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Osteoporosis International

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01-10-2016 | Original Article

Men’s health-seeking behaviours regarding bone health after a fragility fracture: a secondary analysis of qualitative data

Authors: J. E. M. Sale, M. C. Ashe, D. Beaton, E. Bogoch, L. Frankel

Published in: Osteoporosis International | Issue 10/2016

Abstract

Summary

In our qualitative study, men with fragility fractures described their spouses as playing an integral role in their health behaviours. Men also described taking risks, preferring not to dwell on the meaning of the fracture and/or their bone health. Communication strategies specific to men about bone health should be developed.

Introduction

We examined men’s experiences and behaviours regarding bone health after a fragility fracture.

Methods

We conducted a secondary analysis of five qualitative studies. In each primary study, male and female participants were interviewed for 1–2 h and asked to describe recommendations they had received for bone health and what they were doing about those recommendations. Maintaining the phenomenological approach of the primary studies, the transcripts of all male participants were re-analyzed to highlight experiences and behaviours particular to men.

Results

Twenty-two men (50–88 years old) were identified. Sixteen lived with a wife, male partner, or family member and the remaining participants lived alone. Participants had sustained hip fractures (n = 7), wrist fractures (n = 5), vertebral fractures (n = 2) and fractures at other locations (n = 8). Fourteen were taking antiresorptive medication at the time of the interview. In general, men with a wife/female partner described these women as playing an integral role in their health behaviours, such as removing tripping hazards and organizing their medication regimen. While participants described giving up activities due to their bone health, they also described taking risks such as drinking too much alcohol and climbing ladders or deliberately refusing to adhere to bone health recommendations. Finally, men did not dwell on the meaning of the fracture and/or their bone health.

Conclusions

Behaviours consistent with those shown in other studies on men were described by our sample. We recommend that future research address these findings in more detail so that communication strategies specific to men about bone health be developed.

van Staa TP, Dennison EM, Leufkens HGM, Cooper C (2001) Epidemiology of fractures in England and Wales. Bone 29(6):517–522CrossRefPubMed

Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353(9156):878–882CrossRefPubMed

Kannegaard PN, van der Mark S, Eiken P, Abrahamsen B (2010) Excess mortality in men compared with women following a hip fracture. National analysis of comedications, comorbidity and survival. Age Ageing 39:203–209CrossRefPubMed

Trombetti A, Herrmann F, Hoffmeyer P, Schurch MA, Bonjour JP, Rizzoli R (2002) Survival and potential years of life lost after hip fracture in men and age-matched women. Osteoporos Int 13:731–737CrossRefPubMed

Mikyas Y, Agodoa I, Yurgin N (2014) A systematic review of osteoporosis medication adherence and osteoporosis-related fracture costs in men. Appl Health Econ Health Policy 12:267–277CrossRefPubMed

Christensen L, Iqbal S, Macarios D, Badamgarav E, Harley C (2010) Cost of fractures commonly associated with osteoporosis in a managed-care population. J Med Econ 13(2):302–313CrossRefPubMed

Sedlak CA, Doheny MO, Estok PJ (2000) Osteoporosis in older men: knowledge and health beliefs. Orthop Nurs 19(3):38–42CrossRefPubMed

Gaines JM, Marx KA (2011) Older men’s knowledge about osteoporosis and educational interventions to increase osteoporosis knowledge in older men: a systematic review. Maturitas 68:5–12CrossRefPubMed

Cindas A, Savas S (2004) What do men who are at risk of osteoporosis know about osteoporosis in developing countries? Scand J Caring Sci 18:188–192CrossRefPubMed

10.

Raphael HM, Gibson BJ, Lathlean JA, Walker JM (2009) A grounded theory study of men’s perceptions and experience of osteoporosis. Bone 44(2):s200–s201CrossRef

11.

Ali NS, Shonk C, El-Sayed MS (2009) Bone health in men: influencing factors. Am J Health Behav 33(2):213–222CrossRefPubMed

12.

Tung WC, Lee IFK (2006) Effects of an osteoporosis educational programme for men. J Adv Nurs 56(1):26–34CrossRefPubMed

13.

Doheny MO, Sedlak CA, Hall RJ, Estok PJ (2010) Structural model for osteoporosis preventing behavior in men. Am J Mens Health 4(4):334–343CrossRefPubMed

14.

Cheng N, Green ME (2008) Osteoporosis screening for men. Are family physicians following the guidelines? Can Fam Physician 54(8):1140–1141PubMedPubMedCentral

15.

Majumdar SR, McAlister FA, Johnson JA, Weir DL, Bellerose D, Hanley DA et al (2014) Critical impact of patient knowledge and bone density testing on starting osteoporosis treatment after fragility fracture: secondary analysis from two controlled trials. Osteoporos Int 25:2173–2179CrossRefPubMed

16.

