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Hirsutism and quality of life with aspects on social support, anxiety and depression
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Hirsutism is excessive hair growth in women. The prevalence is estimated at 5%. The aim of this thesis was to describe different aspects of how life is affected for women suffering from hirsutism. Both qualitative and quantitative methods were used. Study I showed that hirsutism deeply affects women’s experiences of their bodies in a negative way and was experienced as a life sorrow. In Study II the patient-physician relationship was described. The patient-physician relationship from the patient’s perspective was suboptimal, as most meetings included feelings of being rejected and even humiliation. In Study III the aim was to translate and psychometrically evaluate an instrument that measures perceived social support, “The Multidimensional Scale of Perceived Social Support” (MSPSS). The translation was performed according to WHO:s official process, and validation was performed in a sample that consisted of 281 participants, 127 women with hirsutism (main sample) and 154 nursing students. MSPSS had good psychometric properties with regard to factor structure, construct validity, internal consistency and reproducibility. Study IV described different aspects of HRQoL in the main sample, the correlation of anxiety, depression, level of hairiness, age and BMI. The F-G scores were dichotomized into minor (F-G ≤14) and major (F-G≥15) hair growth. Higher levels of hair growth were significantly correlated to a lower level of QoL measured by DLQI, EQ-5D and symptoms of both anxiety and depression measured by HADS. Study V investigated if social support was associated with quality of life and outcome of HRQoL compared to a reference group of women (n=1115). SF-36, the MSPSS and the F-G scale were used. Compared to the reference group, women with hirsutism reported lower quality of life in all dimensions of SF-36 (p<0.01) The dimension most affected was vitality (VT=41.2), which had a lower value than has been reported for patients with MS and myasthenia gravis. A Multiple Regression Analysis showed a significant relation between quality of life and social support, indicating its importance for the ability to adapt, in spite of low quality of life.

Place, publisher, year, edition, pages
Örebro: Örebro university , 2013. , 90 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 98
Keyword [en]
hirsutism, HRQoL, EQ-5D, DLQI, HADS, SF-36, MSPSS
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-32020Libris ID: 14739398ISBN: 978-91-7668-979-0 (print)OAI: oai:DiVA.org:oru-32020DiVA: diva2:656383
Public defence
2013-12-13, Bomanssonsalen, Örebro universitetssjukhus, S Grev Rosengatan, 703 62 Örebro, 13:00 (English)
Opponent
Supervisors
Available from: 2013-10-15 Created: 2013-10-15 Last updated: 2016-12-02Bibliographically approved
List of papers
1. "It is always on my mind": women's experiences of their bodies when living with hirsutism
Open this publication in new window or tab >>"It is always on my mind": women's experiences of their bodies when living with hirsutism
2009 (English)In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 30, no 5, 358-372 p.Article in journal (Refereed) Published
Abstract [en]

Many women suffer from excessive hair growth, often in combination with polycystic ovarian syndrome (PCOS). It is unclear how hirsutism influences such women's experiences of their bodies. Our aim is to describe and interpret women's experiences of their bodies when living with hirsutism. Interviews were conducted with 10 women with hirsutism. We used a qualitative latent content analysis. Four closely intertwined themes were disclosed: the body was experienced as a yoke, a freak, a disgrace, and as a prison. Hirsutism deeply affects women's experiences of their bodies in a negative way.

Place, publisher, year, edition, pages
London: Taylor & Francis, 2009
National Category
Medical and Health Sciences Dermatology and Venereal Diseases
Research subject
Dermatology and Venerology
Identifiers
urn:nbn:se:oru:diva-11650 (URN)10.1080/07399330902785133 (DOI)19350434 (PubMedID)
Available from: 2010-08-27 Created: 2010-08-27 Last updated: 2017-03-26Bibliographically approved
2. “We feel rejected”: experiences of women with hirsutism consulting physicians
Open this publication in new window or tab >>“We feel rejected”: experiences of women with hirsutism consulting physicians
2011 (English)In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 32, no 3, 157-159 p.Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to describe how women with hirsutism experience their relationship with health care. Data were collected by tape-recorded individual interviews, which were analyzed by means of qualitative content analysis. The results showed that the relationship with health care, from the perspective of patients with hirsutism, is suboptimal.

Place, publisher, year, edition, pages
Informa Healthcare, 2011
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-17020 (URN)10.3109/0167482X.2011.599461 (DOI)000293692200008 ()21824045 (PubMedID)2-s2.0-80051707123 (Scopus ID)
Available from: 2011-09-07 Created: 2011-09-02 Last updated: 2017-02-09Bibliographically approved
3. The Swedish version of the multidimensional scale of perceived social support (MSPSS): a psychometric evaluation study in women with hirsutism and nursing students
Open this publication in new window or tab >>The Swedish version of the multidimensional scale of perceived social support (MSPSS): a psychometric evaluation study in women with hirsutism and nursing students
2013 (English)In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 11, no 168Article in journal (Refereed) Published
Abstract [en]

Background: The Multidimensional Scale of Perceived Social Support (MSPSS) is a short instrument, developed to assess perceived social support. The original English version has been widely used. The original scale has demonstrated satisfactory psychometric properties in different settings, but no validated Swedish version has been available. The aim was therefore to translate, adapt and psychometrically evaluate the Multidimensional Scale of Perceived Social Support for use in a Swedish context.

