1
|
Zubick P, Dahlke S. Family/caregiver influence on osteoporosis management for older people: an integrative review. Osteoporos Int 2024; 35:1153-1163. [PMID: 38622263 DOI: 10.1007/s00198-024-07081-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/22/2024] [Indexed: 04/17/2024]
Abstract
An integrative literature review was conducted to understand family/caregiver influence on osteoporosis management for older people. Findings include caregivers' overprotection, caregivers' risks for fragility fractures due to caregiving role, poor bone health in caregivers, and caregivers' burden and facilitators. Caregivers should be included in bone health and discharge planning. Literature on family/caregiver influence on osteoporosis management for older people is sparse. Older people are prone to osteoporosis and fragility fractures due to their age, often triggering the need for a caregiver after experiencing a fragility fracture. These fractures pose significant costs to the patient and health systems and are projected to increase with the aging population. This study applied an integrative literature review methodology to key literature findings on family/caregiver influence on osteoporosis management for older people. Key findings include caregivers' tendency to overprotect persons who experience hip fracture by limiting mobilization, thus impeding recovery, caregivers' risks for their own fragility fractures due to the demands of their caregiving role, risks of poor bone health in caregivers, and caregivers' experience of significant burden for which facilitators have been identified. Family caregivers of older people with osteoporosis have unique needs and require support and resources, especially after their loved one experiences a hip fracture. Informal caregivers must be considered in bone health education and discharge planning. They should be considered in the creation of osteoporosis guidelines and within the work of fracture liaison services. More research is needed to increase understanding about family caregiver influence on osteoporosis management.
Collapse
Affiliation(s)
- Paula Zubick
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada.
| |
Collapse
|
2
|
Manning FM, Mughal F, Ismail HASM, Baines LM, Chew-Graham CA, Paskins Z, Prior JA. Osteoporosis and fracture as risk factors for self-harm and suicide: a systematic review and meta-analysis. Br J Gen Pract 2023; 73:e735-e743. [PMID: 37722857 PMCID: PMC10523335 DOI: 10.3399/bjgp.2023.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/03/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Increase in presentations of self-harm to primary care, a risk factor of suicide, has led to a growing interest in identifying at-risk populations. AIM To examine whether osteoporosis or fractures are risk factors for self-harm, suicidal ideation, and suicide. DESIGN AND SETTING This was a systematic review of observational studies in adults (>18 years) that had examined the role of osteoporosis and/or fractures in subsequent self-harm, suicidal ideation, and/or suicide. METHOD Six databases were searched from inception to July 2019. Additional citation tracking of eligible studies was undertaken in November 2022. Screening, data extraction, and quality assessment of full-text articles were performed independently by at least two authors. Where possible, meta-analysis was run on comparable risk estimates. RESULTS Fifteen studies were included: two examined the outcome of self-harm, three suicidal ideation, and 10 suicide. In approximately half of studies on osteoporosis, the risk of suicidal ideation and suicide remained significant. However, pooling of adjusted odds ratios from three studies indicated no association between osteoporosis and suicide (1.14, 95% confidence interval = 0.88 to 1.49). Nine studies examined the risk of a mixture of fracture types across different outcomes, limiting comparisons. However, all studies examining vertebral fracture (n = 3) reported a significant adjusted negative association for self-harm and suicide. CONCLUSION Patients with vertebral fractures, a risk potential factor for suicide, may benefit from clinical case finding for mood disorders with personalised primary care management. However, because of the limited number and quality of studies and mixed findings, further examination of these associations is warranted.
Collapse
Affiliation(s)
- Fay M Manning
- School of Medicine, Keele University, Keele, and Department of Medical Imaging, University of Exeter, Exeter, UK
| | - Faraz Mughal
- School of Medicine, Keele University, Keele; Centre for Mental Health and Safety, Division of Psychology and Mental Health, University of Manchester, Manchester; and honorary clinical research fellow, Warwick Medical School, Warwick, UK
| | | | | | | | - Zoe Paskins
- Keele University, Keele, and Haywood Academic Rheumatology Centre, Midlands Partnership Foundation Trust, Stoke-on-Trent, UK
| | - James A Prior
- School of Medicine, Keele University, Keele, and Haywood Academic Rheumatology Centre, Midlands Partnership Foundation Trust, Stoke-on-Trent, UK
| |
Collapse
|
3
|
Sale JEM. The role of analytic direction in qualitative research. BMC Med Res Methodol 2022; 22:66. [PMID: 35282835 PMCID: PMC8918296 DOI: 10.1186/s12874-022-01546-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/11/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The literature on qualitative data analysis mostly concerns analyses pertaining to an individual research question and the organization of data within that research question. Few authors have written about the entire qualitative dataset from which multiple and separate analyses could be conducted and reported. The concept of analytic direction is a strategy that can assist qualitative researchers in deciding which findings to highlight within a dataset. The objectives of this paper were to: 1) describe the importance of analytic direction in qualitative research, and 2) provide a working example of the concept of analytic direction.
