Nurse-Led E-Health Program on Evidence Based Holistic Lifestyle Modification for young women with Polycystic Ovary Syndrome

 

Narayani Sahu1*, Umesh Kumar Sharma2

1Ph.D. Scholar, LNCT University, Bhopal, M.P., India.

2Associate Professor, L.N. Nursing College, J.K. Town, Near J.K. Hospital and Medical College

Sarvdharam, "C" Sector, Kolar Road, Bhopal, M.P., India.

*Corresponding Author E-mail: narayanisahu@gmail.com

 

ABSTRACT:

Polycystic ovary syndrome (PCOS), also known as Stein-Leventhal syndrome, is not classified as a disease but rather a collection of symptoms that can differ among individuals. The global prevalence of this syndrome varies between 2.2% and 26%, influenced by the diagnostic criteria used and the specific population under examination. In India, there have been limited studies on the prevalence of PCOS. According to the available data, the incidence of PCOS in India is estimated to be between 3.7% and 22.5%. Consequently, the researcher aimed to evaluate the effectiveness of a nurse-led e-health program that incorporates evidence-based holistic lifestyle modifications on the quality of life for both normal and overweight young women diagnosed with polycystic ovary syndrome. Study Type: Mixed methods study. Sampling Method: Phase 1 – Convenience Sampling. Phase 2 – Randomized stratified sampling. Sample Size: Phase 1 – until data saturation is reached. Phase 2 – A total of 240 young women with polycystic ovary syndrome will be included. Each intervention group will consist of 60 subjects, and an additional 60 subjects will be included in each control group, all recruited from the outpatient departments of selected hospitals in Raipur, Bhilai, and Kabirdham, Chhattisgarh. Anticipated Outcome: The nurse-led e-health program, which focuses on evidence-based holistic lifestyle modifications, is expected to enhance the quality of life for normal and overweight young women with polycystic ovary syndrome when compared to no intervention.

 

KEYWORDS: Polycystic ovary syndrome, Holistic, Lifestyle modification, Nurse-led e-health program, Quality of life.

 

 

INTRODUCTION:

Polycystic ovary syndrome (PCOS) is a hormonal disorder that impacts the ovaries, which are the female reproductive organs responsible for egg production. It is among the leading causes of infertility.  It affects about 1 in every 10 women (and individual’s assigned female at birth) who is of childbearing age.1 Worldwide, the prevalence of the syndrome ranges from 2.2%-26%, depending on the choice of diagnostic criteria and population being studied2. In India, the occurrence of PCOS ranges from 3.7%-22.5%3.

 

 

A study was carried out by Stephanie Cowan and her colleagues in 2023 to examine lifestyle management in polycystic ovary syndrome, which encompasses things other than diet and physical activity. Found that to reduce heterogeneity more research in specific PCOS populations, EG. Determining age and BMI ranges, having consistent approaches to intervention delivery, duration, and comparators, and conducting robust clinical trials are necessary. So that the relatively limited evidence base on holistic lifestyle management should be expanded, as it is justifiable.4

 

Aly et al, (2021) did a study on Lifestyle Modifications in PCOS. Found that investigator highlights a significant gap in knowledge and is reflective of the lack of evidence-based guidance for lifestyle modification.5

 

Thus, considering all these factors a mixed method study will be conducted to assess the efficacy of nurse-led e-health programme with evidence based holistic lifestyle modification on quality of life among normal and overweight young women with polycystic ovary syndrome.

 

A Brief Review of the Work Already Done in the Field:

Shringarika Mishra et al, 2024 conducted a review on Polycystic Ovary Syndrome and its management through lifestyle changes. This paper examines the significance of lifestyle management, which encompasses dietary changes, physical exercise, weight control, stress alleviation, and sleep patterns, within the framework of PCOS, emphasizing its capacity to enhance overall health and well-being.6

 

Stańczak, N. A., Grywalska, E., and Dudzińska, E. (2024) conducted an evaluation of the most recent reports and treatment approaches regarding polycystic ovary syndrome. Results showed that the appropriate diet, physical activity - lifestyle changes (Sleep quality, physical activity and stress reduction) are crucial in the treatment of PCOS.7

 

Zeinab Hamzehgardeshi and colleagues (2024) conducted a study examining the impact of motivational interviewing based on social networks on health-promoting behaviors and quality of life in infertile women suffering from polycystic ovary syndrome: a randomized controlled trial. The study revealed that support via WhatsApp enhances the rate of health-promoting self-care behaviors and positively influences follow-up outcomes.8

 

