Mani Hamidreza, Chudasama Yogini, Hadjiconstantinou Michelle, Bodicoat Danielle H, Edwardson Charlotte, Levy Miles J, Gray Laura J, Barnett Janette, Daly Heather, Howlett Trevor A, Khunti Kamlesh, Davies Melanie J
Diabetes Research CentreLeicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester, UK
Department of Diabetes and EndocrinologyLeicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK.
Endocr Connect. 2018 Jan;7(1):26-35. doi: 10.1530/EC-17-0274. Epub 2017 Nov 13.
To evaluate the effectiveness of a structured education programmes in women with polycystic ovary syndrome (PCOS).
Single-centre, randomised controlled trial, testing a single exposure to a group-based, face-to-face, structured education programme. Inclusion criteria were women with PCOS, aged 18-49 years inclusive and body mass index ≥23 kg/m for black and minority ethnicities or ≥25 kg/m for white Europeans. Primary outcome was step-count/day at 12 months. Secondary outcomes included indices of physical activity, cardiovascular risk factors, quality of life (QoL) and illness perception (IP).
161 women were included (78 control, 83 intervention); 69% white; mean age 33.4 (s.d. 7.6) years, of whom 100 (48 intervention; 52 control) attended their 12-month visit (38% attrition). 77% of the intervention arm attended the education programme. No significant change in step-count was observed at 12 months (mean difference: +351 steps/day (95% confidence interval -481, +1183); = 0.40). No differences were found in biochemical or anthropometric outcomes. The education programme improved participants' IP in 2 dimensions: understanding their PCOS ( < 0.001) and sense of control ( < 0.01) and improved QoL in 3 dimensions: emotions ( < 0.05), fertility ( < 0.05), weight ( < 0.01) and general mental well-being ( < 0.01).
A single exposure to structured education programme did not increase physical activity or improve biochemical markers in overweight and obese women with PCOS. However, providing a structured education in parallel to routine medical treatment can be beneficial for participants' understanding of their condition, reducing their anxiety and improving their QoL.
评估结构化教育项目对多囊卵巢综合征(PCOS)女性的有效性。
单中心随机对照试验,测试单次接触基于小组的面对面结构化教育项目的效果。纳入标准为年龄在18至49岁(含)的PCOS女性,黑人及少数族裔的体重指数≥23 kg/m²,或白人欧洲人的体重指数≥25 kg/m²。主要结局是12个月时的每日步数。次要结局包括身体活动指标、心血管危险因素、生活质量(QoL)和疾病认知(IP)。
纳入161名女性(78名对照组,83名干预组);69%为白人;平均年龄33.4(标准差7.6)岁,其中100名(48名干预组;52名对照组)参加了12个月的随访(失访率38%)。干预组77%的人参加了教育项目。12个月时未观察到步数有显著变化(平均差异:+351步/天(95%置信区间-481,+1183);P = 0.40)。在生化或人体测量学结局方面未发现差异。教育项目在两个维度上改善了参与者的疾病认知:对PCOS的理解(P < 0.001)和控制感(P < 0.01),并在三个维度上改善了生活质量:情绪(P < 0.05)、生育能力(P < 0.05)、体重(P < 0.01)和总体心理健康(P < 0.01)。
单次接触结构化教育项目并未增加超重和肥胖PCOS女性的身体活动或改善生化指标。然而,在常规医疗治疗的同时提供结构化教育可能有助于参与者了解自身病情,减轻焦虑并改善生活质量。