Population Based Intervention Plan on Polycystic Ovary Syndrome - Research Paper Example

Fit for Mums The Prevention of the Risks Associated with the Development of Polycystic Ovary Syndrome among the middle Pakistani Women Living in Hounslow, West London: Proper Diet, Lower Sugar Level and Physical Exercise Word count: 2500 TABLE OF CONTENTS Cover page………………………………………………………………………… 1 Table of Contents………………………………………………………………….. 2 Background…………………………………………………………………………3 Review………………………………………………………………………………4 Impact on women…………………………………………………………………..5 Proper Diet………………………………………………………………………….6 Low Sugar Level & Physical Exercise…………………………………………….7 Strategy………………………………………………………………………………7 Objectives……………………………………………………………………………8 Design, Setting, Criterion, Standards & Sources……………………………….8-9 Outcome and Results……………………………………………………………….9 Implementation……………………………………………………………………..10 The Legal Model…………………………………………………………………….10 Audit Cycle………………………………………………………………………….11 Limitations and Areas of Change…………………………………………………11 References……………………………………………………………………….. …12 Polycystic ovary syndrome (PCOS) Background Polycystic ovary syndrome is one of the most common form of women disorder most especially those of the reproductive age, that is the period of giving birth. This kind of problem is characterised by a situation in which the woman’s hormones gets out of control and balance. It becomes to either extreme that can alter the woman’s appearance such as a situation where a woman have excess hair growth or in some extreme cases, it can hinder the woman from giving birth. In the medical context, PCOS is characterised by many small cysts on the woman’s ovaries. These cysts are painless and harmless; however they have the negative effect of causing hormonal imbalances in the woman. One of the main causes the disorder is believed to genetics (Karaca, Ibrahim 2013). Therefore if one member of the family has PCOS, then the possibility of the syndrome affecting the other women of the family is high. The main symptoms of this female disorder include anovulation, excess androgenic hormones and insulin resistance. Insulin resistance is a situation whereby the body does not efficiently use insulin leading to a rise in the blood sugar levels and excess body weight. This rise in sugar levels increases an individual’s chance of contracting diabetes. This therefore indicates that a patient suffering from PCOS has high chances of contracting diabetes Health (Koball 2012, pg. 35). Other very common symptoms include extreme instance of weight gain or a terrible weight loss by the patient, development of abnormal hair growth by the woman, mostly on the face, chest and back like a man. The woman can also experience thinning hair on her scalp and irregular periods of ovulation, for example they can experience fewer months in their pregnancy. It is noted that women suffering from PCOS during their pregnancy periods are likely to experience miscarriages, pregnancy induced-high blood pressure or in some cases they experience premature deliveries before the expected nine months, thereby giving birth to premature babies that are malnourished. Review Pakistanis are among the minority ethnic groups in UK .In the West London, in the city of Hounslow, about 13,676 Pakistanis, giving a percentage of 5.39% % of the Indians stay there. Out of the women living in the city, 5-10% of them are approximated to be suffering from the PCOS disorder. (UK Census 2011) This mostly affects those women in the reproductive stage or is pregnant. Many of the victims however do not realize fast that they are affected by the syndrome. They therefore just seek medication to prevent the unborn baby from any infection that they do not have an idea of its origin or course. Most of the women suffer from diabetes, too much weight gain, high cholesterol and high blood pressure. Early identification of the symptoms of the disease can help prevent the disease from spreading to the human body causing adverse effects to the woman such as permanent infertility or frequent miscarriages. Due to this unawareness’s by the Indian women, there is therefore urgent need for resources and strategies for the prevention of the PCOS prevalence among these Indian women and to find long-term solution to any future occurrences of the disease (Cheung 2011). Over the years, studies have shown that [roper and balanced diet coupled with adequate physical exercise help reduce overweight that causes obesity among the women. Community based gymnasium are highly encouraged for the pregnant women to help them not be victims of PCOS. Most of the women suffering from PCOS also have long-term effects of diabetes. To reduce this, studies have found that a lot of body exercise help lower the human blood sugar level. This also increases the sensitivity of the insulin hence reducing the risk of women from contacting PCOS. Women are also encouraged to eat more grains as this maintains a balance of the sugar level. (Mayo Clinic Report, 2013). Researchers and medical practitioners have developed several pharmacological therapies to help alleviate the symptoms as soon as they are noticed on the women (Franks 2006, pg. 102). There is also widespread awareness that is done to the victims to modify their lifestyles, eating good and balanced diet and also they are encouraged to take part in physical activities exercise. The physical exercise