Osteoporotic Caucasian and South Asian women: a qualitative study of general practitioners' support

Abstract

Health professionals face two complicated but contradictory epidemics: obesity and osteoporosis (OP). While obesity is obvious, OP progresses silently affecting one in two UK women. Both South Asian and Caucasian women are at OP risk. This study compared experiences of osteoporotic Caucasian and South Asian women in a purposive sample of 21 volunteers from south east England, aged 43 to 82 years. The women had been diagnosed for eight months to 40 years. Long disease duration was marked by complacent OP dialogue, although OP was objectionable and marked a loss of quality of life. Inductive content analysis of transcripts showed that 'uncertainty'--about one another and about what constituted helpful self-care--affected both GPs and patients. Instead, support groups and the media supported learning about OP care. Beyond providing drug prescriptions, women reported desiring, but rarely feeling, that GPs fully supported their preferences for self-care. Self-care often included specialist exercise classes. Some younger women led their GPs to better understand the range of self-care options. GPs were seen as being unsure about how and when to discuss physical activity (PA). In conclusion, women with OP in this sample are sensitive to their GP's hesitance about offering detailed PA recommendations. Regardless of ethnicity, younger women undertook PA based on personal initiative. Positive PA experiences stimulated an interest in discussing PA with GPs, and these dialogues broke the silence surrounding OP care. By providing important information regarding the OP patient experience, the findings highlight the unmet desire of OP sufferers for better and closer attention from GPs.

What are the barriers and facilitators to exercise and physical activity uptake and adherence among South Asian older adults: A systematic review of qualitative studies

“…Investigations were conducted in Canada and the UK. Participants included SA men and women with the following conditions who were advised to undertake PA to improve their health: CHD (Bedi et al, 2008;Darr et al, 2008;Galdas et al, 2011;King et al, 2006;Webster et al, 2002), diabetes (Webster et al, 2002), osteoporosis (McKenna and Ludwig, 2008) and for the prevention of falls (Horne et al, 2009(Horne et al, , 2010. Indian Sikh, Indian Gujarati and Pakistani Muslim individuals were represented, but not those originating from Bangladesh or Sri Lanka.…”

“…Dependency on family for instrumental support, such as transport and translation (Horne et al, 2010;King et al, 2006;Lawton et al, 2006;McKenna and Ludwig, 2008;Ollife et al, 2007Ollife et al, , 2009) influenced older adults' ability to access advice, health services and to negotiate language barriers during consultations.…”

“…Advancing age was also cited as limiting their capacity to exercise (McKenna and Ludwig, 2008), with illness regarded as an inevitable consequence of growing older (Ollife et al, 2007).…”

Review of Barriers to Engaging Black and Minority Ethnic Groups in Physical Activity in the United Kingdom

“…Ethnicity was described by all the studies with 10 out of 18 papers restricted to South Asians mainly Indians, Pakistan, and Bangladesh (McKenna & Ludwig 2008;Sriskantharajah & Kai 2006;Carroll et al 2002;Lawton et al 2006;Khanam & Costarelli 2008;Farooqi et al 2000;Snape & Binks 2008;Burney 2006;Khunti et al 2007). Six studies combined mixed populations of South Asians, Whites and/or Afro-Caribbean (Greenhalgh et al 1998;Mahoney 1992;Jolly 2007;Darr et al 2008; Health Education Authority 1999; Rai & Finch 1997) while one study each focused on Afro-Caribbean (Molokhia & Oakeshott 2000) and West Africans (Elam et al 2001).…”

Systematic scoping review of patients’ perceived needs of health services for osteoporosis

“…Of the included studies, 20 were from North America 34,35,37-40,43,45-48,52,54-57,59,60,64,65 , 6 from Europe 41,42,50,53,61,67 , 3 from the United Kingdom 36,49,51 , 1 from South America 66 and 1 from the Middle-east 63 . There was 1 multi-centre study 44 .…”