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Ribeiro EM, Silva EDC, Sera EAR, Borges TA, Dias MF, Travassos A, Osório NB, Silva Neto LS. Bone health education programs for older people: an integrative review. CIENCIA & SAUDE COLETIVA 2023; 28:2025-2034. [PMID: 37436316 DOI: 10.1590/1413-81232023287.10602022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/10/2022] [Indexed: 07/13/2023] Open
Abstract
Osteoporosis is a systemic disease characterized by a reduction in bone mineral density. The dissemination of knowledge about the disease can be a viable alternative for promoting preventive behavior and self-care. This study sought to identify the main characteristics of bone health programs for older persons. We conducted an integrative review, searching for studies published between 2011 and 2022 in the CAPES periodicals database, Web of Science, PubMed, and Google Scholar using English descriptors. A total of 10,093 studies were retrieved, seven of which were selected after applying the inclusion criteria. The findings show that bone health education programs aim to empower older people by increasing knowledge about the disease and raising awareness about calcium and vitamin D intake, osteoporosis medications, and the importance of changing habits and exercise. Programs generally consist of group or individual meetings, with sessions lasting 50 to 60 minutes. Class sizes may be limited or unrestricted. Follow-up during the educational process was also found to be important. Tailoring topics to the reality and interests of participants appears to be another positive way of promoting the adoption of self-care practices.
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Affiliation(s)
- Emerson Moura Ribeiro
- Universidade da Maturidade, Campus Palmas da Universidade Federal do Tocantins. Av. NS-15, Quadra 109, Norte, s/n, Plano diretor norte, alcno 14, Bloco D. 77001-090 Palmas TO Brasil.
| | - Elzivânia de Carvalho Silva
- Universidade da Maturidade, Campus Palmas da Universidade Federal do Tocantins. Av. NS-15, Quadra 109, Norte, s/n, Plano diretor norte, alcno 14, Bloco D. 77001-090 Palmas TO Brasil.
| | - Eduardo Aoki Ribeiro Sera
- Universidade da Maturidade, Campus Palmas da Universidade Federal do Tocantins. Av. NS-15, Quadra 109, Norte, s/n, Plano diretor norte, alcno 14, Bloco D. 77001-090 Palmas TO Brasil.
| | - Thais Araújo Borges
- Universidade da Maturidade, Campus Palmas da Universidade Federal do Tocantins. Av. NS-15, Quadra 109, Norte, s/n, Plano diretor norte, alcno 14, Bloco D. 77001-090 Palmas TO Brasil.
| | - Matheus Freire Dias
- Universidade da Maturidade, Campus Palmas da Universidade Federal do Tocantins. Av. NS-15, Quadra 109, Norte, s/n, Plano diretor norte, alcno 14, Bloco D. 77001-090 Palmas TO Brasil.
| | - Andreia Travassos
- Universidade da Maturidade, Campus Palmas da Universidade Federal do Tocantins. Av. NS-15, Quadra 109, Norte, s/n, Plano diretor norte, alcno 14, Bloco D. 77001-090 Palmas TO Brasil.
| | - Neila Barbosa Osório
- Universidade da Maturidade, Campus Palmas da Universidade Federal do Tocantins. Av. NS-15, Quadra 109, Norte, s/n, Plano diretor norte, alcno 14, Bloco D. 77001-090 Palmas TO Brasil.
| | - Luiz Sinésio Silva Neto
- Universidade da Maturidade, Campus Palmas da Universidade Federal do Tocantins. Av. NS-15, Quadra 109, Norte, s/n, Plano diretor norte, alcno 14, Bloco D. 77001-090 Palmas TO Brasil.
