Unmet clinical needs in women with polycystic ovary syndrome in regard to mental health: a cross-sectional study.

PURPOSE Polycystic ovary syndrome (PCOS) management has hardly been standardized until recent years. Despite the existence of a detailed, evidence-based guideline published by the European Society of Human Reproduction and Embryology (ESHRE), it remains unclear to what extent healthcare providers adhere to this guideline. Our aim is to evaluate the gynaecological medical care provided in women with PCOS, particularly in terms of mental health, from the patients' perspective. METHODS For this cross-sectional online cohort study in women with PCOS, we designed a standardized, non-validated questionnaire covering aesthetic aspects, metabolism, menstrual cycle, reproduction, mental health, and prevention of chronic non-communicable diseases. RESULTS Among 1879 participants, various mental health aspects were reported: body image (n = 1879), eating patterns/habits (n = 1878), and emotional well-being (n = 1874). Although nearly all women (99.7%) reported complaints on at least one session of mental health, consultation rates were low (body image 9.7%, eating patterns/habits 16.6%, emotional well-being 4.4%). Mean satisfaction with counselling on the different domains varied from moderate to fairly satisfying, with scores of 56.0 points (SD 31.7), 53.5 points (SD 32.0), and 63.7 points (SD 30.2), respectively. More complaints were associated with lower satisfaction. The overall satisfaction with the management provided by the healthcare practitioner (HCP) was low, averaging 36.5 points (SD 29.7). Consequently, most women wished for more counselling (58.9%). CONCLUSION Women affected by PCOS are not properly managed according to ESHRE guideline in regard to mental health issues. Overall consultation rates and corresponding satisfaction with management were poor, highlighting the need for significant improvements in healthcare provision

Unmet Clinical Needs in Women with Aesthetic Manifestations of Polycystic Ovary Syndrome: A Cross-Sectional Study.

Background: Polycystic ovary syndrome (PCOS) management has hardly been standardized until recent years. There is an accurate, evidence-based guideline published by the European Society of Human Reproduction and Embryology (ESHRE). However, it remains unclear to which extent, if at all, the guideline is followed by health care providers. The aim was to explore the subjectively perceived quality of gynecological medical care in women with PCOS suffering from aesthetic complaints. Materials and Methods: A nonvalidated questionnaire was constructed in a standardized manner covering the domains: aesthetic aspects, metabolism, menstrual cycle, reproduction, mental health, and prevention of chronic noncommunicable diseases. Results: A total of 1960 participants with aesthetic complaints, such as acne (66.2%), alopecia (43.9%), hirsutism (77.9%), or overweight/obesity (72.3%) were included. The percentage of women being counseled was low (acne 20.3%, alopecia 12.9%, hirsutism 17.5%, overweight/obesity 36.2%). Satisfaction with counseling was moderate (40.4-44.1 points). Many women tried at least one therapeutic method (75.9%), whereas only a few were counseled for therapy (acne 27.0%, alopecia 24.6%, hirsutism 24.0%, overweight/obesity 18.8%) with moderate satisfaction for hyperandrogenism (mean 55.1-59.5 points) and good satisfaction for overweight/obesity (mean 60.8 points). Overall satisfaction was rated with a mean of 30.5 points (standard deviation 27.1) on a scale from 0 to 100 and thus considered "not satisfied." Fewer complaints were significantly correlated with higher satisfaction. Most women wished for more counseling (80.8%), as well as more diagnostic (63.2%) and therapeutic options (70.2%). Conclusions: Women affected by PCOS are not properly managed according to the ESHRE guideline. Indeed, this guideline recommends comprehensive history and physical examination for clinical hyperandrogenism as well as holistic approaches in therapy, including education and counseling of patients. Still, overall consultation rates and satisfaction were poor

You learn, we teach? : questioning relations between education and health from the perspective of vulnerability

Neste artigo, a exploração dos sentidos associados à frase-síntese de uma campanha promovida no Dia Mundial Sem Tabaco instiga a discussão das principais ênfases constitutivas do campo da educação em saúde, no Brasil. Retoma-se o conceito de vulnerabilidade para situar/explorar suas interseções com o educativo para, então, apontar a produtividade teóricoprática e política da articulação entre educação em saúde e estudos de vulnerabilidade. Conclui-se que a necessária renovação das práticas de saúde em geral e, particularmente, das práticas de educação em saúde, pode beneficiar-se grandemente do referencial da vulnerabilidade, na medida em que ele delineia um novo horizonte para situar e articular riscos, “causalidades” e “determinações”, trazendo a saúde – assim como a possibilidade de adoecer – para o campo da vida real, para o mundo dos sujeitos em relação, no qual esses processos ganham sentidos singulares.This article explores the meanings associated with the motto used in a World No-Tobacco Day campaign to stimulate a discussion of the principal underlying messages in the field of health education in Brazil. The study focuses on the concept of vulnerability to contextualize and explore its interfaces with education in order to highlight the theoretical, practical, and political productivity of the link between health education and studies on vulnerability. In conclusion, the necessary renewal of health practices in general and health education practices in particular can benefit tremendously from the vulnerability reference, to the extent that it demarcates a new horizon for situating and linking risks, “causalities”, and “determinations”, drawing health – as well as the possibility of illness – into the field of real life, into the world of inter-subjective relations, where these processes gain unique meanings

"Você aprende. A gente ensina?": interrogando relações entre educação e saúde desde a perspectiva da vulnerabilidade "You learn, we teach"?: questioning relations between education and health from the perspective of vulnerability

Neste artigo, a exploração dos sentidos associados à frase-síntese de uma campanha promovida no Dia Mundial Sem Tabaco instiga a discussão das principais ênfases constitutivas do campo da educação em saúde, no Brasil. Retoma-se o conceito de vulnerabilidade para situar/explorar suas interseções com o educativo para, então, apontar a produtividade teórico-prática e política da articulação entre educação em saúde e estudos de vulnerabilidade. Conclui-se que a necessária renovação das práticas de saúde em geral e, particularmente, das práticas de educação em saúde, pode beneficiar-se grandemente do referencial da vulnerabilidade, na medida em que ele delineia um novo horizonte para situar e articular riscos, "causalidades" e "determinações", trazendo a saúde ­ assim como a possibilidade de adoecer ­ para o campo da vida real, para o mundo dos sujeitos em relação, no qual esses processos ganham sentidos singulares.<br>This article explores the meanings associated with the motto used in a World No-Tobacco Day campaign to stimulate a discussion of the principal underlying messages in the field of health education in Brazil. The study focuses on the concept of vulnerability to contextualize and explore its interfaces with education in order to highlight the theoretical, practical, and political productivity of the link between health education and studies on vulnerability. In conclusion, the necessary renewal of health practices in general and health education practices in particular can benefit tremendously from the vulnerability reference, to the extent that it demarcates a new horizon for situating and linking risks, "causalities", and "determinations", drawing health ­ as well as the possibility of illness ­ into the field of real life, into the world of inter-subjective relations, where these processes gain unique meanings