological well-being in women with PCOS and used these to adapt a web-based self-management program, tailoring it for PCOS, which is a comprehensive group intervention combining education, empowerment, lifestyle management, peer support with cognitive behavioral tools, and goal-setting (to be delivered by peers or codelivered with health care professionals). The modular structure offers flexibility to adapt the program further as new clinical recommendations emerge. The intervention has the potential to be delivered, evaluated for feasibility, and, if effective, integrated into health care services. Self-management interventions are not designed to replace clinical care; rather, they serve as an additional source of support. The HOPE PCOS program conveys this message in its content and activities. Future research should evaluate the prototype intervention using primary outcomes such as measures of psychological well-being, self-management self-efficacy, depression, anxiety, and PCOS-related quality of life. They should also assess the intervention's acceptability, scalability, and cost-effectiveness.
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Affiliation(s)
- Carol Percy
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Andrew Turner
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Charys Orr
- Harris Church of England Academy, Diocese of Coventry Multi Academy Trust, Coventry, United Kingdom
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Malhotra K, Kempegowda P. Appraising Unmet Needs and Misinformation Spread About Polycystic Ovary Syndrome in 85,872 YouTube Comments Over 12 Years: Big Data Infodemiology Study. J Med Internet Res 2023; 25:e49220. [PMID: 37695666 PMCID: PMC10520765 DOI: 10.2196/49220] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/20/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women, resulting in substantial burden related to metabolic, reproductive, and psychological complications. While attempts have been made to understand the themes and sentiments of the public regarding PCOS at the local and regional levels, no study has explored worldwide views, mainly due to financial and logistical limitations. YouTube is one of the largest sources of health-related information, where many visitors share their views as questions or comments. These can be used as a surrogate to understand the public's perceptions. OBJECTIVE We analyzed the comments of all videos related to PCOS published on YouTube from May 2011 to April 2023 and identified trends over time in the comments, their context, associated themes, gender-based differences, and underlying sentiments. METHODS After extracting all the comments using the YouTube application programming interface, we contextually studied the keywords and analyzed gender differences using the Benjamini-Hochberg procedure. We applied a multidimensional approach to analyzing the content via association mining using Mozdeh. We performed network analysis to study associated themes using the Fruchterman-Reingold algorithm and then manually screened the comments for content analysis. The sentiments associated with YouTube comments were analyzed using SentiStrength. RESULTS A total of 85,872 comments from 940 PCOS videos on YouTube were extracted. We identified a specific gender for 13,106 comments. Of these, 1506 were matched to male users (11.5%), and 11,601 comments to female users (88.5%). Keywords including diagnosing PCOS, symptoms of PCOS, pills for PCOS (medication), and pregnancy were significantly associated with female users. Keywords such as herbal treatment, natural treatment, curing PCOS, and online searches were significantly associated with male users. The key themes associated with female users were symptoms of PCOS, positive personal experiences (themes such as helpful and love), negative personal experiences (fatigue and pain), motherhood (infertility and trying to conceive), self-diagnosis, and use of professional terminology detailing their journey. The key themes associated with male users were misinformation regarding the "cure" for PCOS, using natural and herbal remedies to cure PCOS, fake testimonies from spammers selling their courses and consultations, finding treatment for PCOS, and sharing perspectives of female family members. The overall average positive sentiment was 1.6651 (95% CI 1.6593-1.6709), and the average negative sentiment was 1.4742 (95% CI 1.4683-1.4802) with a net positive difference of 0.1909. CONCLUSIONS There may be a disparity in views on PCOS between women and men, with the latter associated with non-evidence-based approaches and misinformation. The improving sentiment noticed with YouTube comments may reflect better health care services. Prioritizing and promoting evidence-based care and disseminating pragmatic online coverage is warranted to improve public sentiment and limit misinformation spread.
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Affiliation(s)
- Kashish Malhotra
- Department of Surgery, Dayanand Medical College and Hospital, Ludhiana, India
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Punith Kempegowda
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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Ghazeeri G, Ibrahim N, Khalifeh F, Beyrouthy C, El-Taha L, Bizri M. Character strengths of women with polycystic ovary syndrome in a single center. PLoS One 2022; 17:e0266398. [PMID: 35363827 PMCID: PMC8975165 DOI: 10.1371/journal.pone.0266398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/18/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the difference in character strengths (CSs) between patients with and without polycystic ovary syndrome (PCOS) and the association between biological (i.e., testosterone levels) and psychological factors (i.e., character strengths). Patients and methods A total of 99 women divided into PCOS (49) and non-PCOS (50) groups who presented to the gynecological clinics at the women’s center in the American University of Beirut Medical Center in 2017 were included. Women were assessed for testosterone bioavailable levels and completed a questionnaire that included Hospital Anxiety and Depression Scale and Values in Action Survey-72. Univariate and multivariable analyses were performed to examine the association of CSs between the two groups and its predictors. Results The scores of hope, judgement, perspective, and transcendence of the PCOS group were significantly higher in comparison with healthy participants. An increase in free androgen index was negatively correlated to the score of judgement only. Conclusion Women with PCOS have their own profile of character strengths and virtues that constitute judgement, hope, perspective, and transcendence. This in turn can be utilized to reinforce those personality strengths and thus decrease the psychological distress and mood disorders accompanied with this disease.