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Rubæk M, Hitz MF, Holmberg T, Schønwandt BMT, Andersen S. Effectiveness of patient education for patients with osteoporosis: a systematic review. Osteoporos Int 2022; 33:959-977. [PMID: 34773131 DOI: 10.1007/s00198-021-06226-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/27/2021] [Indexed: 12/15/2022]
Abstract
UNLABELLED In this systematic review, the effects of osteoporosis patient education were examined. All studies found an effect on physical function, but for the other themes, the results were inconclusive. The findings indicate a need for further research in this topic. INTRODUCTION Osteoporosis is a chronic disease with serious consequences for the individual and major societal costs. With the aim of fracture prevention, many countries offer osteoporosis patient education. The objectives were to examine the effects and mediators of osteoporosis patient education and describe the characteristics of studies with and without an effect. Though, none of the included studies reported mediators, and therefore, we could not examine that. METHODS Six databases were searched in October 2020. Two researchers independently conducted title and abstract screening as well as full-text review. Records were included if participants had osteoporosis, and the patient education was group-based, face-to-face, and addressed two or more aspects, e.g., diet, medication, and exercise. The Cochrane Collaboration tools were used for risk of bias assessment. Finally, data were extracted into a standardized form and presented narratively. RESULTS In total, 2934 records were identified, and 13 studies met the inclusion criteria. All six studies examining the effects of patient education on physical function demonstrated improvements. In addition, one out of two RCT studies and one non-randomized study reported improved psychological wellbeing. Just one out of five RCT studies showed improvements regarding physical discomfort and disability. Effects on health-related quality of life, adherence and persistence, and knowledge of osteoporosis were inconclusive. CONCLUSION There is limited evidence for the effectiveness of osteoporosis patient education. There is a need for high-quality randomized controlled trials, which should describe the characteristics of the interventions and examine the mechanisms of osteoporosis patient education. PROSPERO REGISTRATION NUMBER CRD42020211930.
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Affiliation(s)
- M Rubæk
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
- National Research Center for Bone Health, Zealand University Hospital, Køge, Denmark.
| | - M F Hitz
- National Research Center for Bone Health, Zealand University Hospital, Køge, Denmark
| | - T Holmberg
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - B M T Schønwandt
- National Research Center for Bone Health, Zealand University Hospital, Køge, Denmark
| | - S Andersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Lee Y, Kim DH. A preliminary study on the effects of an osteoporosis prevention program based on an Information-Motivation-Behavioral skill model in older adult women: A cluster randomized controlled trial. Geriatr Nurs 2022; 45:55-63. [PMID: 35334422 DOI: 10.1016/j.gerinurse.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/06/2022] [Accepted: 03/08/2022] [Indexed: 11/24/2022]
Abstract
We aimed to evaluate the feasibility and effects of an osteoporosis prevention program using the Information-Motivation-Behavioral skill (IMB) model in older adult women in this preliminary study. Korean women ≥65 years were randomly assigned to control (N=21) and intervention (N=23) groups. The intervention group participated in an IMB model-based, 12-week osteoporosis prevention program. The primary outcome was osteoporosis prevention behavior over time in both groups directly before, immediately after (post-test 1), and 4 weeks after (post-test 2) the intervention. Participants had a higher retention and attendance rate for the intervention, and the osteoporosis prevention behavior of the intervention group at post-test 1 and post-test 2 had significantly improved. The program based on the IMB model may be a feasible and effective intervention for osteoporosis prevention behavior in older adult women.
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Affiliation(s)
- Yeongsuk Lee
- College of Nursing, Catholic University of Pusan, 57 Oryundae-ro, Geumjeong-gu, Busan 46252, Republic of Korea.
| | - Dong-Hee Kim
- College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan-si 50612, Republic of Korea.
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Tardi P, Szilagyi B, Makai A, Gyuro M, Acs P, Jaromi M, Molics B, Hock M. The development of a reliable and valid instrument to measure the osteoporosis-related knowledge: validation of the Hungarian version of Osteoporosis Knowledge Assessment Tool (OKAT). BMC Public Health 2021; 21:1515. [PMID: 33892674 PMCID: PMC8063278 DOI: 10.1186/s12889-020-09565-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoporosis is one of the most common chronic musculoskeletal diseases. Osteoporosis-related knowledge is an important contributor in to prevent osteoporosis. There is no validated reliable questionnaire to measure the knowledge in Hungary. The aim of the study was to validate the Osteoporosis Knowledge Assessment Tool (OKAT) Hungarian version. METHODS The research was a randomized validation study of a new Hungarian language instrument. The questionnaire was administered to 557 randomly selected healthy women (age between 25 and 44 years) from December 2018 to July 2019 in Baranya county, Hungary. The reliability was examined by the Flesch reading ease and McNemar's test. We examined item discrimination and item-total correlations, inter-item consistency (Cronbach's alpha coefficient) and principal component factor analysis. RESULTS Significant differences (p < 0.001) were reported between total scores and the age categories. Significant (p < 0.001) correlation (r = 0.25) was found between the education level and the knowledge. Significantly (p < 0.001) higher knowledge were found in health care profession (14.53 ± 3.58) than the non-health care profession (9.99 ± 4.04). Participants with osteoporosis or fracture in family history had better knowledge (p < 0.001). Flesch reading ease was 44, the questionnaire had a Ferguson's sigma of 0.94 and a Cronbach's alpha of 0.81. There were no negative inter-item correlations psychometric properties of the OKAT, all items had more than 70% of correlations (p < 0.001). CONCLUSIONS The Hungarian version of the Osteoporosis Knowledge Assessment Tool is a reliable and objective questionnaire to measure women's knowledge in Hungary.
