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ISSN 2394-7330International Journal of Novel Research in Healthcare and NursingVol. 6, Issue 3, pp: (1249-1258), Month: September - December 2019, Available at: www.noveltyjournals.comPOLYCYSTIC OVARIAN SYNDROMEKNOWLEDGE AND AWARENESS OF NONMEDICAL UNDERGRADUATE STUDENTSMaha Ramadan Ali*, Om Hashim M mahmoud ***Lecturer of MaternityObstetrics, &Gynecological Nursing, Faculty ofNursing,PortsaidUniversityEgypt**Lecturer of woman’s Health& Midwifery Nursing, Nursing Faculty .Mansoura University, Egypt.*Corresponding authorAbstract: Polycystic ovary syndrome (PCOS) is areproductive age endocrine problems in females. The PCOSprevalence is increasing widely rapid but the women haven’t sufficient knowledge.Aim: to determine polycysticovary syndrome knowledge &awareness of female non medical undergraduate students by using a descriptivedesign the study conducted at non medical faculties in portsaid city on a total of 1000 girl. Data collection by,structured interviewed questionnaire Results findings indicated that The level of awareness of PCOS among nonmedical famle students was 3.7% which was agood knowledge, on the other hand ,52.4% of females do not haveprior knowledge about PCOS .44.9%, 40.2%, 11.4%, and 2% have known about PCOS via internet, family&friends, medical team, and general information respectively anf finally 1.5% via the past history,there werehighly statisatically significant correlation bettween total PCOS Knowledge and age ,faculty ,shool years,andfamily history p value less than .001 .Conclusion:The current study indicated that, level of knowledge andawearness of PCOS of non medical famle students was poor Recommendation: Polycystic ovary syndrome is vitalhealth concern its assessment is needed to be a part of care monitoring and improvement courses .Keywords: knowledge &awareness , Polycystic ovarian syndrome.I. INTRODUCTIONPolycystic ovary syndrome (PCOS) is a prevalent, chronic endocrine disorders with reproductive, metabolic andpsychological character. It is afemale sex hormones imbalance. The polycystic ovary syndrome name is misrelated as thechief disorder isn’t ovaries, the main cause is increased levels effect of hormones on the ovaries that trigger symptoms.More specific, involve higher levels of the male hormones, androgens which involve testosterone and the insulinhormone (Sunanda & Nayak . 2016).Polycystic ovary syndrome is more prevelant, occurring in up to 1 in 5 reproductive age females . Up to 25% ofreproductive-aged female are affected in India . Although there is no treatment for PCOS, the signs can be managed. Thismay caause menstrual cycle changes , ovarian cyst, failure to conceive and other health disease. It is a common healthdisease among adolescents and young female . PCOS affects about 10 million female world wide. It always comes postmenarche in adolescent girls or young female with oligomenorrhea, infertility, and often obesity (Borruel et al.,2013).Page 1249Novelty Journals
ISSN 2394-7330International Journal of Novel Research in Healthcare and NursingVol. 6, Issue 3, pp: (1249-1258), Month: September - December 2019, Available at: www.noveltyjournals.comModern technology ascertainment affects in daily life and changed our lifestyle morely . Food intake of sugar, fast food,and soft drinks and lack of exercise cause PCOS . PCOS may be due to high insulin production level. PCOS seems tooccur in families, too, so if it is aheredity disorder (Boyle &Teede .,2012).Clinical manifestations of POS are oligomenorrhea, amenorrhea, infertility or intial trimester miscarriage, obesity,hirsutism, acne, acanthosisnigricans, male alopecia . It is a heterogeneous disease, ultrasound and combinations of signsto do diagnosis and treatment is depend on signs (Lujan, Chizen, & Pierson, 2008).PCOS diverse manifestations occur in an early age . It is vital to do an early diagnosis to prevent early and late syndromesequel . PCOS occur also in girls with early pubarche and thelarche(Joshi etal .,2014). Therefore, the diagnosis andmanagement must be considered in risk factors young girls. Increased PCOS awareness