Self-Reported Symptoms and Health Literacy of Polycystic Ovary Syndrome (PCOS) Among Student and Registered
Nurses in a Tertiary-Care Hospital of a Low-Income Country: Associations with Dietary Habits and Workload
(All responses are confidential. Please answer honestly.)
Section A: Demographic Information
Age (in years): ☐ 18–25 ☐ 26–30 ☐ 31–35 ☐ 36–45 Marital Status: ☐ Single ☐ Married
Height (feet): ______ Weight (kg): ______ Waist Circumference (cm): _______
Acanthosis nigricans (thickened, velvety appearance of skin): ☐ Yes ☐ No
If yes, please mention the number of sites involved (1–3) or 0: _____
Designation:
☐ Student Nurse (Year 1) ☐ Registered Nurse
☐ Student Nurse (Year 2) ☐ MBBS Doctor (4th year)
☐ Student Nurse (Year 3) ☐ MBBS Doctor (5th year)
☐ Student Nurse (Final Year) ☐ House Officer
Years of Service (for RNs and House Officers only):
☐ < 1 year ☐ 1–3 years ☐ 4–7 years ☐ > 7 years ☐ Not applicable
Current Posting:
☐ Ward ☐ ICU ☐ Emergency ☐ OPD ☐ Operation Theatre ☐ Other ☐ Not applicable
City of Work:
☐ Lahore ☐ Hyderabad ☐ Multan ☐ Peshawar ☐ Gilgit ☐ Other: ______
Section B: Workload and Lifestyle Profile
Duty Hours per Week:
☐ < 30 hours ☐ 30–40 hours ☐ > 40 hours ☐ Not applicable
Night Shifts per Month:
☐ 0 ☐ 1–2 ☐ 3–4 ☐ > 4 ☐ Not applicable
Sleep Duration per Night:
☐ < 5 hours ☐ 6–7 hours ☐ ≥ 8 hours ☐ Not applicable
Rest Between Shifts (minimum 3 hours):
☐ Adequate ☐ Sometimes adequate ☐ Inadequate
Fatigue After Duty: ☐ Never ☐ Occasionally ☐ Frequently ☐ Always
Perceived Stress Level (Likert Scale 1–5; 1 = no stress, 5 = very high stress) ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ 5
Do you skip meals due to workload? ☐ Never ☐ 1–2 times/week ☐ 3–4 times/week ☐ Daily
Section C: Self-Reported PCOS Symptom Checklist (Based on self-reported Rotterdam criteria)
Menstrual Patterns
Age of Menarche: ☐ < 8 years ☐ 8–10 years ☐ > 10 years
How long is your Usual Menstrual Cycle Length:
☐ < 21 days ☐ 21–35 days ☐ > 35 days ☐ Irregular/Varies
Have you Missed periods for more than 2 months (excluding pregnancy): ☐ Yes ☐ No
Hyperandrogenism Symptoms
Excessive facial/body hair: ☐ Yes ☐ No ☐ Not sure
If yes, please score according to the provided scale: ______
Body Area 0 1 2 3 4
Upper Lip ○ ○ ○ ○ ○
Chin ○ ○ ○ ○ ○
Chest ○ ○ ○ ○ ○
Upper Abdomen ○ ○ ○ ○ ○
Lower Abdomen ○ ○ ○ ○ ○
Arms ○ ○ ○ ○ ○
Thighs ○ ○ ○ ○ ○
Upper Back ○ ○ ○ ○ ○
Lower Back ○ ○ ○ ○ ○
Do you have moderate to severe acne
☐ Yes ☐ No
Primary site of acne (mention site number): ______
Hair thinning or hair loss:
☐ Yes ☐ No
If yes, please mention grade number or 0: ______
Weight and Metabolic Features
Have you Unexplained weight gain in the last 6 months:
☐ Yes ☐ No
Do you find it Difficulty losing weight despite effort:
☐ Yes ☐ No
Have you been Diagnosed with impaired sugar levels or diabetes: ☐ Yes ☐ No ☐ Not applicable
Other Common Symptoms
Do you frequently experience Mood swings: ☐ Yes ☐ No
Do you feel Persistent fatigue: ☐ Yes ☐ No