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Affiliation(s)
- Peter Tardi
- University of Pécs, Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, Pécs, Hungary. .,University of Pécs, Faculty of Health Sciences, Doctoral School of Health Sciences, Pécs, Hungary.
| | - Brigitta Szilagyi
- University of Pécs, Faculty of Health Sciences, Doctoral School of Health Sciences, Pécs, Hungary
| | - Alexandra Makai
- University of Pécs, Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, Pécs, Hungary
| | - Monika Gyuro
- University of Pécs, Faculty of Health Sciences, Institute of Health Insurance, Pécs, Hungary
| | - Pongrac Acs
- University of Pécs, Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, Pécs, Hungary
| | - Melinda Jaromi
- University of Pécs, Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, Pécs, Hungary
| | - Balint Molics
- University of Pécs, Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, Pécs, Hungary
| | - Marta Hock
- University of Pécs, Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, Pécs, Hungary
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Van Ancum JM, Meskers CGM, Reijnierse EM, Yeung SSY, Jonkman NH, Trappenburg MC, Pijnappels M, Maier AB. Lack of Knowledge Contrasts the Willingness to Counteract Sarcopenia Among Community-Dwelling Adults. J Aging Health 2019; 32:787-794. [DOI: 10.1177/0898264319852840] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: Sarcopenia is highly prevalent in older adults. Knowledge among community-dwelling adults is important for effective prevention and treatment of sarcopenia. This study aims to assess current knowledge about sarcopenia, investigate willingness for treatment and prevention, and awareness of muscle health. Method: Participants who attended health educational events completed a questionnaire on knowledge about sarcopenia. Self-perceived muscle health was assessed by visual analog scale. Objective muscle measures included muscle mass, handgrip strength, and gait speed. Results: Included participants were 197 (median aged 67.9 years [interquartile range = 57.0-75.1]). Eighteen participants (9%) reported to know what sarcopenia is. Participants’ self-perceived muscle health showed a low correlation with all objective muscle measures. 76% were willing, in case of sarcopenia diagnosis, to start treatment and 71% were willing to prevent sarcopenia. Discussion: Knowledge about sarcopenia is limited while participants were willing to start treatment and prevention. Strategies to increase knowledge among community-dwelling adults are needed.
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Affiliation(s)
- Jeanine M. Van Ancum
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Carel G. M. Meskers
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Esmee M. Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Suey S. Y. Yeung
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nini H. Jonkman
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Marijke C. Trappenburg
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands
| | - Mirjam Pijnappels
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Andrea B. Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
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A Theoretically Based Behavioral Nutrition Intervention for Elderly Women: A Cluster Randomized Controlled Trial. INT J GERONTOL 2018. [DOI: 10.1016/j.ijge.2017.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Anderson-Wurf J, Harding C, Seal A. Increasing the knowledge, identification and treatment of osteoporosis through education and shared decision-making with residents living in a retirement village community. Australas J Ageing 2018; 37:E17-E22. [DOI: 10.1111/ajag.12494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jane Anderson-Wurf
- School of Medicine Sydney; Wagga Wagga Sub School; University of Notre Dame Australia; Wagga Wagga New South Wales Australia
| | - Catherine Harding
- School of Medicine Sydney; Wagga Wagga Sub School; University of Notre Dame Australia; Wagga Wagga New South Wales Australia
| | - Alexa Seal
- School of Medicine Sydney; Wagga Wagga Sub School; University of Notre Dame Australia; Wagga Wagga New South Wales Australia
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Kalkım A, Dağhan Ş. Theory-based Osteoporosis Prevention Education and Counseling Program for Women: A Randomized Controlled Trial. Asian Nurs Res (Korean Soc Nurs Sci) 2017; 11:119-127. [DOI: 10.1016/j.anr.2017.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 05/18/2017] [Accepted: 05/19/2017] [Indexed: 10/19/2022] Open
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Morfeld JC, Vennedey V, Müller D, Pieper D, Stock S. Patient education in osteoporosis prevention: a systematic review focusing on methodological quality of randomised controlled trials. Osteoporos Int 2017; 28:1779-1803. [PMID: 28236127 DOI: 10.1007/s00198-017-3946-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 01/26/2017] [Indexed: 01/23/2023]
