Womenʼs Perspectives On Doctorsʼ Promotion Of Physical Activity For Osteoporosis Care

Abstract

Caucasian and Asian women have heightened risks for osteoporosis (OP). With few preliminary symptoms, this 'silent' condition affects 1-in-2 US and 1-in-3 UK women and prevalence rates are set for dramatic increases. The publication of the 2004 Surgeon General's Report on Osteoporosis highlights the urgent need for the promotion of physical activity (PA) in prevention and management. PURPOSE To explore medical support of General Practitioners (GPs) for PA as experienced by South-East (SE) Asian and Caucasian female post-OP patients in the UK. METHODS Volunteers were recruited through OP support classes in London, England. Female-only qualitative interviews focussed on recent consultations with GPs. Interviews were transcribed verbatim and subject to inductive thematic analysis. RESULTS Twenty-one women (9 SE Asians), aged 43 to 82 years, experienced diagnosed OP for 8 months to 40 years. Physical symptoms of OP were objectionable and marked a loss of function, independence and autonomy. Learning about OP-care was supported and sustained by active engagement with support groups, other OP-sufferers, magazines and searching the internet. Beyond providing drugs, women desired, but rarely felt, that doctors fully supported their preferences for the self-care that often included PA provided by OP charities. Many women found class-based PA to be a rewarding experience. Doctors inconsistently recommended PA (preferring to recommend drugs), but were willing to take a lead from knowledgeable patients. Women felt that their doctors were unsure about how and when to discuss PA and did not understand how OP limited activities in everyday life. Younger women typically initiated PA discussions: they felt better informed than their doctors. Doctor's PA recommendations were often misunderstood ('I should be doing weight lifting…'), lacked specificity for bone-building effects ('You got to walk…'). Some women had never discussed PA with their doctor. CONCLUSIONS Women with OP are sensitive to their doctor's hesitance about offering detailed PA recommendations. Regardless of ethnicity, younger women undertook PA based on personal initiative. Positive PA experiences stimulated an interest in discussing PA with doctors and these dialogues broke the silence that would otherwise have surrounded PA within OP-care.