The effect of transtheoreticalmodel-based individual lifestyle counseling on university students with polycystic ovary syndrome

THE EFFECT OF TRANSTHEORETICALMODEL-BASED INDIVIDUAL LIFESTYLE COUNSELING ON UNIVERSITY STUDENTS WITH POLYCYSTIC OVARY SYNDROME Objectives: This study aims to evaluate the effects of individual counseling based on the Transtheoretical Model on the management of Polycystic Ovary Syndrome (PCOS) through healthy nutrition and physical activities in university students. Methods: The study comprised scanning, diagnosis, randomization and selection, counseling and monitoring stages. The universe of the study consisted of 1134 female students enrolled in the Afyon Health School, Faculty of Medicine and Veterinary Science, Afyon Kocatepe University, Turkey. During the scanning, sample selection was not considered but the "PCOS Risk Diagnosis Form" was applied to 884 students who volunteered. 274 of them were determined to be at risk of PCOS. For various reasons 21 of the students were excluded from the study. In total 218 of the participants at risk were directed to Gynecology Department of the Faculty of Medicine. 76 of the students were diagnosed by a specialist with PCOS according to the Rotterdam Criteria and 6 of them were excluded from the study. During randomization and selection, 70 volunteer students with PCOS who met the participation criteria were divided into control and experimental groups by the randomization method. 3 of them were excluded from the study, as they did not complete the monitoring stage. The study was conducted with a total of 67 students. A theory-based individual counseling program was given to the experimental group and routine follow-up and care services were given to the control group. The findings were evaluated with the SPSS 17.0 package program. Findings: The frequency of PCOS among university students was 8.8%. Most of the participants had had menstrual disorders, hirsutism, alopecia and acne problems, almost half of them were pre-obese and many of them had experienced changes in psychological state, nervousness or tiredness. The average age of the students was 20.79±1.4. There was a decrease in weight, waistline, buttock measurement, body mass index and Ferriman-Gallwey (mFG) scores of the students between initial and final follow-up measurements in experimental group and these differences were statistically significant difference (p=0.000 p<0.001). There was no significant difference in the menstrual cycle averages in the initial follow-ups, while in the final follow-ups, the average menstrual cycle (32.35±6.3) of the experimental group was more regular than of the control group (36.96±6.4). There was a significant difference between the groups (p=0.000, p<0.001). For the experimental group, there was a decrease in the perceptions of restlessness, nervousness, changes in psychological state, anxiety and fatigue related to the illness in the final follow-up compared to the initial follow-up but an increase in the perception of PCOS management and self-confidence were seen (p<0.05). In the final follow-up of the experimental group getting individual counseling service, the consumption of vegetables and fruits and increased compared to the initial follow-ups. Consumption of bread, wheat, daily oil, foods containing sugar and the amount of the daily calories consumed had decreased significantly (p<0.05). However, there was no significant change in the nutritional habits of the control group (p>0.05). In the experimental group, the time spent inactive each day decreased while average physical activity levels, walking levels and the total physical activity levels increased significantly (p<0.05). There was no difference in nutrition or in the physical activities of the two groups in terms of behavioral change at the initial follow-up (p>0.05), but there was a significant difference in mid-term and final follow-ups (p<0.05). No difference was seen in total scores for quality of life and in the sub-groups for the control group between the initial and final follow-ups but there was a significant difference in these for the experimental group (p<0.05). Conclusion: The individual counseling service based on the Transtheoretical Model for the management of PCOS improved students' physical activities and nutritional habits and initiated a higher quality of life and degree of awareness for the students by positively affecting anthropometric measures, clinical diagnosis and perceptions regarding to the illness. Key Words: PCOS, Transtheoretical Model, Individual Counseling, Nutrition, Physical Activity, PCOS Control, Life Quality.