{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T01:04:20Z","timestamp":1790384660094,"version":"4.1.0"},"reference-count":28,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"unspecified","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,2,4]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Self-management emerges as paramount for effective outcomes in patients with polycystic ovary syndrome (PCOS) and acne. This study aimed to investigate the disease and self-management-related knowledge, attitude and practice (KAP) in PCOS patients with acne.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Demographic information and KAP scores were collected through a self-administered questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>This study enrolled PCOS patients with acne at Hebei Academy of Chinese Medicine Sciences between April and October 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Primary outcomes were the total scores for disease-related and self-management-related KAP and the proportions of participants with adequate levels in each KAP dimension. Secondary outcomes were the associations between KAP levels and sociodemographic and clinical characteristics, including employment status and duration since PCOS diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 489 valid questionnaires were enrolled, including 458 (93.66%) patients unmarried, with a mean age of 23.03\u00b12.46 years. The mean scores of KAP were 11.98\u00b14.82 (possible range: 0\u201320), 40.48\u00b13.16 (possible range: 11\u201355), 38.04\u00b13.92 (possible range: 9\u201345), respectively. Multivariate logistic regression analysis showed that people who were unemployed or without a fixed job had lower knowledge levels (OR=0.370, 95%\u2009CI 0.182 to 0.753, p=0.006), those who had suffered from PCOS for 1\u20133 years (OR=18.067, 95%\u2009CI 9.259 to 35.254, p&lt;0.001), those with PCOS for greater than or equal to 3 years (OR=19.195, 95%\u2009CI 7.508 to 49.074, p&lt;0.001) were associated with sufficient knowledge. Multiple linear regression analysis indicated that longer PCOS duration was significantly associated with higher total KAP scores, with 1\u20133 years (\u03b2=5.678, 95%\u2009CI 3.858 to 7.498, p&lt;0.001) and \u22653 years (\u03b2=5.817, 95%\u2009CI 3.170 to 8.465, p&lt;0.001) showing substantial positive associations compared with those diagnosed less than 6 months ago.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PCOS patients with acne had inadequate knowledge, active attitude and proactive practice towards disease and self-management. To enhance clinical practice, targeted educational interventions are recommended, specifically addressing the knowledge gaps observed in unemployed individuals and those in the early stages of PCOS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-103398","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T14:40:28Z","timestamp":1772203228000},"page":"e103398","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Disease-related and self-management-related knowledge, attitude and practice among patients with polycystic ovary syndrome and acne in Hebei, China: a cross-sectional study"],"prefix":"10.1136","volume":"16","author":[{"given":"Xiaoli","family":"Kou","sequence":"first","affiliation":[{"name":"The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimeng","family":"Ma","sequence":"additional","affiliation":[{"name":"Hebei Academy of Chinese Medicine Sciences, Shijiazhuang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingmo","family":"Li","sequence":"additional","affiliation":[{"name":"The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danning","family":"Pei","sequence":"additional","affiliation":[{"name":"The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoqiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7414-8644","authenticated-orcid":false,"given":"Zhiqiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"2026022706402206000_16.2.e103398.1","first-page":"281","article-title":"Bioinformatics identification of microRNAs involved in polycystic ovary syndrome based on microarray data","volume":"20","author":"Hou","year":"2019","journal-title":"Mol Med Rep"},{"key":"2026022706402206000_16.2.e103398.2","doi-asserted-by":"crossref","DOI":"10.1042\/BSR20181380","article-title":"Total flavonoids extracted from Nervilia Fordii function in polycystic ovary