Method: In total 281 participants accepted to join the study, a main sample of 127 women with hirsutism and a reference sample of 154 nursing students. The MSPSS was translated and culturally adapted according to the rigorous official process approved by WHO. The psychometric evaluation included item analysis, evaluation of factor structure, known-group validity, internal consistency and reproducibility.

Results: The original three-factor structure was reproduced in the main sample of women with hirsutism. An equivalent factor structure was demonstrated in a cross-validation, based on the reference sample of nursing students. Known-group validity was supported and internal consistency was good for all scales (α = 0.91-0.95). The test-retest showed acceptable to very good reproducibility for the items (κw = 0.58-0.85) and the scales (ICC = 0.89-0.92; CCC = 0.89-0.92).

Conclusion:The Swedish version of the MSPSS is a multidimensional scale with sound psychometric properties in the present study sample.

Place, publisher, year, edition, pages
BioMed Central, 2013
Keyword
Psychometrics, Validation, Hirsutism, Social support, Translations
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-32708 (URN)10.1186/1477-7525-11-168 (DOI)000326568500001 ()24112950 (PubMedID)2-s2.0-84885097900 (Scopus ID)
Available from: 2013-12-10 Created: 2013-12-10 Last updated: 2017-03-26Bibliographically approved
4. Health-Related Quality of Life,Depression and Anxiety Correlate with the Degree of Hirsutism
Open this publication in new window or tab >>Health-Related Quality of Life,Depression and Anxiety Correlate with the Degree of Hirsutism
2013 (English)In: Dermatology, ISSN 1018-8665, E-ISSN 1421-9832, Vol. 227, no 3, 278-284 p.Article in journal (Refereed) Published
Abstract [en]

Background: Hirsutism has a negative impact on women’s quality of life. The relation between quality of life, anxiety, depression and the level of hairiness has not been described.

Aims: To investigate the correlations between the levels of hairiness, quality of life, anxiety and depression. Methods: 200 patients from Malmö, Örebro and Uppsala, who had been in contact with the clinics for problems with excessive hair growth, were invited to answer a self-administered questionnaire including sociodemographic questions, EQ- 5D index score, Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS) and Ferriman- Gallwey scale (F-G); of these, 127 women participated in the study.

Results: The mean values were: EQ-5D index 0.73 (SD = 0.27), EQ visual analogue scale 61.0 (SD = 22.6), HADSanxiety 9.5 ± 5.3 and HADS-depression 6.5 ± 4.6. The mean DLQI was 11.8 ± 8.4, indicating a very large effect on patients’ lives. All were significantly correlated with the amount of hairiness.  

Conclusions: Higher levels of hair growth were significantly correlated with a lower level of quality of life and symptoms of both anxiety and depression.

Keyword
hirsutism, ferriman-gallwey scale, poor health-related quality of life, dermatology life quality index, eq-5d index score, hospital, anxiety and depression scale, low health status

National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-32710 (URN)10.1159/000355356 (DOI)000327675500014 ()24107472 (PubMedID)
Note

Funding Agency: Nyckelfonden; Örebro County Council

Available from: 2013-12-10 Created: 2013-12-10 Last updated: 2017-03-17Bibliographically approved
5. Social support and quality of life among women diagnosed with hirsutism
Open this publication in new window or tab >>Social support and quality of life among women diagnosed with hirsutism
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: Women with hirsutism report more anxiety, depression and lower quality of life. However, their social situation with a family and employment does not differ from other women. Social support is a factor that might increase quality of life in chronic diseases. Little is known about social support and skin diseases.

Objectives: The aim was to evaluate the relation between health-related quality of life and social support among women with hirsutism.

Methods: A questionnaire including socio-demographic questions, Short Form 36 (SF-36), the Multidimensional Scale of Perceived Social Support (MSPSS) and a self-estimation of hairiness using the Ferriman-Gallway scale (F-G scale) was filled out by 127. MSPSS has three sub-scales (family, friends, significant others) and a total score, that was used for calculation.

Results: Compared to a Swedish population based reference group women with hirsutism reported lower quality of life in all dimensions of SF-36 (p<0.01). Multiple regression analysis showed a significant correlation between the MSPSS and SF-36 in the initial and adjusted model.

Conclusions: There is a significant positive relation between quality of life and social support, demonstrating its importance for the ability to adapt to problems associated with hirsutism. It can be postulated that social support is important for the quality of life in chronic skin diseases wich merits further investigations.

Keyword
hirsutism; health-related quality of life; social support.
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-32839 (URN)
Available from: 2013-12-19 Created: 2013-12-19 Last updated: 2013-12-19Bibliographically approved

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