in young girls is necessary(Bronstein etal .2011).Lack of lifestyle changes knowledge are the major factor cause this disorder. There is a need to improve awareness amongfemales to prevent major fertilityproblems cases . Amaterity nurse plays a critical role beyond the day to dayreponsabilities. Nurses provide comprehensive care to adolescent suffer from the syndrome. Essential component ofnursing practice must be involved in the nursing education. So updating the knowledge of PCOS to modify adolescentgirls lifestyle and the risk reduction (Sunanda &Sabitha 2016).Significance of study:PCOS is being undiagnosed in the adolescent population. Awareness of PCOS and its treatment should be increased foradolescent girls(Jiskoot et al .,2017). Given the increased PCOS prevalence, its short- and long-term effects, and its coststo the health care system, one may wonder why such lack of awareness about PCOS(Stefanaki et al,2015).Limitednarrow studies have investigated awarness PCOS in young females in portsaid city ,So we aim todetermine polycystic ovary syndrome knowledge &awareness of female non medical undergraduate studentsAIMDetermine polycystic ovary syndrome knowledge &awareness of female non medical undergraduate studentsSpecific Objectives: Assess knowledge and awareness of polycystic ovary syndrome among female non medical undergraduate student- Identify the relation between knowledge and awareness of polycystic ovary syndrome and sciodemographiccharacteristicsof female non medical undergraduate studentII. MATERIAL AND METHODSThis research was cross sectional descriptive on 1000 participants who at non medical faculties affiliated to portsaiduniversity at portsaid governorate.Inclusion criteria :Female non medical students were included.Exclusion criteria.Males were excluded, medical students were excluded and anyone unwilling to participate or unable to comply withprotocol requirements were excludedStudy tools.To determine the level of knowledge and awareness of POS., a structured questionnaire was established. Thequestionnaire included 3 domains: First section was demographics of the subjects. Second part of questionnaire is 20PCOS Knowledge questions, and third part of questionnaire contained question regarding the information sources.Page 1250Novelty Journals
ISSN 2394-7330International Journal of Novel Research in Healthcare and NursingVol. 6, Issue 3, pp: (1249-1258), Month: September - December 2019, Available at: www.noveltyjournals.comScoring was done by making cutoff value of 11 for 20 knowledge questions . The score 11 was poor knowledge whilescore 12 was adequate knowledgeBefore distributing the tools a pilot study was done that represents(10%) 100 girl and excluded from study. Certainmodifications on the tools were done. The tools were reviewed by 5 expertise's from nursing and medical staff to judgecontent validity, The tool was found reliable by alpha cronbach coefficient (Cronbach’s alpha 0.7).All ethical consideration were followed in the study: an anonymity and confidentiality of the participants weremaintained. The investigator explained the aim and young famle were assured that the study will lead to no actual orpotential harm. Young famale were also assured that the information obtained will be confidential and used for theresearch aim only. The researcher collect data three times per week. The investigator begain the interview, which lastedabout 20 m. The study was take place during the period from septamber 2018 to Junuary 2019.Data analysis:The collected data analyzed using SPSS version 16, running on IBM compatible computer categorical data wereexpressed as relative frequency (number) and percent distribution, Student's t test was utilized for two bunches and oneANOVA (f) test was utilized to compare more than two bunches for nonstop quantitative variables. Person's relationshipcoefficient was utilized to assess relationship of two ceaseless quantitative variables. The distinction was consideredcritical at p 0.05.III. RESULTSThe research includes 1000 girls. Their demographic charactet are shown in table 1. More than half of subjects564(56.4%) were having age