Pamela J. Wright, Cynthia L. Corbett, and Michael D. Wirth (2021) conducted a cross-sectional study examining the effects of exercise perceptions and depressive symptoms on health-related quality of life specific to polycystic ovary syndrome. The results indicated that respondents experienced low health-related quality of life, reported more barriers to exercise than benefits, held neutral expectations regarding exercise outcomes, and exhibited high levels of depressive symptoms. The findings indicate that emphasizing the advantages of exercise, tackling obstacles to exercising, and managing depressive symptoms are crucial areas for future initiatives aimed at enhancing health-related quality of life for women suffering from polycystic ovary syndrome.9

 

Note Worthy Contributions in the Field of Proposed Work:

a.     According to research, approximately 1 in every 10 women (and individuals assigned female at birth) of childbearing age are affected, making it the most prevalent cause of infertility and psychological issues.1

b.     Aly et al, (2021) found that 45% of women with PCOS have reported that they have never been provided information about lifestyle management. This highlights a significant gap in knowledge and is reflective of the lack of evidence-based guidance for lifestyle modification. 5

c.     Stephanie Cowan and colleagues (2023) discovered that in order to decrease heterogeneity, further research focusing on specific populations with PCOS, such as those defined by age and BMI ranges, as well as consistent methods for delivering interventions, their duration, and comparators, is essential. Although there are various lifestyle factors alongside population-based recommendations for diet and physical activity that may be beneficial for individuals with PCOS, there is a pressing need for rigorous clinical trials to enhance the currently limited evidence base concerning comprehensive lifestyle management. 4

d.     Previous review done on Effects of Non pharmacological and Pharmacological Interventions on the Management of Polycystic Ovarian Syndrome suggest nursing professionals should enhance their advocacy for patients and recognize the necessity of approaching PCOS management in a more holistic and personalized way. 10

e.     By reviewing various researches, the Researcher found that the too many studies done on lifestyle management among obese PCOS patients but no study found on comparative analysis of young women with polycystic ovarian syndrome of normal and overweight as women have normal weight were also affected by PCOS as per studies.

 

Hence, in this study an effort will be made to document the Efficacy of nurse-led e-health programme with evidence based holistic lifestyle modification on quality of life among normal and overweight young women with polycystic ovary syndrome.

Proposed Methodology During the Tenure of The Research Work:

Type of Study: Mixed method study.

 

Source of Data: Phase 1- (Qualitative) Will take interview from Gynaecologists, Counsellor, Dietician and physiotherapist to prepare evidence based holistic lifestyle modification programme.

 

Phase 2- (Quantitative) All the participants of normal and overweight young women with polycystic ovary syndrome will be selected from OPDs of selected hospitals. The study population will be divided into two groups each ie; interventional group and control group according to their weight.

 

 

 

 

 

Study design: Phase 1: Qualitative approach

 

Phase 2: Quantitative approach

 

 

 

 

Sampling procedure: Phase 1 – Convenience Sampling.

 

Phase 2 - Randomized stratified sampling.

Sample size: Phase 1- till data saturation.

 

Phase 2 - The sample size was calculated based on the sample size determination table (90% confidence intervals, ±2.5% margin of error). Sample size is calculated considering it as a ‘Superiority Trial’. The total sample size will be 240 young women with polycystic ovary syndrome.  Total 60 subjects in each intervention groups and another 60 subjects in each control groups were recruited from the OPDs of selected hospitals of Raipur, Bhilai and Kabirdham, C.G. [13]

 

Inclusion criteria:

·       Young women with PCOS age between18 - 40 years.

·       PCOS patients with stable health condition.

·       PCOS patients willing to give informed consent.

 

Exclusion criteria:

·       Young women with PCOS not able to understand English, Hindi or local language.

·       The presence of a severe and uncorrectable cognitive, visual, or hearing impairment that would preclude a participant's ability to participate.

·       Women who were pregnant with endocrine disorders and those with a history of eating disorders were excluded from the study.

·       Young women with PCOS who were already attended the lifestyle modification programme.

 

Withdrawal criteria -

·       In between, patients who wish to stop will be permitted to do so.

·       If patient develops any acute illness during the trial which may hamper the study.

·       Withdrawn patients will be replaced.

 

Tool and Assessment Criteria:

PHASE I: Questions of qualitative study for Gynaecologists, Dietician, Councellor and physiotherapist. TTF – HLSMP (tool to form- holistic lifestyle modification program) for PCOS women.

 

PHASE II: Tool consists of three sections:

 

SECTION A: Socio-Demographic Data: includes age, sex, qualification, marital status, occupation, weight, BMI, type of family, family income, age of menarche, method of contraception, hormonal contraceptive use, parity, family history of obesity, Meal frequency per day, Type of food consumed, Fast food consumption (junk food), Performing exercises, Present lifestyle pattern, Sleep duration, Smoking habit, co-morbid conditions and medications if taken, attended previous lifestyle modification programme for PCOS management etc.