syndrome through IL-6 mediated JAK2\/STAT3 signaling pathway","volume":"39","author":"Zhou","year":"2019","journal-title":"Biosci Rep"},{"key":"2026022706402206000_16.2.e103398.3","doi-asserted-by":"crossref","unstructured":"Zhou G , Gu Y , Zhou F , et al . n.d. Adipocytes-Derived Extracellular Vesicle-miR-26b Promotes Apoptosis of Cumulus Cells and Induces Polycystic Ovary Syndrome. Front Endocrinol 12:789939. doi:10.3389\/fendo.2021.789939","DOI":"10.3389\/fendo.2021.789939"},{"key":"2026022706402206000_16.2.e103398.4","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.2147\/PPA.S207693","article-title":"A Chinese and Western medication adherence scale in patients with Chronic Kidney Disease","volume":"13","author":"Tan","year":"2019","journal-title":"Patient Prefer Adherence"},{"key":"2026022706402206000_16.2.e103398.5","doi-asserted-by":"crossref","first-page":"8527320","DOI":"10.1155\/2020\/8527320","article-title":"Development, Reliability, and Validity of the\u201cKnowledge\u2010Attitude\u2010Practice\u201d Questionnaire of Foreigners on Traditional Chinese Medicine Treatment","volume":"2020","author":"Li","year":"2020","journal-title":"Evid Based Complement Alternat Med"},{"key":"2026022706402206000_16.2.e103398.6","doi-asserted-by":"crossref","unstructured":"Khalid A , Haque S , Alvi S , et al . Promoting Health Literacy About Cancer Screening Among Muslim Immigrants in Canada: Perspectives of Imams on the Role They Can Play in Community. J Prim Care Community Health 2022;13. doi:10.1177\/21501319211063051","DOI":"10.1177\/21501319211063051"},{"key":"2026022706402206000_16.2.e103398.7","article-title":"Knowledge, Attitude, and Practice of Lifestyle Modifications Among Saudi Women Diagnosed With Polycystic Ovary Syndrome (PCOS)","volume":"15","author":"Aljuaid","year":"2023","journal-title":"Cureus"},{"key":"2026022706402206000_16.2.e103398.8","doi-asserted-by":"crossref","DOI":"10.1098\/rsos.201040","article-title":"Firing patterns of gonadotropin-releasing hormone neurons are sculpted by their biologic state","volume":"7","author":"Penix","year":"2020","journal-title":"R Soc Open Sci"},{"key":"2026022706402206000_16.2.e103398.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0285284","article-title":"Knowledge, attitude, and perceptions about polycystic ovarian syndrome, and its determinants among Pakistani undergraduate students","volume":"18","author":"Rizvi","year":"2023","journal-title":"PLoS ONE"},{"key":"2026022706402206000_16.2.e103398.10","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2022.829339","article-title":"Assessment of Knowledge, Attitude, and Practice of Obstetricians and Gynecologists Toward Off-Label Medicine Use in Female Reproductive Health Issues","volume":"10","author":"Shakeel","year":"2022","journal-title":"Front Public Health"},{"key":"2026022706402206000_16.2.e103398.11","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1080\/07399332.2021.1939348","article-title":"Body mass index, menstruation, acne, and hirsutism of polycystic ovary syndrome in women: A cross-sectional study","volume":"43","author":"Kim","year":"2022","journal-title":"Health Care Women Int"},{"key":"2026022706402206000_16.2.e103398.12","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2020.1859474"},{"key":"2026022706402206000_16.2.e103398.13","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-020-09767-2","article-title":"Clients\u2019 satisfaction with preventive services for malaria during pregnancy in Anambra state, Nigeria","volume":"20","author":"Obagha","year":"2020","journal-title":"BMC Public Health"},{"key":"2026022706402206000_16.2.e103398.14","first-page":"1","article-title":"How to calculate sample size for observational and experiential nursing research studies?","volume":"10","author":"Sharma","year":"2019","journal-title":"Natl J Physiol Pharm Pharmacol"},{"key":"2026022706402206000_16.2.e103398.15","doi-asserted-by":"crossref","DOI":"10.1210\/jendso\/bvac003","article-title":"Female Adult Acne and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee","volume":"6","author":"Carmina","year":"2022","journal-title":"J Endocr Soc"},{"key":"2026022706402206000_16.2.e103398.16","doi-asserted-by":"crossref","DOI":"10.3390\/ijms21218211","article-title":"Polycystic Ovary Syndrome: A Brain Disorder Characterized by Eating Problems Originating during Puberty and Adolescence","volume":"21","author":"Steegers-Theunissen","year":"2020","journal-title":"Int