ranges between 21-less than 24 years with mean age 21.149 1.22 . Seventy hundred andfifty nine respondents (75.9%) were in theory faculties with 24.5% of them were in second academic year. Majority ofrespondents (92.2%) were unmarried and (94.2%) were urban.Table (2) Shows medical history of non medical students .Among the study sample 4.2% were already PCOS patient withthe same percent has family history of polycystic ovary with 45.4%in relation class other than first or scondGeneral knowledge for non medical students about the PCOS were revealed in table (3). The table showed that 45.4% ofstudied students don’t know the PCOS definition , 60.6% of them don’t know the difference between PCOS and ovariancysts , 69.6% of them don’t know symptoms of PCOS and 83.9 % of them don’t know effects of PCOS. Finally 54.5% ofthem don’t know important long term concern on PCOS, On the other hand, there is adequate knowledge in causes ,riskfactors, diagnosis, treatment and cure (53.5%,65.8%,71.9%,51.7% and 45.0% respestively ).Health risks knowledge for students about the PCOS is presented in table 4. the table reveals that most odf the studiedfemale non medical students know the health risks of pcos as Menstruation risks , Pregnancy risks , .ectTable (5) showed lifestyle habits knowlged for students about the PCOS . the table reveals that 49.7% of the studiedchildren mention that fast food affect treatment and illness and 40.1 % for Salt-rich meals affect treatment andillnessfinally54.8% for smoking and alcohol affect treatment and illness. On ther other hand , the studied students donknow the health habits regarding eating lots of high-fat diets affect treatment and disease and treatment with alternativemedicine and herbs(62.2% and 43.0%).The awareness level of PCOS among non medical is 3.7% which was agood knowledge, while 43.9% of non medicalfemale had adequate knowledge about PCOS on the other hand ,52.4% of females do not have prior knowledge aboutPCOS (Figure 1).Sources of information is presented in Figures 2 as , 44.9%, 40.2%, 11.4%, and 2% have known about PCOS via internet,family &friends, medical team, and general information respectively anf finally 1.5% via the past historyTable (6) reveals Correlation among socio demographic characteristics, past history, family history and PCOSKnowledge . there were highly statisatically significant correlation bettween total PCOS Knowledge and age ,faculty,shool years,and family history p value less than .001Page 1251Novelty Journals
ISSN 2394-7330International Journal of Novel Research in Healthcare and NursingVol. 6, Issue 3, pp: (1249-1258), Month: September - December 2019, Available at: www.noveltyjournals.comTable (1):- Socio- demographic characteristics of studentsPersonal characteristics.AgeNo.%(years)4275649Less than 2020-less than 2424or moreMean SDFacultyPracticeTheoryAcademic yearfirstSecondThirdFourthMarital statusSingleMarriedMonthly incomeMore than enoughEnoughNot enoughResidenceRuralUrban42.756.4.921.149 892.27.814371214514.371.214.5589425.894.2Table (2):- Medical history of non medical students (n 1000)Personal characteristicsNo.Suffer from polycystic ovarYesNo%269584.295.8YesNo429584.295.8If yes "mention" the relationFirst classScond cclassothers2821266.64.828.6Family suffer from polycystic ovaryTable (3):-General knowledge for non medical students about the PCOS n (1000)ITEMSDefinition polycystic ovary syndrome (PCOS)?TrueFalseDon’t knowNo%28226445428.226.445.4Page 1252Novelty Journals
ISSN 2394-7330International Journal of Novel Research in Healthcare and NursingVol. 6, Issue 3, pp: (1249-1258), Month: September - December 2019, Available at: www.noveltyjournals.comDifference between PCOS and ovarian cystsTrueFalseDon’t knowSymptoms of PCOS?Don’t knowknowCause of PCOS- Don’t know- Causes of hormones and genesRisk factors of PCOSKnowDon’t knowDiagnosis of PCOSKnowDon’t knowtreatment of PCOS be treatedtruefalseDon’t knowCure for PCOS?YesNoDon’t knowEffects of PCOS?Don’t knowknowImportant long term concern on PCOS?YesNoDon’t 26.654.5Table (4): Health risks knowledge for students about the PCOSInformation for studentsNo%75324775.324.767332767.332.7Minimize the health risks of PCOSHealthy balanced diet, exercise regularly.There is no health risk to the injured.Menstruation risksKnowDon’t knowPregnancy risksKnowDon’t knowCope with PCOS health risksKnowDon’t knowPregnancy occurance risksYes, but is difficultHappens with ease75324775.324.755544555.544.586713386.713.3Page 1253Novelty Journals