is encouraged because it helps reduce obesity which is also associated by the disease as it helps burn down the excess fats that are accumulated in the body. The physical exercises also help reduce the chances of high blood pressure among the victims. It is noted from the research and studies that the main cause of PCOS is the genetics inherited from the family; however an individual can also be predisposed to PCOS by accumulation of insulin resistance which arises due to deposition of the dispose tissue that may lead to the expression of the once dormant PCOS phenotype. Past studies have therefore advocated for early prevention mechanisms of treating this disorder before an individual reaches the adolescence stage because at adolescence stage, the disease is likely to affect the individual’s fertility (Cheung 2011). Impacts of PCOS on the Pakistani women There are widespread harmful effects of PCOS on the Pakistani women living in Hounslow and these ranges from the physiology metabolism of their body and the other long-term effects such as diabetes and obesity. This often leads to the giving birth of malnourished children or miscarriages. Most of the women have also developed body hair like in men on their chests, faces and belly. Some have the male pattern baldness where there are thinning of hair on the head. These effects are attributed to the hormonal imbalance in the women which is mostly caused by the insulin resistance among the women. Insulin resistance often arises due to the increased sugar and glucose levels that are not effectively burnt down as a result of ignorance on physical exercises. These too much glucose and sugar levels also puts the patients at risks of contracted type two diabetes that is too much prevalent among the obese and overweight women. These effects have been noted among the Pakistani women living in Hounslow who mostly feed on fatty foods and less carbohydrates thereby developing too much fat in their upper body. It is also noted that these Pakistani women undergo very minimal physical exercise and this increases their chance of contracting the PCOS disease. Apart from it being a genetically inherited disorder, researchers have also noted that poor living and bad eating habits increases an individual’s chance of contracting the syndrome (Bloomgarden 2010, pg. 42). Proper Diet Most of the Indian women in Hounslow are either low class or middle class individuals. It is noted that the women nutrition is mostly composed of fatty and oily foods and very less of the carbohydrates and hard foods like grains. This therefore increases the risks of the women having overweight bodies and eventually becoming obese. Any woman with a BMI of between 25 to 30 kg/m2 is considered overweight while that with BMI of over 30 kg/m2 is considered to be obese. Studies conducted in the United States by the medical research body revealed that 61% to 76% of the women suffering from PCOS are either overweight or obese. From the feeding habits of the Pakistani women in Hounslow, the women suffering from PCOS have developed too much upper body parts compared to the normal distribution in their body. This abdominal adiposity increases the insulin resistance among women and hence increases their reproductive metabolic abnormalities in PCOS. Many of the Pakistani women do not realize the risks of too much fatty foods to their health due to lack of community awareness of the risks they are exposed into. There is therefore an urgent need of educating the women on the importance of having a balanced diet in their meals that comprises of both carbohydrates and less of the fatty and oily foods (Azziz 2005, pg. 130). Low sugar and physical activity The patients suffering from PCOS have high chances of contracting diabetes due to the too much sugar and glucose levels in their bodies. The Pakistani women suffering from PCOS are noted to have a desire of eating too much. This is often caused by too much insulin in the body that stimulates the person’s hunger and therefore eat too much. This will lead to the patient gaining more weight hence need for physical activity to help reduce the weight. Too much glucose in the body is also believed to cause metabolic syndrome among the women with PCOS and this increases the risk of coronary artery disease and it also causes insulin resistance in the body of these patients. These effects can be reduced by increased regular physical activity hence lowering the adverse risks of effects of PCOS to patients. Women who have PCOS are therefore encouraged to undergo regular exercises to help reduce the adverse effects of PCOS of contacting diabetes which is fatal. Community based health awareness is needed for the Pakistani women in Hounslow to create the awareness of the benefits of physical exercise and reducing the amount of sugar intake among the victims of PCOS so that they do not develop other diseases such as diabetes and hormonal imbalance but maintain the POCS at the lowest possible level (Bloodgarden 2004). The Strategy The strategy that will be developed aims at creating awareness to the Indian women in Hounslow on the adverse effects associated with Polycystic Ovary Syndrome (POCS) victims. Since the main course of the disease genetic and therefore it is hereditary, it cannot be treated. Its effects however can be minimised such as obesity, high blood pressure, diabetes, irregular