Older men's explanatory model for osteoporosis.

Abstract

To explore the nature of men's experiences of osteoporosis by developing an understanding of men's explanatory models. This descriptive study invited community-residing male osteoporosis patients aged 50+ to participate in interviews about osteoporosis. Participants were recruited from a hospital-affiliated bone clinic. Men completed a questionnaire on demographic, medication, and fracture-related information, and descriptive statistics were calculated using Statistical Package for the Social Sciences. Interviews elicited the 5 domains of men's explanatory model (Kleinman, 1987) and open-ended information regarding men's experiences living with this disorder. Narrative data were analyzed both for content and inductively. Men's narratives demonstrate that an osteoporosis diagnosis is accompanied by negative psychosocial sequelae in this population. Men defined it as a disease of the bone that may increase the likelihood of fracture and that may cause pain. Participants reported that osteoporosis is diagnosed by bone mineral density (BMD) score and that disease progression is measured by a decrease in BMD and an increase in pain or new fractures. Men described a reluctance to take medications, dissatisfaction with side effects, and a perception that osteoporosis treatment in men had little basis in long-term medication efficacy or safety data. They viewed osteoporosis as a degenerative chronic disease with an overall stable course. Participants' explanatory models for osteoporosis are substantively different than clinical models. These differences provide a foundation for exploring the importance of gender to osteoporosis outcomes, a context for making sense of men's bone health behavior, and a clear case for an increase in advocacy and educational efforts for men who have or are at risk for osteoporosis.