ISSN 2394-7330International Journal of Novel Research in Healthcare and NursingVol. 6, Issue 3, pp: (1249-1258), Month: September - December 2019, Available at: www.noveltyjournals.comTable (5): Lifestyle habits knowledge for students about the PCOSlifestyle 7Eating lots of high-fat diets affect treatment and diseaseYesNoDon’t know14922962214.922.962.2Smoking and alcohol affect treatment and illnessYesNoDon’t know54815230054.815.230.032924143032.924.143.0Fast food affect treatment and illnessYesNoDon’t knowSalt-rich meals affect treatment and illnessYesNoDon’t knowTreatment with alternative medicine and herbsYesNoDon’t knowlevel of knowledge60504052.443.930knowledge20103.70Poor knowledgeAdequateknowledgeGood KnowledgeFigure(1): Distribution of students regarding their level of knowledgePage 1254Novelty Journals
ISSN 2394-7330International Journal of Novel Research in Healthcare and NursingVol. 6, Issue 3, pp: (1249-1258), Month: September - December 2019, Available at: different mean ofcommunuication&media3025medical team2015105011.4past history1.5general information2Figure (2) Source of information of non medical students regarding PCOSTable (6): Correlation among socio demographic characteristics, past history, family history and PCOSKnowledgeRP valueRP valueRP valueRP valueRP valuePast ily historyP valueCorrelation significant at the 0.01 .IV. DISCUSSIONPCOS is a chronic multisystem problem, occurs by endocrine disorders . It occur with a wide range symptoms involvingirregular menstrual cycle, obesity, hirsutism, rogenisation, insulin resistance, and subfertility. PCOS has manycomplications like breast cancer, diabetes mellitus, and hypertension. (Brennan et al .,2017).It is a very prevelant problem of reproductive age women (Mahoney., 2014). So the the current study aim is to determinelevel of knowledge &awareness of polycystic ovary syndrome among female non medical undergraduate student. In thisstudy, a number of females non medical undergraduate student involved in the study had prior knowledge about PCOS upto 3.7%. This awareness level is unsatisfactory especially due to the large number of students involving in this study inwhich more than half of them had poor knowledge about PCOS.Page 1255Novelty Journals
ISSN 2394-7330International Journal of Novel Research in Healthcare and NursingVol. 6, Issue 3, pp: (1249-1258), Month: September - December 2019, Available at: www.noveltyjournals.comThe findings were similar to the descriptive study conducted by Ms. Khushboo (2016) to assess knowledge level ofPOS in Mohali. 200 girls were taken as sample from the schools. The result shows that majority of girls 61.5% had fairknowledge, 17.5% girls had good level of knowledge and minority of girls 0.5% had excellent knowledge level. Themean was 8.0 with 2.7 standard deviation. The findings showed that there was lack of knowledge of girls regardingPCOS. Additionally the study of Mohamed, 2016 showed that most of the subjects had poor knowledge and only 7.3% ofsubjects had good knowledge.Thispoor knowledge level of PCOS may be because of that students did not receive the basic information about PCOS.As This rational supported by Sowmya and Philomena (2013) whom mentioned that POS teaching program waseffective . Also, the above rational supported by Jayasena& Franks., (2014)who mentioned the effectiveness ofstructured teaching program regarding knowledge on POS among the students and showed that pre program the majorityof students had poor knowledge, whereas 9.17% of them had fair level.Also the current study findings rationals were supported by study of Simu (2013) that shows the effectiveness ofselfinstructional programe on knowledge of POS between adolescent and stated that adolescent girls have markedimprove in knowledge after self-instruction programe. As same as results are in the same line with Jayshree &Chaitanya (2017) mentioned that the educational program improve PCOS knowledge.Finally onthe side of knowledge level concern ,a survey on symptoms and awareness of PCOS in urban Pakistani womenfound that only 10% were familiar with PCOS, which is inconsistent with our study(Ansari et al., 2014) Another studyperformed in Nitte Usha Institute of Nursing Sciences found 76% had moderate knowledge and 10.7% had goodawareness of PCOS(Sabitha & Sunanda. 