Papaioannou A, Kennedy CC, Ioannidis G, Gao Y, Sawka AM, Goltzman D et al (2008) The osteoporosis care gap in men with fragility fractures: the Canadian Multicentre Osteoporosis Study. Osteoporos Int 19:581–587CrossRefPubMed

17.

Fraser LA, Ioannidis G, Adachi JD, Pickard L, Kaiser SM, Prior J et al (2011) Fragility fractures and the osteoporosis care gap in women: the Canadian Multicentre Osteoporosis Study. Osteoporos Int 22(3):789–796CrossRefPubMed

18.

Liu Z, Weaver J, de Papp A, Li Z, Martin J, Allen K et al (2016) Disparities in osteoporosis treatments. Osteoporos Int 27:509–519CrossRefPubMed

19.

McBride CM, Emmons KM, Lipkus IM (2003) Understanding the potential of teachable moments: the case of smoking cessation. Health Educ Res 18(2):156–170CrossRefPubMed

20.

Schwandt TA (2001) Dictionary of qualitative inquiry, 2nd edn. Sage Publications, Inc., Thousand Oaks, CA

21.

Sokolowski R (2000) Introduction to phenomenology. Cambridge University Press, Cambridge

22.

Kvale S, Brinkmann S (2009) Interviews: learning the craft of qualitative research interviewing, 2nd edn. Sage Publications Ltd., Thousand Oaks

23.

Moustakas C (1994) Phenomenological research methods. Sage Publications, Thousand Oaks, CACrossRef

24.

Polkinghorne DE (1989) Existential-phenomenological perspectives in psychology. In: Valle RS, Halling S (eds) Phenomenological research methods. Plenum Press, New York, pp 41–60

25.

Kralik D, Koch T, Price K, Howard N (2004) Chronic illness self-management: taking action to create order. J Clin Nurs 13(2):259–267CrossRefPubMed

26.

Thorne S, Paterson B, Russell C (2003) The structure of everyday self-care decision making in chronic illness. Qual Health Res 13(10):1337–1352CrossRefPubMed

27.

Giorgi A (2008) Concerning a serious misunderstanding of the essence of the phenomenological method in psychology. J Phenomenol Psychol 39:33–58CrossRef

28.

Bogoch ER, Elliot-Gibson V, Beaton DE, Jamal SA, Josse RG, Murray TM (2006) Effective initiation of osteoporosis diagnosis and treatment for patients with a fragility fracture in an orthopaedic environment. J Bone Joint Surg Am Vol 88(1):25–34CrossRef

29.

Jaglal SB, Hawker G, Cameron C, Canavan J, Beaton D, Bogoch E et al (2010) The Ontario osteoporosis strategy: implementation of a population-based osteoporosis action plan in Canada. Osteoporos Int 21:903–908CrossRefPubMed

30.

Sale JEM, Gignac MA, Hawker G, Beaton D, Frankel L, Bogoch E et al (2016) Patients do not have a consistent understanding of high risk for future fracture: a qualitative study of patients from a post-fracture secondary prevention program. Osteoporos Int 27:65–73CrossRefPubMed

31.

Sale JEM, Bogoch E, Hawker G, Gignac M, Beaton D, Jaglal S et al (2014) Patient perceptions of provider barriers to post-fracture secondary prevention. Osteoporos Int 25:2581–2589CrossRefPubMed

32.

Sale J, Gignac M, Hawker G, Frankel L, Beaton D, Bogoch E et al (2011) Decision to take osteoporosis medication in patients who have had a fracture and are ‘high’ risk for future fracture. BMC Musculoskelet Disord 12:92CrossRefPubMedPubMedCentral

33.

Sale JEM, Beaton D, Fraenkel L, Elliot-Gibson V, Bogoch E (2010) The BMD muddle: the disconnect between bone densitometry results and perception of bone health. J Clin Densitom 13(4):370–378CrossRefPubMed

34.

Sale JEM, Hawker G, Cameron C, Bogoch E, Jain R, Beaton D et al (2015) Perceived messages about bone health after a fracture are not consistent across health care providers. Rheumatol Int 35(1):97–103CrossRefPubMed

35.

Heaton J (2008) Secondary analysis of qualitative data. Hist Social Res 33(3):33–45

36.

Hinds PS, Vogel RJ, Clarke-Steffen L (1997) The possibilities and pitfalls of doing a secondary analysis of a qualitative data set. Qual Health Res 7(3):408–424CrossRef

37.

Nvivo [computer program]. Victoria, Australia: Qualitative Solutions and Research Pty Ltd.; 2010.

38.

