JMIR Publications

ABSTRACT

Background:

Polycystic ovary syndrome (PCOS) is a common chronic hormonal condition affecting 8-13% of women and individuals assigned female at birth. Symptoms may include subfertility, menstrual, skin and metabolic problems, with long-term health risks including diabetes and cardiovascular disease. PCOS has a significant negative impact on mental health, quality of life and wellbeing. We explored proof of concept for a web-based self-management support intervention ‘Hope PCOS’ designed to reduce anxiety and depression and increase positive wellbeing for women living with PCOS.

Objective:

To pilot the intervention to test feasibility for web-based recruitment and delivery, acceptability and potential to reduce anxiety and depression and increase positive wellbeing.

Methods:

Women with PCOS were recruited via social media with support from a patient advocacy charity and offered places on a six-session cohort of the intervention. In a pre-post design participants reported depression (PHQ-9), anxiety (GAD-7), wellbeing (Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS)), hope (State Hope Scale (SHS)) and gratitude (Gratitude Questionnaire (GQ-6)) at baseline and six weeks. All participants who accessed 3 or more sessions were invited to a follow-up qualitative interview to explore user experience. Data from 8 interviews were thematically analysed and pre-post data explored with descriptive statistics.

Results:

Sixty-three eligible women responded and were given access to the intervention. Three withdrew, leaving a baseline sample of N=60, aged 20-58 (median 30) years. Forty-eight of the 60 started, of whom 44% (22/48) completed at least three sessions and 27% (14/48) completed all six. Eight women (aged 25-38, median 29) years who completed all sessions reported acceptability and experiences in exit interviews, including prioritising self-care, developing a self-management mindset, setting motivating goals, improved mental health, self-compassion, reduced shame, openness about PCOS, preparedness for future health concerns, and continuing practice to consolidate behaviour change. Eleven women aged 25-43 (median 31) years, who completed 1-6 sessions (median 6), completed pre-and post-intervention outcomes. Descriptive analysis indicated decreases in anxiety and depression and increases in hope agency, hope pathways and gratitude. There was a meaningful (≥3 points) increase in wellbeing. Among patients with baseline and follow-up data, 73% (8/11) met clinical caseness for depression at baseline and 36% (4/11) post intervention.

Conclusions:

We explored proof of concept. Recruitment and delivery online was feasible. We detected early signs of acceptability and potential benefits for anxiety, depression, and positive wellbeing that warrant testing in a controlled trial. Future research should assess feasibility of a randomised controlled trial to evaluate effectiveness, acceptability and cost-effectiveness. Clinical Trial: N/A - exploratory proof of concept study