Social construction of biopsychosocial and medical experiences of women with polycystic ovary syndrome. (17th April 2020)

• Record Type: Journal Article
• Authors: Wright, Pamela J.; Dawson, Robin M.; Corbett, Cynthia F.
• Is Part Of: Journal of advanced nursing. Volume 76:Number 7(2020)
• Page Start: 1728
• Page End: 1736
• Publication Date: 2020-04-17
• Subjects: biopsychosocial -- content analysis -- endocrinopathy -- medical experiences -- nursing -- polycystic ovary syndrome -- qualitative -- social construction of illness -- social support websites -- women's health; Nursing -- Periodicals; 610.7305
• DOI: 10.1111/jan.14371
• Languages: English
• ISSNs: 0309-2402

Abstract

Abstract: Aim: To explore the perceived biopsychosocial and medical experiences of women with polycystic ovary syndrome, as presented in stories written by women on a social support website. Design: Qualitative descriptive using low inference content analysis, guided by the social construction of illness theoretical framework. Methods: In July 2018, 95 of 379 website stories were randomly selected. The stories were analysed, ending in September 2018. Results: Three major themes aligning with framework constructs were identified: Biopsychosocial struggles and management: "I can't even look in the mirror without wanting to cry, " Sociocultural navigation: "I feel all alone and no one understands me." and Healthcare encounters: "I don't feel like I'm getting the help I need". These themes revealed that Polycystic ovary syndrome (PCOS) has biological and experiential components, which exist independently of each other and hold social and cultural meanings. Conclusion: Care for women with PCOS should be multidisciplinary, multidimensional, and multi‐level to ameliorate biopsychosocial issues. Provider (physicians, nurse practitioners, physician assistants) education about PCOS is necessary to enhance timely diagnosis and implement individualized treatment strategies. Non‐advanced practice nurses are in a unique position to have an impact on patient satisfaction and clinical outcomes by providing and reinforcing patient education, coordinating management processes, counselling via telephone or in‐person appointments and facilitating referrals to ancillary providers. Evidence‐based and accessible psychosocial supports and interventions will lead to improved self‐esteem and effective coping skills, and reduced stigma‐related stress. Lastly, policy changes are warranted to address access to care, health insurance inequities and inadequate funding for PCOS‐related research. Impact: Increased awareness of PCOS and its biopsychosocial aspects will aid providers with timely diagnosis and meaningful treatment plans. Women with PCOS will gain acknowledgment, acceptance, and insight towards health care and self‐management. Abstract : 目的: 探讨多囊卵巢综合征的女患者在社会支持网站上发表自身经历故事的生物心理社会和医学经历。 设计: 采用少量推理内容分析方法的定性描述分析, 并以疾病社会建构的理论框架为指导。 方法: 2018年7月, 在379篇网站文章中随机抽取95篇, 然后对这些故事进行分析, 研究工作于2018年9月结束。 结果: 确定了符合框架结构的三大主题:生物心理社会的斗争和管理:"我一照镜子就忍不住想哭";社会文化的引导:"我感到孤独, 没人理解我";以及求医过程的遭遇:"我觉得我没有得到我需要的帮助"。这些主题揭示了多囊卵巢综合征具有生物和经验方面的组成部分, 彼此独立存在, 具有社会和文化意义。 结论: 对多囊卵巢综合征女患者的护理应是涉及多学科的、多层面的和多层次的过程, 以缓解生物心理社会的问题。为加强多囊卵巢综合征的及时诊断和实施个性化的治疗策略, 有必要对多囊卵巢综合征的医疗提供者(医生、护士、助理医生)进行教育。非高级执业护士在提供和加强患者教育、协调管理流程、通过电话或当面预约提供咨询以及帮助转介给辅助医疗服务提供者方面具有独特的作用, 能够影响患者满意度和临床疗效。基于证据和可获得的心理社会支持和介入治疗将提升自尊感和有效的应激技能, 减少受辱的压力。最后, 有必要改革政策, 以解决获得护理、医疗保险不平等和多囊卵巢综合征相关研究资金不足的问题。 影响: 提高对多囊卵巢综合征及其生物心理社会方面的认识将有助于提供及时诊断和有意义的治疗计划。患有多囊卵巢综合征的妇女将获得承认、接受和对保健和自我管理的认识。