2016). In a study performed in a Semi Urban School of Sambalpur, India, itwas identified that 78% students never heard of PCOS before which is inconsistent with our value(Hansa et al. 2016) In astudy in Tertiary Care Hospitals of Pakistan, 55.6% patients were found to be unaware about PCOS (Abbas et al., 2014).A survey in Mumbai performed on women visiting gynaecological clinics showed that 6% of the participants consideredthemselves as not at all aware about PCOS. The previous study of Mumbai also showed 81% participants think PCOS ismanageable (Pitchai, Sreeraj & Anil, 2016)In current study, The knowledge source was commonly from internet, followed by almost equal by asking family andfriends and the last resource is doctors, which gives us an view about preferred way of gathering information in Egyptiancommunity. This is disagree with a study on POS in girls in Rotterdam revealed that 11.5% of the subjects gotinformation from a doctor and 5% from the internet (Jayshree et al, 2017). In another in Mumbai, India the respondent’smain source information about PCOS was doctor and internet which account for 51% and 22% respectively(Pitchai,Sreeraj & Anil, 2016).The results of the present study revealed that there were highly statisatical significant correlation bettween total PCOSKnowledge and age ,faculty ,shool years,and family history . The results of the current study agreed with the results ofMohamed (2016 ) that mentioned that there were highly statistical significant relationship of students age , family historyand education with knowledge level. These findings was congruent with Sowmya and Philomena (2013) whom revealedthat there was relation between the age years with pre-test knowledge level. While findings of Jayasena& Franks.,(2014).were incongruent as it , showed no relation between knowledge level and students age.V. CONCLUSIONThe study conclude that the knowledge level about causes, symptoms, possible complications and management ofpolycystic ovary syndrome is insufficient so it is necessary to improve knowledge about PCOS and upgrading the currenthealth care curriculam.VI. RECOMMENDATIONS-Apply educational program for girls in various areas in order to improve PCOS knowledge level- The ministry can also introduce health education at the earliest level regarding PCOS. This is to ensure an earlyprevention by providing a good understanding on the condition.-Adolescents Counseling must be involved in the curriculum to provide an awareness about the disease-Study can be reconducted on a larger number to generalize the results.Page 1256Novelty Journals
ISSN 2394-7330International Journal of Novel Research in Healthcare and NursingVol. 6, Issue 3, pp: (1249-1258), Month: September - December 2019, Available at: www.noveltyjournals.comREFERENCES[1] Abbas, N., Rizvi, M., Tanwir, S. Sabah, A., Mansoor, Z. Mehwish, A. Sundrani, M., Arif, S., Afzal, A. Mir,H.A. (2014). Perception and attitude of patients regarding polycystic ovarian syndrome (PCOS) in tertairy carehospitals of Pakistan- A survey based study. International Journal of Pharmacy & Therapeutics 5(3) 147-152.[2] Ansari, A., Gul, S., Zahid, S.A. (2014), PCOS: Symptoms and Awareness in Urban Pakistani Women, InternationalJournal of Pharma Research and Health Sciences, [Online], Available 07254 PCOS Symptoms and Awar eness in Urban Pakistani Women [Accessed: 15th August2017][3] Borruel S., Fernández-Durán E., Alpañés M., Martí D., Álvarez-Blasco F.,Luque-Ramírez M., et al. .(2013). Global adiposity and thickness ofintraperitoneal and mesenteric adipose tissue depots are increased inwomen withpolycystic ovary syndrome (PCOS). J. Clin. Endocrinol. Metab. 