Methods
A qualitative dataset from one of the author’s research programs was selected for review. Ten potential analytic directions were identified after the initial phenomenological analysis was conducted. Three analytic directions based on the same coding template but different content areas of the data were further developed using phenomenological analysis (n = 2) and qualitative description (n = 1) and are the focus of this paper. Development and selection of these three analytic directions was determined partially relying on methodological criteria to promote rigour including a comprehensive examination of the data, the use of multiple analysts, direct quotations to support claims, negative case analysis, and reflexivity.
Results
The three analytic directions addressed topics within the scope of the overall research question. Each analytic direction had its own central point or story line and each highlighted a different perspective or voice. The use of an inductive and deductive approach to analysis and how the role of theory was integrated varied in each analytic direction.
Conclusions
The concept of analytic direction enables researchers to organize their qualitative datasets in order to tell different and unique “stories”. The concept relies upon, and promotes, the conduct of rigourous qualitative research.
Collapse
|
5
|
Rothmann MJ, Jakobsen PR, Jensen CM, Hermann AP, Smith AC, Clemensen J. Experiences of being diagnosed with osteoporosis: a meta-synthesis. Arch Osteoporos 2018; 13:21. [PMID: 29511831 DOI: 10.1007/s11657-018-0436-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 02/15/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED This systematic review provides synthesised knowledge and guidance to health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point of view. Using individuals' experiences and meanings can promote tailored and targeted information and guidance on osteoporosis, bone care and treatment at different stages of the osteoporosis trajectory. INTRODUCTION To be diagnosed with osteoporosis with or without fragility fractures affects individuals differently. The aim of this review was firstly to aggregate existing qualitative evidence regarding an individual's experience of being diagnosed with osteoporosis at different stages, and secondly, to use a systematic approach to develop a conceptual understanding of central issues relevant for health professionals in order to provide support and guidance to patients/individuals. METHODS This study used a systematic review methodology and methods for qualitative synthesis as recommended by Cochrane and integrated the findings of qualitative research from eight databases (Medline, PubMed, CINAHL, Embase, SweMed+, PsycINFO, ERIC, Web of Science) to July 2016. Selection and assessment were performed by three authors while four authors were involved in the analysis. Findings were cross-checked with the original article to ensure consistency with the individual's accounts. RESULTS Our findings have revealed that individuals diagnosed with osteoporosis do not perceive osteoporosis as a biomedical trajectory but as a self-perceived continuum of severity and health. To be diagnosed with osteoporosis affects individuals differently depending on, for example, personal experience, pre-conceived notions of or knowledge about the disease, fragility fractures or pain. Hence, individuals will create a meaning of the diagnosis based on self-perceived fracture risk, self-perceived severity of osteoporosis and at the same time, self-perceived health. CONCLUSIONS This meta-synthesis provides knowledge for health professionals on the experiences and perspectives of being diagnosed with osteoporosis from the patient's point of view. The experience, meaning and significance of osteoporosis must be taken into consideration and can be used to promote tailored and targeted information and guidance on osteoporosis, bone care and treatment at different stages of the osteoporosis trajectory.
Collapse
Affiliation(s)
- M J Rothmann
- Department of Endocrinology, Odense University Hospital, Kloevervaenget 6, 8.sal, 5000, Odense C, Denmark. .,Department of Rheumatology, Odense University Hospital, Odense, Denmark. .,Department of Clinical Research, University of Southern Denmark, Odense, Denmark. .,Centre for Innovative Medical Technology, University of Southern Denmark & Odense University Hospital, Odense, Denmark.
| | - P R Jakobsen
- Department of Endocrinology, Odense University Hospital, Kloevervaenget 6, 8.sal, 5000, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Centre for Innovative Medical Technology, University of Southern Denmark & Odense University Hospital, Odense, Denmark
| | - C M Jensen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Centre for Innovative Medical Technology, University of Southern Denmark & Odense University Hospital, Odense, Denmark.,Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
| | - A P Hermann
- Department of Endocrinology, Odense University Hospital, Kloevervaenget 6, 8.sal, 5000, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - A C Smith
- Centre for Innovative Medical Technology, University of Southern Denmark & Odense University Hospital, Odense, Denmark.,Centre for Online Health, University of Queensland, Brisbane, QLD, Australia
| | - J Clemensen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Centre for Innovative Medical Technology, University of Southern Denmark & Odense University Hospital, Odense, Denmark
| |
Collapse
|