Giorgi A (1997) The theory, practice, and evaluation of the phenomenological method as a qualitative research procedure. J Phenomenol Psychol 28:235–260CrossRef

39.

Wertz FJ (2005) Phenomenological research methods for counseling psychology. J Couns Psychol 52(2):167–177CrossRef

40.

Giorgi A (1989) Some theoretical and practical issues regarding the psychological phenomenological method. Saybrook Rev 7:71–85

41.

Patton MQ (1999) Enhancing the quality and credibility of qualitative analysis. Health Serv Res 34(5 Part II):1189–1208PubMedPubMedCentral

42.

Creswell JW (1998) Qualitative inquiry and research design: choosing among five traditions. Sage Publications, Thousand Oaks, CA

43.

Norcross WA, Palinkas LA, Ramirez C (1996) The influence of women on the health care-seeking behavior of men. J Fam Pract 43(5):475–480PubMed

44.

Griffith DM, Wooley AM, Allen JO (2013) I’m ready to eat and grab whatever I can get: determinants and patterns of African American men’s eating practices. Health Promot Pract 14(2):181–188CrossRefPubMed

45.

O’Brien R, Hunt K, Hart G (2005) It’s caveman stuff, but that is to a certain extent how guys still operate: men’s accounts of masculinity and help seeking. Soc Sci Med 61:503–516CrossRefPubMed

46.

Gray RE, Fitch M, Phillips C, Labrecque M, Fergus K (2000) Managing the impact of illness: the experiences of men with prostate cancer and their spouses. J Health Psychol 5(4):531–548CrossRefPubMed

47.

Giorgianni SJ, Porche DJ, Williams ST, Matope JH, Leonard BL (2013) Developing the discipline and practice of comprehensive men’s health. Am J Mens Health 7(4):342–349CrossRefPubMed

48.

Gilson K-M, Bryant C, Judd F (2014) Exploring risky drinking and knowledge of safe drinking guidelines in older adults. Subst Use Misuse 49:1473–1479CrossRefPubMed

49.

Ensrud KE, Blackwell TL, Cawthon PM, Bauer DC, Fink HA, Schousboe JT, et al. (2015) Degree of trauma differs for major osteoporotic fracture events in older men versus older women. J Bone Mineral Res; in press.

50.

Patel A, Coates PS, Nelson JB, Trump DL, Resnick NM, Greenspan SL (2003) Does bone mineral density and knowledge influence health-related behaviors of elderly men at risk for osteoporosis? J Clin Densitom 6(4):323–329CrossRefPubMed

51.

Sale JEM, Cameron C, Hawker G, Jaglal S, Funnell L, Jain R et al (2014) Strategies use by an osteoporosis patient group to navigate for bone health care after a fracture. Arch Orthop Trauma Surg 134:229–235CrossRefPubMed

52.

Gignac MA, Cott C, Badley EM (2002) Adaptation to disability: applying selective optimization with compensation to the behaviors of older adults with osteoarthritis. Psychol Aging 17(3):520–524CrossRefPubMed

53.

Gignac MAM, Cott C, Badley EM (2000) Adaptation to chronic illness and disability and its relationship to perceptions of independence and dependence. J Gerontol: Psychol Sci 55B(6):362–372CrossRef

54.

Rice RE (2006) Influences, usage, and outcomes of Internet health information searching: multivariate results from the Pew surveys. Int J Med Inform 75:8–28CrossRefPubMed

55.

Addis ME, Mahalik JR (2003) Men, masculinity, and the contexts of help seeking. Am Psychol 58(1):5–14CrossRefPubMed

56.

Benetou V, Orfanos P, Feskanich D, Michaelsson K, Pettersson-Kymmer U, Ahmed LA et al (2015) Education, marital status, and risk of hip fractures in older men and women: the CHANCES project. Osteoporos Int 26:1733–1746CrossRefPubMed

57.

Michie S, Ashford S, Sniehotta FF, Dombrowski SU, Bishop A, French DP (2011) A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health 26(11):1479–1498CrossRefPubMed

58.

Dixon-Woods M, Shaw RL, Agarwal S, Smith JA (2004) The problem of appraising qualitative research. Quality Saf Health Care 13:223–225CrossRef

Title: Men’s health-seeking behaviours regarding bone health after a fragility fracture: a secondary analysis of qualitative data
Authors: J. E. M. Sale
M. C. Ashe
D. Beaton
E. Bogoch
L. Frankel
Publication date: 01-10-2016
Publisher: Springer London
Published in: Osteoporosis International / Issue 10/2016
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-016-3641-4

2024 ASCO Annual Meeting

Springer Medicine

Men’s health-seeking behaviours regarding bone health after a fragility fracture: a secondary analysis of qualitative data

Abstract

Summary

Introduction

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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