J Mol Sci"},{"key":"2026022706402206000_16.2.e103398.17","article-title":"Improving Asthma Management: Patient-Pharmacist Partnership Program in Enhancing Therapy Adherence","volume":"10","author":"Makhinova","year":"2022","journal-title":"Pharmacy (Basel)"},{"key":"2026022706402206000_16.2.e103398.18","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2023.e13715","article-title":"Effects of psychosocial interventions for caregivers of breast cancer patients: A systematic review and meta-analysis","volume":"9","author":"Liu","year":"2023","journal-title":"Heliyon"},{"key":"2026022706402206000_16.2.e103398.19","doi-asserted-by":"crossref","DOI":"10.1016\/j.pmedr.2022.101968","article-title":"User-centered approach in the development of an eHealth tool for self-management skills in functional insulin therapy to prevent complications of diabetes","volume":"29","author":"Fezzi","year":"2022","journal-title":"Prev Med Rep"},{"key":"2026022706402206000_16.2.e103398.20","doi-asserted-by":"crossref","unstructured":"Elbers S , Pool J , Wittink H , et al . n.d. Mobile Health App (AGRIPPA) to Prevent Relapse After Successful Interdisciplinary Treatment for Patients With Chronic Pain: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 9:e18632. doi:10.2196\/18632","DOI":"10.2196\/18632"},{"key":"2026022706402206000_16.2.e103398.21","doi-asserted-by":"crossref","DOI":"10.1186\/s12875-018-0810-x","article-title":"A protocol for a cluster randomized trial comparing strategies for translating self-management support into primary care practices","volume":"19","author":"Dickinson","year":"2018","journal-title":"BMC Fam Pract"},{"key":"2026022706402206000_16.2.e103398.22","doi-asserted-by":"crossref","DOI":"10.1186\/s12905-020-01090-7","article-title":"\u201cThe whole package deal\u201d: experiences of overweight\/obese women living with polycystic ovary syndrome","volume":"20","author":"Ee","year":"2020","journal-title":"BMC Womens Health"},{"key":"2026022706402206000_16.2.e103398.23","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-061309","article-title":"Patient-centered outcomes for gastrointestinal cancer care: a scoping review protocol","volume":"12","author":"Yang","year":"2022","journal-title":"BMJ Open"},{"key":"2026022706402206000_16.2.e103398.24","doi-asserted-by":"crossref","DOI":"10.1186\/s13584-017-0194-8","article-title":"Implementation of a competency-based medical education approach in public health and epidemiology training of medical students","volume":"7","author":"Dankner","year":"2018","journal-title":"Isr J Health Policy Res"},{"key":"2026022706402206000_16.2.e103398.25","doi-asserted-by":"crossref","DOI":"10.1002\/advs.201801039","article-title":"Engineering Precision Medicine","volume":"6","author":"Sun","year":"2019","journal-title":"Adv Sci (Weinh)"},{"key":"2026022706402206000_16.2.e103398.26","doi-asserted-by":"crossref","DOI":"10.1155\/2021\/6616693","article-title":"The Antiobesity Effect of GLP-1 Receptor Agonists Alone or in Combination with Metformin in Overweight \/Obese Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis","volume":"2021","author":"Lyu","year":"2021","journal-title":"Int J Endocrinol"},{"key":"2026022706402206000_16.2.e103398.27","doi-asserted-by":"crossref","unstructured":"Perche P , Peck G , Robinson L , et al . n.d. Prescribing Trends for Acne Vulgaris Visits in the United States. Antibiotics (Basel) 12:269. doi:10.3390\/antibiotics12020269","DOI":"10.3390\/antibiotics12020269"},{"key":"2026022706402206000_16.2.e103398.28","doi-asserted-by":"crossref","first-page":"2436","DOI":"10.1210\/clinem\/dgab232","article-title":"Clinical Practice Guidelines on the Diagnosis and Management of Polycystic Ovary Syndrome: A Systematic Review and Quality Assessment Study","volume":"106","author":"Al Wattar","year":"2021","journal-title":"J Clin Endocrinol Metab"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-103398","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T14:40:31Z","timestamp":1772203231000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-103398"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":28,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,27]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bmjopen-2025-103398"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-103398","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}