Any Concerns about infertility: ☐ Yes ☐ No ☐ Prefer not to say
Section D: Health Literacy on PCOS (HL-PCOS – 17 Items)
Knowledge
PCOS is a hormonal disorder affecting women of reproductive age. ☐ Yes ☐ No ☐ Don’t know
Irregular menstrual cycles are a common feature of PCOS. ☐ Yes ☐ No ☐ Don’t know
PCOS can cause excessive facial/body hair. ☐ Yes ☐ No ☐ Don’t know
PCOS increases the risk of diabetes and obesity. ☐ Yes ☐ No ☐ Don’t know
PCOS can affect fertility. ☐ Yes ☐ No ☐ Don’t know
Comprehension
Lifestyle modification (diet and exercise) is the first treatment step. ☐ Yes ☐ No ☐ Don’t know
Oral contraceptives may help regulate menstrual cycles in PCOS. ☐ Yes ☐ No ☐ Don’t know
Metformin has a role in the management of PCOS. ☐ Yes ☐ No ☐ Don’t know
PCOS requires timely medical evaluation to prevent complications. ☐ Yes ☐ No ☐ Don’t know
Weight reduction improves PCOS symptoms. ☐ Yes ☐ No ☐ Don’t know
Not every woman with PCOS has cysts on pelvic ultrasound. ☐ Yes ☐ No ☐ Don’t know
Application
Women with irregular periods should seek clinical evaluation. ☐ Yes ☐ No ☐ Don’t know
Women with PCOS should monitor their weight regularly. ☐ Yes ☐ No ☐ Don’t know
Healthy eating reduces long-term PCOS complications. ☐ Yes ☐ No ☐ Don’t know
Stress management is important in PCOS control. ☐ Yes ☐ No ☐ Don’t know
If Women with excessive body hair and irregular cycles ☐ Yes ☐ No ☐ Don’t know
should be screened for PCOS
Regular exercise improves insulin resistance in PCOS. ☐ Yes ☐ No ☐ Don’t know
PCOS management requires long-term follow-up. ☐ Yes ☐ No ☐ Don’t know
Section E: Dietary Pattern Questionnaire
How often do you eat breakfast? ☐ Daily ☐ 4–5 times/week ☐ 2–3 times/week ☐ Rarely/Never
Fruit intake per day: ☐ ≥ 2 servings ☐ 1 serving ☐ < 1 serving ☐ Rare
Vegetable intake per day: ☐ ≥ 2 servings ☐ 1 serving ☐ < 1 serving
Protein sources per day (eggs, meat, lentils): ☐ ≥ 2 servings ☐ 1 serving ☐ < 1 serving
Sugary drink consumption (cola/juices): ☐ Daily ☐ 3–4/week ☐ 1–2/week ☐ Rare
Fast food/junk food intake: ☐ > 3 times/week ☐ 1–2 times/week ☐ < 1/week ☐ Rare
Do you frequently skip meals? ☐ Yes ☐ No
Section F: Additional Variables
Family history of PCOS: ☐ Yes ☐ No ☐ Not sure
Family history of diabetes or obesity: ☐ Yes ☐ No ☐ Not sure
Smoking status: ☐ Yes ☐ No
Level of physical activity: ☐ High ☐ Moderate ☐ Low/Sedentary
How many days per week physically active: ☐ Daily ☐ 4 days ☐ 2 days ☐ None
Section G: Laboratory Investigations
Have you undergone any of the below mentioned tests, if yes please mention the results. If no, please write 0
Serum testosterone (ng/dl): ______ Prolactin (ng/dl): ______ TSH (IU): ______
Ultrasound pelvis:_________ AMH (ng/dl): ______
Section H: Medication History
Metformin: ☐Yes☐ No Oral contraceptives :☐Yes☐No Anti-androgens (Aldactone):☐Yes☐No
Section I: Consent
Do you voluntarily agree to participate in this study? ☐ Yes ☐ No
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