This study explored knowledge, attitude and practice towards lifestyle management among women with PCOS in China. Although life management has been listed as the preferred choice during the treatment, only 45.9% of participants got knowledge education for PCOS Lifestyle management. The result was a litter higher than a previous study conducted among PCOS women at Taif city, where 34.0% had received knowledge through health education[17, 18]. Women with PCOS feel there is a lack of information for their condition[17, 18, 19]. It suggests significant room to improve health education among women with PCOS worldwide. It is noteworthy that the results of this study also revealed poor follow-up in patients with PCOS, with approximately 69.56% of PCOS patients having the disease within 3 years, but as a lifelong disease that is difficult to cure and requires long-term follow-up treatment, this population generally ignores the long-term risks and focuses on immediate clinical symptom control. Therefore, it is necessary to improve adherence in patients with PCOS.
In previous studies, some investigated the knowledge regarding PCOS among women or students[15, 20], and only one evaluated the knowledge focus on women with PCOS[21]. Results of the current study indicated women with PCOS have a better knowledge level than women or students[15, 20]. Another interesting aspect of our findings is that the correct Knowledge rate in PCOS women was higher than the knowledge education rate among ordinary people. There are several reasons for these phenomenons. Firstly, due to the experience of the disease, the patients may comprehend the feeling of PCOS better than the persons without getting the disease. Secondly, although women with PCOS have inadequate knowledge education chance about PCOS, they are keen to learn more about the information of their disease[18, 19 ], which makes them keep the motivation to obtain information.
The majority of participants in the current study showed a positive attitude towards PCOS management. Especially 92.7% of participants believe that patients should collect and learn relevant knowledge about PCOS management. The study results correspond with what was reported earlier, where women with PCOS long to know more about the information of their disease[18, 19 ]. In the present study, about 92.8% of participants indicated that PCOS patients should follow the health advice of medical staff. But a study in another country found something different, and it reported 47% of PCOS patients attempting to follow the official diet recommendations[16]. In this study, approximately 92.7% of the participants had positive attitudes towards life management of PCOS and believed that they should learn about life management of PCOS, which was similar to their level of life management knowledge.
The result indicates a close relationship between knowledge and attitude.Interestingly, despite the observed lots of participants have the correct knowledge and positive attitude in life management, these data are not consistent with their lower heath behavior rates in diet (11.1%) management and exercise (10.6%) in the present study. Moreover, compared with the previous research, the present one showed the lowest physical activity rates among women with PCOS. The results indicate a big gap between knowledge, attitude and behavior among participants in life management. According to the Information–Motivation–Behavioral skills (I.M.B.) model of health behavior change posits that performing a health promotion behavior is a function of the extent to which someone is well informed about the behavior, motivated to perform the behavior, and has the requisite skills to execute the behavior[22, 23]. Hence, poor health behavior among women with PCOS may line with inadequate skill. As to the emotion of PCOS women, most of the participants suffered emotional distress. Only 18.6% of participants never felt anxious or lacked self-confidence due to PCOS in recent three months. In agreement with previous studies, the research found that PCOS women are at higher risk for emotional distress than the average person[24]. Combined with previous research and this one, we can see that PCOS patients have significantly increased psychological burden and severely impaired quality of life due to the combination of multiple factors such as reproductive endocrine disorders, altered self-image, and fear of infertility[25].
The current study highlighted that online course or web site was one of the most frequent sources of information received by PCOS women. The findings corroborate the results of a previous study[26]. Yet researchers found differences in another study, in which PCOS women get the most information from their friends[16]. While in the present study, about 61.8% and 31.4% of PCOS women expressed their optimal source to get information is no internet, but healthy management software and medical staff. There are many reasons for this phenomenon. First of all, the information on the internet is not necessarily straightforward and concise, and users may need to refer to multiple sites to find their answers[27]. Secondly, with the widespread use of mobile networks and mobile phones for the past few years, most participants are young. They have received at least a middle school education (over nine years), which suggests that this population has the ability and instruments to get information from the healthy management software.
The study still had certain limitations. In the current study, we only described the knowledge, attitudes and practice level among women with PCOS. Still, we did not investigate the factors affecting knowledge, attitudes and practice. Therefore, future studies should be conducted at variable sites, and more participants should be recruited randomly. In addition, the associated factors are also needed to investigate.
In conclusion, our study observes majority of women with PCOS have adequate knowledge and positive attitude, while poor health behavior in PCOS management. It can be concluded that there is a big gap between knowledge, attitude and practice among women with PCOS in lifestyle management. Therefore, how to strengthen the practice of patients with PCOS is an issue that should be the focus of future studies, and future studies can strengthen the implementation of practice of patients with PCOS.