Heterogeneity and associated factors of patients with polycystic ovary syndrome health behaviors: a latent class analysis.

OBJECTIVE: Using latent class to analyze whether there are subtypes of health behaviors in patients with PCOS can be addressed using targeted interventions. METHODS: October 2021 to June 2022, 471 PCOS patients were surveyed using the Health Promoting Lifestyle Profile Questionnaire. Latent class analysis (LCA) was used to identify subgroups of PCOS patients. Subsequent multinomial latent variable regressions identified factors that were associated with health behaviors. RESULTS: A three-class subtypes was the optimum grouping classification: (1)High healthy behavior risk; (2)high healthy responsibility and physical activity risk; (3)low healthy behavior risk. The multinomial logistic regression analysis revealed that (1)Single (OR = 2.061,95% CI = 1.207-3.659), Education level is primary school or below (OR = 4.997,95%CI = 1.732-14.416), participants is student (OR = 0.362,95%=0.138-0.948), participants with pregnancy needs (OR = 1.869,95%=1.009-3.463) were significantly more likely to be in the high healthy behavior risk subtypes; (2)The older the age (OR = 0.953,95%=0.867-1.047) and the larger the WC (OR = 0.954,95%=0.916-0.993), participants is married (OR = 1.126,95%=0.725-1.961), participants is employed ( OR = 1.418,95%=0.667-3.012) were significantly more likely to be in the high health responsibility and physical activity risk subtypes. CONCLUSION: Patients with PCOS are a heterogeneous population with potential subtypes that may be suitable for customized multi-level care and targeted interventions.

A structural equation model linking health literacy, self-efficacy, and quality of life in patients with polycystic ovary syndrome.

BACKGROUND: Health literacy is a crucial factor that affects health outcomes. Understanding the current status of health literacy among patients with polycystic ovary syndrome (PCOS) is the basis for helping patients better manage risk factors and improve their health outcomes. This study aimed to explore the status of and factors influencing health literacy in patients with PCOS, and to validate the pathway between health literacy, quality of life, and self-efficacy for these patients. METHODS: A cross-sectional study was conducted using a convenience sample of 300 patients with PCOS in the gynecology outpatient clinic of a tertiary hospital in Zunyi from March to September 2022. Data on health literacy, demographic features, quality of life, and self-efficacy were collected. Multiple stepwise linear regression was conducted to assess the risk factors associated with health literacy for the study participants. A structural equation model was used to construct and validate the pathways. RESULTS: Most participants exhibited low health literacy (3.61 ± 0.72), and only 25.70% had adequate health literacy. Multiple regression analysis revealed that the main factors associated with health literacy among participants included Body Mass Index (BMI) (B = -0.95, p < 0.01), education (B = 3.44, p < 0.01), duration of PCOS (B = 4.66, p < 0.01), quality of life (B = 0.25, p < 0.01), and self-efficacy (B = 0.76, p < 0.01). Multiple fit values indicated that the model fit the data effectively. The direct effect of health literacy on self-efficacy and quality of life was 0.06 and 0.32, respectively. The indirect effect of health literacy on quality of life was -0.053, and the total effect of health literacy on quality of life was 0.265. CONCLUSIONS: Health literacy was low among patients with PCOS. Healthcare providers should pay more attention to health literacy and to developing the corresponding intervention strategies urgently needed to improve the quality of life and health behavior of patients with PCOS.

Effects of mind mapping based on standardized patient program in patient education among postgraduate nursing students in clinical setting.

