Abstract
Background: Early detection and treatment of osteoporosis are essential in preventing fractures and fracture-related morbidity and mortality. Fractures beget fractures and it is relevant and well-documented beneficial to target osteoporosis screening in patients already suffering a fracture. The associated increased number of patients being confronted with a potential diagnosis of osteoporosis makes it worth considering how this affects patients. Objective: The aim of this study was to explore fracture patients’ experiences when confronted with the option of being screened for osteoporosis as the underlying reason of their fracture. Methods: In a phenomenological hermeneutic framework, semi-structured interviews were performed in 15 fragiligty fracture patients being offered screening for osteoporosis. Analysis inspired by Ricoeur consisting of naive reading, structural analysis, and critical analysis and discussion was applied. Results: Fracture patients were condemned to make a choice when confronted with the possibility of the early detection of osteoporosis. Many questions regarding prevention of new fractures and prospects in the case of a positive test result were raised. The major themes were related to the consequences of knowing what might be hidden in the bones, and the responsibility to prevent illness. Conclusion: The confrontation with the potential risk of osteoporosis provokes fear and worry in patients about lived daily life and anxiety about being treated as a sick person, but in return, it motivates patients to adopt a bone-healthy lifestyle. In general, patients prefer to be given knowledge of their bone health status over not knowing, and being able to seek further information on the condition facing them.
Highlights
Despite its global dissemination, osteoporosis is an underdiagnosed condition [1 - 5]
Fracture patients were condemned to make a choice when confronted with the possibility of the early detection of osteoporosis
The major themes were related to the consequences of knowing what might be hidden in the bones, and the responsibility to prevent illness
Summary
Osteoporosis is an underdiagnosed condition [1 - 5]. A Danish study of 65+ year old women’s experiences at the time of diagnosis and six months later suggested a need for improving information on osteoporosis and how to live with it [15]. Patients' experiences of living with osteoporosis and their need for health services are well-described especially in elderly women (not necessary fractured) and recently published systematic reviews exist on these topics [16 - 18]. An impending implementation of a more systematic Fracture Prevention Programme (FFP) in Denmark (where FFP is very sparse yet) may result in an increasing number of male and female middle-age fracture patients being target about osteoporosis screening. The aim of this study was to investigate male and female fracture patients' awareness of osteoporosis and to explore their experiences when confronted with the choice of being tested for osteoporosis given that their fracture might be a result of reduced bone strength
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