 

SECTION B: The quality of life of patients with PCOS is evaluated using the Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (mPCOSQ) tool.12

 

SECTION C: According to the World Health Organization (WHO) and National Institutes of Health (NIH) (.gov) the BMI Categories:

·       Normal Weight: BMI between 18.5 and 24.9.

·       Overweight: BMI between 25.0 and 29.9.

 

BMI Calculation: To assess Body Mass Index (BMI) in women, use the formula: weight (in kilograms) divided by height (in meters) squared (kg/m˛).

 

Formula: BMI = weight (kg) / height (m˛).

Variables: Independent variable: Nurse-Led e-Health Programme with Evidence- Based Holistic Lifestyle Modification intervention.

 

 

Dependent variable: Quality of life among young women with Polycystic Ovary Syndrome.

 

Expected Outcome of the Proposed Work:

The nurse-led e-health program with evidence based holistic lifestyle modification improves quality of life among normal and over-weight young women with polycystic ovary syndrome compared with no intervention.

 

CONFLICT OF INTEREST:

The authors have no conflicts of interest.

 

REFERENCES:

1.      Deanna Altomara, Polycystic Ovary Syndrome (PCOS) Medically Reviewed by Poonam Sachdev on December 27, 2023 [online]. 2023; Available from : URL: https://www.webmd.com/women/what-is-pcos

2.      Choudhary A, Jain S, Chaudhari P. Prevalence and symptomatology of polycystic ovarian syndrome in Indian women: Is there a rising incidence? Int J Reprod Contracept Obstet Gynaecol. 2017;6(11):4971-75;4971-76. [crossref]

3.      Ganie MA, Vasudevan V, Wani IA, Baba MS, Arif T, Rashid A. Epidemiology, pathogenesis, genetics and management of polycystic ovary syndrome in India. Indian J Med Res. 2019;150(4):333-44. [crossref] [PubMed]

4.      Cowan, S., Lim, S., Alycia, C. et al. Lifestyle management in polycystic ovary syndrome – beyond diet and physical activity. BMC Endocr Disord.   2023; 23(14). https://doi.org/10.1186/s12902-022-01208-y

5.      Aly et al, (2021) Lifestyle Modifications in PCOS. Clinical Obstetrics and Gynecology.  2021; 64(1): 83-89. DOI: 10.1097/GRF.0000000000000594

6.      Shringarika Mishra et al, Polycystic ovary syndrome and Lifestyle management. Neuro Quantology 2024; 22(2): 233-241; DOI Number: 10.48047/nq.2024.22.2.NQ24026

7.      Stańczak, N. A., Grywalska, E., and Dudzińska, E. The latest reports and treatment methods on polycystic ovary syndrome. Annals of Medicine. 2024; 56(1). https://doi.org/10.1080/07853890.2024.2357737

8.      Zeinab Hamzehgardeshi et al, effect of social network-based motivational interviewing on health- promoting behaviors and quality of life among infertile women with polycystic ovary syndrome. [online]. Sci Rep. 2024; Available from: URL: https://www.researchsquare.com/article/rs-3591010/v1

9.      Pamela J Wright et al. The impact of exercise perceptions and depressive symptoms on polycystic ovary syndrome–specific health-related quality of life. [online]. 2021; Available from: URL: https://journals.sagepub.com/doi/full/10.1177/17455065211065865

10.   Ellington Fagg;Effects of Nonpharmacological and Pharmacological Interventions on the Management of Polycystic Ovarian Syndrome[online]. 2024; Available from: URL: https://scholarworks.uark.edu/nursuht/206/

11.   Princey Shaji et al. Effectiveness of Nurse-led Lifestyle Modification Intervention on Obesity Among Young Women in India [online]. 2023 Available from : URL: https://www.researchgate.net/publication/372545298_Effectiveness_of_Nurse-led_Lifestyle_Modification_Intervention_on_Obesity_Among_Young_Women_in_India

12.   Barnard L, Ferriday D, Guenther N, Strauss B, Balen AH, Dye L. Quality of life and psychological well being in polycystic ovary syndrome. Hum Reprod. 2007; 22: 2279–2286. doi: 10.1093/humrep/dem108. [DOI] [PubMed] [Google Scholar]

13.   Abobakr Ibrahim A,Ghoneim HM, Elsaid NM, Shalaby NS. Effectiveness of lifestyle modification on health‑related quality of lifeamong women with polycystic ovary syndrome. IranJ Nurs Midwifery Res 2023; 28: 286‑92.

 

 

 

Received on 11.08.2025         Revised on 13.10.2025

Accepted on 24.11.2025         Published on 23.02.2026

Available online from February 25, 2026

Int. J. Nursing Education and Research. 2026;14(1):11-14.

DOI: 10.52711/2454-2660.2026.00002

©A and V Publications All right reserved

 

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.