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Affiliation(s)
- Ghina Ghazeeri
- Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nour Ibrahim
- Department of Psychiatry, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fatin Khalifeh
- Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christine Beyrouthy
- Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Lina El-Taha
- Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Bizri
- Department of Psychiatry, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- * E-mail:
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Lee ITL, Sansone S, Irfan M, Copp T, Beidas R, Dokras A. Implementation of International Guidelines for Polycystic Ovary Syndrome: Barriers and Facilitators Among Gynecologists and Primary Care Providers. F S Rep 2022; 3:94-101. [PMID: 35789712 PMCID: PMC9250120 DOI: 10.1016/j.xfre.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/16/2021] [Accepted: 01/19/2022] [Indexed: 11/19/2022] Open
Abstract
Objective To identify barriers and facilitators to the implementation of evidence-based guidelines among gynecologists and primary care physicians (PCPs) caring for women with polycystic ovary syndrome (PCOS). Design Qualitative semi-structured interview study. Setting Academic medical center. Patients None. Interventions None. Main Outcome Measures Barriers and facilitators in the diagnosis and management of PCOS. Results We interviewed 10 gynecologists and 8 PCPs to reach thematic saturation using a thematic analysis approach. Four themes were identified: diagnostic considerations, treatment of symptoms of PCOS, screening for long-term complications of PCOS, and counseling on long-term complications. Many gynecologists did not perform the recommended metabolic screening and were uncomfortable managing metabolic complications of PCOS. They uniformly counseled patients on the risk of endometrial hyperplasia and infertility. PCPs expressed the lack of familiarity with diagnostic criteria and often did not complete a comprehensive workup before making a diagnosis of PCOS. However, they routinely counseled patients on cardiometabolic risk and were familiar with managing the related long-term complications. Common barriers to comprehensive care delivery included the lack of knowledge and inadequate time and resources. Important facilitators included the overlap between the management of PCOS and other conditions such as obesity and abnormal uterine bleeding. Conclusions Our study highlights the need for interventions that target the barriers identified among gynecologists and PCPs in implementing guidelines for diagnosing and managing PCOS. In conjunction with prior studies, our findings support a multidisciplinary care model for women with PCOS. Future studies should focus on implementation strategies to facilitate evidence-based care.
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Affiliation(s)
- Iris Tien-Lynn Lee
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
- Reprint requests: Iris Tien-Lynn Lee, M.D., Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, 3701 Market Street, Suite 800, Philadelphia, Pennsylvania 19104.
| | - Stephanie Sansone
- Department of Urology, Weill Cornell Medicine, New York City, New York
| | - Maryam Irfan
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Tessa Copp
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Rinad Beidas
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Medical Ethics & Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Penn Implementation Science Center (PISCE@LDI), Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania
- Penn Medicine Nudge Unit, University of Pennsylvania Health System, Philadelphia, Pennsylvania
- Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Medicine, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Tan H, Gao L, Guo Y, Liu Y, Ding R, Yan X, Wang X, Wang Y, Wang L. Development and evaluation of a psychological adjustment communication system for adolescents with polycystic ovary syndrome at a high risk of depression: A mixed-method study protocol. Front Psychiatry 2022; 13:937280. [PMID: 36458120 PMCID: PMC9705960 DOI: 10.3389/fpsyt.2022.937280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Depression is a serious psychological disorder that causes substantial psychological and physical suffering in adolescents, contributes to over 50% of suicide attempts, and affects the health status and psychosocial functioning of 25% of the adult population. The prevalence of polycystic ovary syndrome (PCOS) in adolescents is 5.6∼11.04%, and the prevalence of depression in adolescents with PCOS is as high as 50-60%. Depression seriously affects the rehabilitation and quality of life of adolescents with PCOS. In this study, we present a protocol for a mixed-method study to develop and evaluate the effectiveness of a psychological adjustment communication system for reducing the prevalence of depression among adolescents with PCOS who are at a high risk of depression in China. This study utilizes social support theory to develop a mobile phone-based intervention for adolescents with PCOS at a high risk of depression. METHODS This sequential exploratory mixed-method study consists of four consecutive phases. In the first phase, we will review the literature to understand the disease experience and needs of adolescents with PCOS to construct an initial psychological adjustment communication system. In the second phase, researchers will interview patients and their parents using purposeful sampling methods and semi-structured interviews to appropriately modify the psychological adjustment communication system. In the third phase, the Delphi method will be used to improve the psychological adjustment communication system. The fourth phase will employ a quantitative approach using a before-and-after design to measure the effectiveness of the system. DISCUSSION The results of this study will indicate the effectiveness of the psychological adjustment communication system in adolescents with PCOS who are at a high risk of depression. REGISTRATION NUMBER ChiCTR2100050123.
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Affiliation(s)
- Huiwen Tan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Li Gao
- Department of Reproductive Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yunmei Guo
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Ying Liu
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Rui Ding
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Xin Yan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Xueting Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Yousha Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Lianhong Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
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Wilson NA, Peña AS. Quality of life in adolescent girls with polycystic ovary syndrome. J Paediatr Child Health 2020; 56:1351-1357. [PMID: 32810373 DOI: 10.1111/jpc.15097] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/24/2020] [Accepted: 07/06/2020] [Indexed: 12/20/2022]
Abstract
Quality of life (QoL) is an important aspect of health and well-being. QoL is reduced in women with polycystic ovary syndrome (PCOS), but there is limited data in adolescents. This review aimed to assess studies regarding the QoL of adolescent girls with PCOS. Five databases were searched for relevant studies. Studies were included if they were conducted in adolescent girls with PCOS, aged 12-22 years old, and used a questionnaire to measure QoL. The search identified a total of 254 studies, and after exclusions, 11 relevant studies were included in the review. Most studies had a relatively small sample size, but overall included a total of 512 adolescents with PCOS. In most cases, adolescent girls with PCOS have reduced QoL when compared to healthy girls, and PCOS symptoms/excess weight impact on their QoL. Further research is required due to limited data on QoL in adolescents with PCOS of normal weight.
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Affiliation(s)
- Nina A Wilson
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Alexia S Peña
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, Australia
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