Healthy risk awareness motivates fracture prevention behaviour: A grounded theory study of women with osteoporosis

Abstract

Osteoporosis is a public health problem implying an increased risk of fractures. Successful fracture prevention contributes to prevention and treatment of osteoporosis as well as reduction of accidents from falling. Determinants such as lifestyle and environmental factors depend on human behaviour. In order to obtain a deeper understanding of the behavioural changes needed for fracture prevention, the aim of this study was to explore women's experience of living with osteoporosis and related lifestyle changes. In-depth interviews with 13 women diagnosed with osteoporosis were analysed according to the grounded theory method. The data formed a pattern in which developing healthy risk awareness is the key to motivating risk reduction behaviour as part of a fracture preventing lifestyle. The other five categories are elements in achieving healthy risk awareness: accepting having fragile bones, living with fear, needing to learn, and having confidence as well as experiencing a sense of social context. These findings might be useful to understand better the motivational process underpinning fracturepreventing behaviour among women with osteoporosis.

Women's experiences of their osteoporosis diagnosis at the time of diagnosis and 6 months later: A phenomenological hermeneutic study

“…According to fracture preventive behavior, it has been found to be a motivational process through which healthy risk awareness can be developed. The knowledge of fracture risk in everyday life may be handled well by some patients, but may affect others in a degree which could limit their daily activities (Hjalmarsson, Strandmark, & Klässbo, 2007; Nielsen et al, 2013). …”

Women’s lived experiences of learning to live with osteoporosis: a longitudinal qualitative study

“…Similarities may be drawn to the grounded theory study of “healthy risk awareness” [27], which develops through an emotional cognitive process of acceptance. Being motivated to act in a preventative way was found to impact upon acceptance, which underwent a development through the fear of having fragile bones [27].…”

“…Being motivated to act in a preventative way was found to impact upon acceptance, which underwent a development through the fear of having fragile bones [27]. Descriptions of fear in the current study were primarily elaborated through concerns related to the medical treatment, side effects and making the right choice, but also concerns regarding possible fractures [44].…”

“…Although this is of a smaller scale when compared to international findings [21, 22, 24, 25], it is still a problem from a fracture prevention perspective [16]. The decision-making process has been reported in other studies to be an emotional and cognitive learning process [27]; a sense-making process [8]; and a process of trial and error to find useful strategies [28]. One common limitation of these and other qualitative studies that investigate the decision-making process regarding medication use of individuals with osteoporosis appears to be the lack of studies with longitudinal design following patients’ experiences over time (no qualitative studies on this matter were found).…”

“…Despite extensive investigations of this phenomenon, it seems that the underlying causal explanations of medication failure (such as quitting treatment early or low compliance to treatment leading to lack of treatment efficacy) [23] have not yet been fully explored. It has been suggested that the research in the field of fracture prevention treatment needs to focus on patients’ own perceptions [23, 27, 28]. This type of research calls for the use of qualitative research methods to make the voices of those involved heard.…”