Facilitating and inhibiting factors related to treatment adherence in women with polycystic ovary syndrome: a qualitative study

Background: Adherence issues in PCOS patients have not been examined thoroughly. Patients report prolonged periods of treatment and side effects of drug as the most common reason for withdrawal from treatment. To improve the effective management of PCOS patients, it is fundamental to understand facilitating and inhibiting factors to treatment adherence. Objective: to explore facilitating /inhibiting factors related to treatment adherence among PCOS patients. Material and Methods: This was a qualitative study with a purposive sample of women with confirmed diagnosis of PCOS. The data were collected via 20 in-depth semi-structured interviews with women aged between 21 to 34. A qualitative content analysis was used to analyze the data. Results: Five themes were identified which described different types of facilitating /inhibiting factors to treatment adherence. Inhibiting factors included financial issues, patient-related, disease-related, health care provider-related factors; social factors were found to be both facilitating and inhibiting. Conclusion: The findings suggest that successful adherence to PCOS treatment is highly dependent on patients recognizing and adapting to financial, social, and health care related inhibiting factors. It is also crucial for clinicians and policy makers to recognize these key inhibiting factors in order to improve treatment outcomes Keywords: polycystic ovarian syndrome, adherence, qualitative researc

From transformative learning to social change? Using action research to explore and improve informal complaints management in an NHS trust

Background: The number of complaints concerning aspects of care from patients and/or carers have increased over time. Yet, in spite of a growing body of national and international literature on health care complaints there is a lack of knowledge around how nurses and midwives manage informal complaints at ward level, or staff needs in relation to this. Aim: Using an Action research (AR) approach with mixed methods, four phases and four cycles, the aim was to explore informal complaints management by nurses and midwives at ward level. We discuss the AR process primarily in connection with learning and service change, drawing from the qualitative data in this paper. Findings: The analysis of the collected qualitative data resulted in three main themes related to the complexities of complaints and complaints management, staff support needs and the existing ambiguous complaints systems which are hard for both staff and servicer users to negotiate. The AR approach facilitated learning and change in participants in relation to views on complaints management, and the main issues around complaints management in the collaborating trust. Conclusions: The extant body of research on complaints does not sufficiently recognise the complexity of complaints and informal complaints management or the complaints systems in place. Needs based staff training can help support staff to manage informal complaints more effectively