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

The impact of irritable bowel syndrome on health-related quality of life in women with polycystic ovary syndrome

Background: The objectives of this study were to compare the prevalence and quality of life (QOL) of irritable bowel syndrome (IBS) in women with polycystic ovary syndrome (PCOS) compared with healthy women. Methods: This was a case-control study of 201 women recruited at an infertility clinic in Iran. The control group were healthy women (n = 100) and the comparison group, women with PCOS (n = 101). Data were collected by clinical Rome III criteria to determine the IBS, Bristol scale for stool consistency and IBS QOL. Results: The reporting of IBS symptoms were higher in PCOS (20.7%) than control group (11%) (P = 0.05). The IBS QOL score in the IBS + PCOS group was lower than other groups (IBS+ non PCOS, non IBS + PCOS, non IBS+ non PCOS; scores in food avoidance and worries about health domains were significant (P < 0.01). Conclusions: We conclude that having PCOS and an increased level of LH/FSH tends to cause IBS symptoms. IBS + PCOS women experience significant impaired quality of life scores particularly in relation to worries about health and food avoidance. These results offer further insights into IBS in PCOS women and their functional status and wellbeing

Comparing pregnancy, childbirth, and neonatal outcomes in women with different phenotypes of polycystic ovary syndrome and healthy women: a prospective cohort study

The aim of this study was to compare pregnancy, childbirth, and neonatal outcomes in women with different phenotypes of polycystic ovary syndrome (PCOS) with healthy women. A prospective cohort study from the beginning to the end of pregnancy for 41 pregnant women with PCOS (case) and 49 healthy pregnant women (control) was completed. Based on the presence or absence of menstrual dysfunction (M), hyperandrogenism (HA), and polycystic ovaries (PCO) on ultrasound, the PCOS (case) group were divided into three phenotypes (HA + PCO (  = 22), M + PCO (  = 9), HA + M+PCO (  = 10). Pre-eclampsia, gestational diabetes, and lower birth weight among newborns were significantly higher in the PCOS case group compared to the control group especially in the phenotype HA + M+PCO (  < .05). High BMI (  = 2.40; =.03) was the strongest predictor of pre-eclampsia in patients with PCOS. High androgen levels (free androgen index) (  = 13.71, 3.02;  < .05), was the strongest predictor of developing diabetes during pregnancy and reduced birth weight baby, respectively.These results suggest that PCOS, particularly in phenotype HA + M+PCO (  < .05), is a risk factor for adverse pregnancy and neonatal outcomes including gestational diabetes, pre-eclampsia, and reduced weight babies

Psychometrics properties of the Iranian version of fertility quality of life tool: a cross- sectional study

Background: Clinical measurement of quality of life for assessing reproductive problems should be considered as a standard investigation at the initial and continuing medical consultations with infertile people. Objective: The purpose of this study was comprehensive testing the psychometric properties of the Iranian version of fertility quality of life (FertiQol) as its use could be considerable due to the prevalence of infertility in Iran and the importance of evaluation of QoL in patients with infertility. Method and material: This was a psychometric properties study of 300 women referred to infertility clinic, Hormozgan, Iran. After linguistic validation of the Iranian version of MPCOSQ, a semi-structured interview was conducted to assess face validity. Consequently exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to indicate the scale constructs. Discriminant validity was assessed using the known groups comparison. Convergent validity was evaluated by assessing the correlation between similar content on the 12-Item Short Form Health Survey, Hospital Anxiety and Depression Scale and FertiQol. In addition, reliability analysis was carried out with internal consistency. Results: The reliability of the Iranian version of the FertiQol questionnaire was satisfactory in all dimensions (Cronbach’s alpha ranging from 0.77 to 0.83 ). Six factors (emotional, mind/body, relational, social, environmental and tolerability) were extracted from the results of EFA with factor loading of the more than 0.3. Discrimination validity showed that FertiQol can differentiate between female patients with differing duration of infertility and number of children; this indicates favorable discrimination validity. Moreover, the results of convergent validity showed a favorable correlation between the related dimensions of 12-Item Short Form Health Survey (correlation ranging from 0.43 to 0.68 ), Hospital Anxiety and Depression Scale(correlation ranging from 0.47 to 0.52 ) and FertiQol. Conclusion: The Iranian version of FertiQol is valid and reliable for assessing infertility problems and the effects of treatment on quality of life of infertile patients referred for diagnosis and treatment at an Iranian infertility clinic. The clinical use of this measure is recommended for Iranian infertility clinics

Health-related quality of life in Iranian women with polycystic ovary syndrome: a qualitative study

Background Polycystic ovary syndrome (PCOS) is associated with a range of challenging symptoms which impact patient’s lives. Iranian women with PCOS are likely to face a number of unique difficulties given particular societal and cultural norms for women. Understanding health-related quality of life (HRQoL) from a patients’perspective is critical to developing the appropriate support interventions. The present study aimed to generate an in-depthunderstanding of HRQoL Iranian women with PCOS. Methods Twenty Iranian women were interviewed and data was subjected to thematic analysis. Results Women reported substantial effects of PCOS on their quality of life, Themes generated from the data related to sexual - physical problems (An unsexualised self: loss, change and pain; and Being pained and painful); exposure and nvasion: the rejecting and invading social world (Concealing and Avoiding and Public property: public scrutiny), diminished self and diminished life (Infertile as inferior and Exhausted mind andbody) respectively. Conclusion PCOS is a physical - sexual, psychological and social syndrome; therefore, it is necessary to taking a more holistic approach to patient care beyond treating physical symptoms

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

Background: Adherence issues in polycystic ovary syndrome (PCOS) patients have not been examined thoroughly. Patients report prolonged periods of treatment and side effects of the 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. Materials 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 21-34 yr. 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, and health care provider-related factors; while 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