BACKGROUND: Patient education as an important process of postgraduate nursing education, however in previous studies there was limited study focus on the improvement of nursing students' patient education in clinical practice.This study examined the effects of a mind mapping based on standardized patient program in the patient education knowledge and communication competence of postgraduate nursing students in clinical setting. METHODS: The present quasi-experimental study was performed in 2022 on 74 postgraduate nursing students who had taken clinical practice courses at affiliated hospital of Zunyi Medical University. Students were underwent two weeks of mind mapping based on standardized patient program. The outcome measures were patient education knowledge and communication competence evaluated were by the self-designed questionnaire consisting of 6 questions based on the Likert scale and nurse-patient communication competency rating scale respectively, self-efficacy was evaluated by the general self-efficacy scale, and patients' satisfaction were measured using a self-designed question. Data collection was conducted before and after intervention. Data analysis was performed using SPSS 19.0 software, and descriptive statistics and inferential statistics were performed. RESULTS: Significant improvements in patient education knowledge, patient education communication competence, and self-efficacy (all P = 0.000)were observed after intervention. Improvements were also seen in measures of patients' satisfaction; 12/74 (16.22%) patients reported satisfied at baseline but only 53/74 (71.62%) at the end of intervention. CONCLUSIONS: A web-based mind maps integrated with standardized patient program could improve patient education knowledge, communication competence,and self-efficacy of postgraduate nursing students in clinical setting.

Status and influencing factors of undergraduate midwifery students' core competencies: A cross sectional study.

INTRODUCTION: Midwifery undergraduate students' core competencies directly affect the quality of midwifery services and overall quality of midwifery teams. However, limited research has explored the core competencies of undergraduate midwifery students in China. OBJECTIVES: This study aimed to describe the level of core competencies among undergraduate midwifery students in China and investigated possible associated factors. DESIGN: This was a cross-sectional descriptive study. SETTINGS AND PARTICIPANTS: The study population comprised third- and fourth-year undergraduate midwifery students at Zunyi Medical University in Guizhou Province in southwest China (n = 207, response rate 94.1 %). METHODS: Data were collected using an online survey that included a general information questionnaire, a general self-efficacy scale, and a core competencies self-assessment questionnaire for midwifery undergraduates. Data were statistically analyzed using SPSS 18.0. Pearson's correlation analysis was used to explore the relationship between self-efficacy and the core competencies. Stepwise multiple linear regression was used to explore influencing factors. RESULTS: The total score for the core competencies among midwifery undergraduates was 118.46 (8.97). The highest mean score was for professional attitude, 4.21 (0.43), and the lowest was for professional skills, 3.70 (0.30). We found a positive association between self-efficacy and core competencies (r = 0.251, P < 0.01). Grade (ß = 0.261, P < 0.01), scholarship (ß = -0.231, P < 0.01), work intention (ß = -0.135, P < 0.05), and self-efficacy (ß = 0.207, P < 0.01) significantly influenced undergraduate midwifery students' core competencies (R2 = 0.189, adjusted R2 = 0.173, F = 11.775, P < 0.001). CONCLUSIONS: Undergraduate midwifery students showed moderate core competencies, indicating room for improvement. Fourth-grade midwifery students had higher core competencies than third-grade students. Additionally, scholarship, work intention, and self-efficacy were significant influencing factors. Midwifery educators should examine students' core competencies and explore targeted interventions, particularly for those with low self-efficacy and core competencies.

The effect of anxiety and depression on the health-related quality of life of severe acute pancreatitis survivors: structural equation modeling approach.

Background: Understanding the relationship between anxiety, depression and health-related quality of life (HRQOL) provides important clues to alleviate anxiety, depression and improve HRQOL in patients after severe acute pancreatitis (SAP). The aim of this study was to examine the effects of anxiety and depression on HRQOL in post-SAP patients using structural equation modeling. Methods: A cross-sectional study design was used and 134 patients with SAP from the Affiliated Hospital of Zunyi Medical University were recruited. Data collected included demographic and clinical characteristics, the English Standard Short Form 36 (SF-36) Health Survey, The Self-rating Anxiety Scale (SAS) and The Self-rating Depression Scale (SDS). Structural equation modeling analysis was conducted using the AMOS 24.0 program. Results: The mean of HRQOL score was 49.42 (SD = 23.01). The prevalence of anxiety and depression in post-SAP patients was 33.6 and 34.3%, respectively. Both anxiety and depression have a direct negative impact on HRQOL (ß = -0.360, p < 0.001; ß = -0.202, p = 0.034). Anxiety also negatively affects HRQOL indirectly through depression (ß = -0.118, p = 0.043). The analysis of the covariance structure revealed that the resulting model had a reasonable goodness of fit. Conclusion: Anxiety and depression reduce the quality of life of SAP patients during recovery. Regular assessment and management of the anxiety and depression status of SAP patients is necessary and will help them improve their HRQOL more effectively.