ovulation, infertility. These can be reduced through proper ways of living and treatment. This strategy therefore will create a community based clinic that provides basic education to the women suffering from the PCOS on the benefits of physical therapy and balanced diet to help reduce the risk of them contacting other diseases. These patients will be given personal attention and advices by community based trained medical practitioners who will involve the women in physical exercises and psychological counselling to help reduce the chances of depression (Ahmed, Mohamed 2007 pg. 15). Objectives To help create awareness to the Pakistani Women on the dangers of PCOS and how to limit its adverse health effects. To introduce community based clinic among the residents of the Pakistanis to help increase the number of medical attenders to patients of PCOS To increase the knowledge on PCOS and help prevent the development of diseases such as diabetes, obesity, infertility, hypertension and heart cancer. Design The design of this strategy will be reducing the Health risks of PCOS victims: use of Random Survey over a period of one year at interval of six months. Setting The clinical practitioners to refer the victims of PCOS to the community based counselling and guidance session that will be held in almost all the households and nearby clinics. At these counselling sessions, the Pakistani women will be introduced to the “Fit for Mums” diets. For the physical exercises, the victims will be encouraged to visit the community gymnasium to help them reduce their weights. Criterion The patients will be advised to reduce their sugar and glucose intake to limit the insulin rise, to reduce the eating of too much fatty food without regular exercises which increases their insulin resistance and eventual hormonal imbalance. Standard The target is to have over 50% of the Pakistani women patients with reduced risks of diabetes, hypertension, obesity, depression, and instances of irregular ovulation after the first six months . Sources The main source of the financial support for this strategy will be obtained from Hounslow’s Local Strategy Partnership that is concerned with the counselling and welfare of the community members in the region. The clinic rooms that will be situated in different areas of the region will be used to provide treatment and counselling sessions for the victims. This will be after the approval by the Public Health and Sanitation body of the region. Clinical experts will provide adequate records of the type of equipment needed in accordance with the number of the victims in the region. This will ensure efficient use of the resources . Outcome and results measurements After the period of one year, the results obtained from Pakistani women who have reduced their weights and increase their hormonal balance will be measured. If the results are over the standard of over 50%, then the strategy is effective in reducing the risks associated with POCS. This can be done using simple random sampling of the patients after which a regression analysis is used to determine the accuracy of the outcome .(Acien, Pedro 2009, pg. 13) . Implementation The patients will be encouraged to visit the community based clinic on a regular basis to check their health progress. The community based nurses and physiotherapists will be advised to carry out door to door visits of the patients’ homes to provide counselling and knowledge on the required diet that should be adopted by the patients. These visits should be done for 3-4 weeks vey two months. There will also be the use of weighing machines that the medical practitioners will be using in households to measure if the patients are indeed attending the physical exercises sessions. Every household with the victims of POCS will be provided with a list of the required food that they should take and the period of taking the named food (Franks 2006, pg. 100). The Logic Model This provides an evaluation framework used to deliver the health care services to the PCOS Pakistani women having the hormonal imbalance, diabetes. It involves the activities that provide both the short-term and long-term solutions to the victims. The first column gives the risks; the second column gives the intervention while the third column gives the changes. Audit Cycle This audit will be vital to check if the team of clinical officers are working within the requirements. The target is to have over 50% of the victims of POCS in the programme to have reduced weight, reduced insulin resistance and reduced risks of having other diseases after one year among the Pakistani women in Hounslow. After the one year, the results will be collected, and then percentage be measured against the target. If the target is not met, then areas that need improvements are identified for rectification. The number of physical exercises carried out by the patients will also be tabulated for one year to determine if the target is being met Limitations/ areas of change If the results show a negative feedback, then more wok must be done on the strategy to ensure the target is achieved. The visits to the patients will be intensified for more periods almost every week. If the Pakistani women have a negative attitude on the physical exercise, they will be encouraged and advised adequately on its benefits on their health. 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