98, 12541263[4] Boyle J, Teede HJ. Polycystic ovary syndrome—an update. Australian FamilyPhysician. 2012;41(10):752–756[5] Brennan L., Teede H., Skouteris H., Linardon J., Hill B., Moran L. Lifestyle and behavioral management ofpolycystic ovary syndrome. J. Women’s Health. 2017;26:836–848[6] Bronstein J1, Tawdekar S, Liu Y, Pawelczak M, David R, Shah B.Age of onset ofpolycystic ovarian syndromein girls may be earlier than previously thought. JPediatr Adolesc Gynecol. 2011 Feb;24(1):15-20.[7] Hansa, J. Rajkumari, P., Sahoo, J., Sujata, P., Sahoo, G., (2016) Awareness about PCOS and the Likelihood ofIts Symptoms in Adolescent Girls in a Semi-Urban Set-Up: A Cross Sectional Study. Journal of Medical science &clinical research, 4(11), pp.12264[8] Jayasena, C.N. and Franks, S., (2014). The management of patients with polycystic ovary syndrome. NatureReviews Endocrinology, 10(10), pp.624-636.[9] Jayshree J.U., Chaitanya A. S. (2017). Awareness of PCOS (polycystic ovarian syndrome) in adolescent andyoung Girls. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 6(6).[10] Jiskoot G., Benneheij S.H., Beerthuizen A., de Niet J.E., de Klerk C., Timman R.,Laven J.E. A threecomponent cognitive behavioural lifestyle program forpreconceptional weight-loss in women with polycystic ovarysyndrome(PCOS): A protocol for a randomized controlled trial. Reprod. Health. 2017;14:34.[11] Joshi B, Mukherjee S, Patil A, Purandare A, Chauhan S, Vaidya R.A crosssectional study of polycystic ovariansyndrome among adolescent and younggirls in Mumbai, India. Indian J Endocrinol Metab. 2014 May;18(3):317-24.[12] Lujan, M., Chizen, D., and Pierson, R. Diagnostic criteria for polycystic ovarysyndrome: pitfalls andcontroversies. J Obstet GynaecolCan. 2008; 30: 671–679[13] Mahoney D. Lifestyle modification intervention among infertile overweight and obese women with polycysticovary syndrome. J. Am. Assoc. Nurse Practit. 2014;26:301–308[14] Mohamed, H. A. A. (2016). Effect of educational program on the level of knowledge regarding polycystic ovariansyndrome among adolescent girls. Journal of Nursing Education and Practice, 6(10), p80.[15] Pitchai, P., Sreeraj, S.R. and Anil, P.R., (2016). Awareness of lifestyle modification in females diagnosed withpolycystic ovarian syndrome in India: explorative study. International Journal of Reproduction, Contraception,Obstetrics and Gynecology, 5(2), pp.470-476.[16] Simu, S. (2013). A study to evaluate the effectiveness of self-instructional module on knowledge regardingpolycystic ovarian syndrome among adolescent girls in selected PU colleges at Hassan. Master thesis, obstetrics andgynecology Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore.Page 1257Novelty Journals
ISSN 2394-7330International Journal of Novel Research in Healthcare and NursingVol. 6, Issue 3, pp: (1249-1258), Month: September - December 2019, Available at: www.noveltyjournals.com[17] Sowmya, A.M., Philomena, F. (2013). Effectiveness of structured teaching of polycystic syndrome amongadolescent girls. Nitte university Journal of Health Science, 3(3), 54-58.[18] Stefanaki C., Bacopoulou F., Livadas S., Kandaraki A., Karachalios A., Chrousos G.P., Diamanti-KandarakisE. Impact of a mindfulness stress management program on stress, anxiety, depression and quality of life in womenwith polycystic ovary syndrome: A randomized controlled trial. Int. J. Biol. Stress. 2015;18:57–66[19] Sunanda B, Nayak S. A study to assess the knowledge regarding PCOS(polycystic ovarian syndrome) amongnursing students at NUINS. NUJHS.2016;6(3).[20] Sunanda B. , Sabitha A Study to Assess the Knowledge RegardingPCOS(Polycystic Ovarian Syndrome) amongNursing Students atNUINS. NUJHSVol. 6, No.3, September 2016, ISSN 2249-7110Page 1258Novelty Journals
Suffer from polycystic ovar Yes No 26 958 4.2 95.8 Family suffer from polycystic ovary Yes No 42 958 4.2 95.8 If yes "mention" the relation First class Scond cclass others 28 2 12 66.6 4.8 28.6 Table (3): -General knowledge for non medical students about the PCOS n (1000) ITEMS No % Definition polycystic ovary syndrome (PCOS)? True False Don .