Assessment of health literacy in patients with polycystic ovary syndrome and its relationship with health behaviours: a cross-sectional study.

OBJECTIVE: Healthy behaviours are important for people with polycystic ovary syndrome (PCOS). However, adopting and maintaining lifestyle changes involves a complex set of behavioural changes, which most patients fail to adhere to. The current research on health literacy, which includes individual and social skills needed in health self-management, in patients with PCOS is limited. Therefore, this study aimed to explore health literacy, health behaviours and the relationship between the two to expand research on PCOS management. DESIGN: Cross-sectional study. SETTING: A gynaecological outpatient clinic. PARTICIPANTS: A total of 286 patients with PCOS (≥18 years, diagnosed via Rotterdam criteria, able to self-report and give informed consent) were recruited from March to June 2022. OUTCOME MEASURES: Health literacy and health behaviours in patients with PCOS were assessed using the Health Literacy Management Scale and the Health Promoting Lifestyle Profile (Chinese version). Multiple logistic regression was used to analyse the factors influencing health literacy, and linear regression to assess the relationship between health literacy and health behaviours, with an F-significance test; p<0.05 was considered statistically significant. RESULTS: Overall, most patients with PCOS had insufficient health literacy (55.9%). The influencing factors of health literacy in patients with PCOS were age (ß=0.154, p<0.05), Body Mass Index (ß=-0.140, p<0.05), income (ß=1.228, p<0.05), duration of illness (ß=0.110, p<0.05) and educational level (ß=1.552, p<0.05). Moreover, 40.6% of patients with poor health behaviours, and 31.8% with moderate health behaviours, needed to improve their health behaviours. Health literacy was positively correlated with health behaviours in patients with PCOS (r=0.473, p<0.05). CONCLUSION: The positive correlation between health literacy and health behaviour in patients with PCOS indicates that promoting health literacy in future treatment and management of PCOS may be beneficial.

Development and validation of a prediction model for depression in adolescents with polycystic ovary syndrome: A study protocol.

Introduction: The high prevalence and severity of depression in adolescents with polycystic ovary syndrome (PCOS) is a critical health threat that must be taken seriously. The identification of high-risk groups for depression in adolescents with PCOS is essential to preventing its development and improving its prognosis. At present, the routine screening of depression in adolescents with PCOS is mainly performed using scales, and there is no early identification method for high-risk groups of PCOS depression in adolescents. It is necessary to use a warning model to identify high-risk groups for depression with PCOS in adolescents. Methods and analysis: Model development and validation will be conducted using a retrospective study. The study will involve normal adolescent girls as the control group and adolescent PCOS patients as the experimental group. We will collect not only general factors such as individual susceptibility factors, biological factors, and psychosocial environmental factors of depression in adolescence, but will also examine the pathological factors, illness perception factors, diagnosis and treatment factors, and symptom-related factors of PCOS, as well as the outcome of depression. LASSO will be used to fit a multivariate warning model of depression risk. Data collected between January 2022 and August 2022 will be used to develop and validate the model internally, and data collected between September 2022 and December 2022 will be used for external validation. We will use the C-statistic to measure the model's discrimination, the calibration plot to measure the model's risk prediction ability for depression, and the nomogram to visualize the model. Discussion: The ability to calculate the absolute risk of depression outcomes in adolescents with PCOS would enable early and accurate predictions of depression risk among adolescents with PCOS, and provide the basis for the formulation of depression prevention and control strategies, which have important theoretical and practical implications. Trial registration number: [ChiCTR2100050123]; Pre-results.

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.

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.