Abstract
UNLABELLED This review summarizes evidence regarding the effects of patient education in osteoporosis prevention and treatment. The included studies reveal mixed results on a variety of endpoints. Methodological improvem ent of future RCTs (e.g. with regard to randomization and duration of follow-up) might yield more conclusive evidence on the effects of patient education in osteoporosis INTRODUCTION: This review aims to evaluate the effects of patient education on osteoporosis prevention and treatment results. METHODS Multiple databases including PubMed and Embase were searched until February 2016. Randomised controlled trials (RCTs) were eligible if they included adults diagnosed with or at risk of osteoporosis and assessed patient education interventions (group- or individual-based). Outcomes regarding osteoporosis management including initiation of and adherence to pharmacological therapy, physical activity, calcium and vitamin D intake, changes in smoking behaviour, fractures, quality of life (QoL) and osteoporosis knowledge were evaluated. The Cochrane collaboration's tool for assessing the risk of bias was used to assess the internal validity of included trials. RESULTS Fifteen articles (13 different studies) published between 2001 and 2013 were included (group-based education = 7, individual-based education = 5, both = 1). The general risk of bias was considered as moderate to high. The effects on 'bone mineral density (BMD) testing and/or pharmacological therapy' (composite endpoint), 'calcium intake' and 'vitamin D intake' as well as 'osteoporosis knowledge' were statistically significant in favour of the intervention in ≥50% of the studies analysing these outcomes. Differences between the intervention and the control group regarding 'pharmacological therapy', 'medication adherence', 'physical activity', 'fractures' and 'QoL' were found to be statistically significant in <50% of the trials. CONCLUSIONS This review indicates that it is still unclear whether patient education is beneficial and whether it has a significant and clinically relevant impact on osteoporosis management results. Educational programmes for osteoporosis require further investigation within the context of well-conducted RCTs.
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Affiliation(s)
- Jana-Carina Morfeld
- Institute for Health Economics and Clinical Epidemiology, The University Hospital of Cologne (AöR), Gleueler Straße 176-178, 50935, Cologne, Germany
| | - Vera Vennedey
- Institute for Health Economics and Clinical Epidemiology, The University Hospital of Cologne (AöR), Gleueler Straße 176-178, 50935, Cologne, Germany
| | - Dirk Müller
- Institute for Health Economics and Clinical Epidemiology, The University Hospital of Cologne (AöR), Gleueler Straße 176-178, 50935, Cologne, Germany.
| | - Dawid Pieper
- Institute for Research in Operative Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, Building 38, 51109, Cologne, Germany
| | - Stephanie Stock
- Institute for Health Economics and Clinical Epidemiology, The University Hospital of Cologne (AöR), Gleueler Straße 176-178, 50935, Cologne, Germany
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Plawecki K, Chapman-Novakofski K. Effectiveness of community intervention in improving bone health behaviors in older adults. J Nutr Gerontol Geriatr 2013; 32:145-160. [PMID: 23663213 DOI: 10.1080/21551197.2013.781421] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
An 8-week, bone-health community program addressed risks/lifestyle changes within the Health Belief Model and Theory of Reasoned Action frameworks in a randomized format (treatment group n = 35; control group n = 34). Median week 1 values for calcium (control, 963 mg; treatment, 1023 mg) and vitamin D (81 IU both groups) were below recommendations, increasing throughout the program for both control (1023 mg calcium, 128 IU vitamin D) and treatment (1005 mg calcium, 122 IU vitamin D) groups. There was limited response to the exercise outcome variables, with many not participating in that section of the program. Psychosocial variables were positive for both control and treatment groups at week 1, with no significant difference at postintervention. Regression analysis indicated that those with a positive attitude about calcium intake and belief that they could choose calcium-fortified foods were more likely to have higher calcium intake. Intention to exercise was modified by peer and family support. Community-based programs can translate and use clinical trial key topics and outcomes, but participation bias makes impact results difficult to interpret the effectiveness of the program.
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Affiliation(s)
- Karen Plawecki
- Department of Nutrition, Benedictine University, Lisle, IL 60532, USA.
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