What is it about?

Osteoporosis is a preventable disease that is usually not managed until the disease becomes evident, although it places huge economic and social burdens on societies worldwide. It is predicted that this burden will grow if left unchecked. Despite this, evidence suggests that osteoporosis prevention activity is given a low priority, and services often only provide biomedically‐based programmes, in which resources are predominantly allocated to screening and pharmacological treatments. Referral to these services mostly occurs when a client is already known to have osteoporosis or to be at risk, rather than as an early preventative intervention.

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Why is it important?

This paper reports an action research project with one hospital osteoporosis service. The aim of the project was to assess the current service, identify areas where change was needed, and evaluate the implementation of such changes. Participatory action research was used, with group meetings and reflective journals to collect data for analysis. The process involved assessment of a preventative osteoporosis service, and determination of clinical issues and problems, and it aided decisions on an appropriate course of organizational reform and evaluated any change processes as they occurred. It also encouraged participants to reflect on and evaluate their experiences of using a participatory framework. This is the first time that action research has been used to re-develop and evaluate a regional osteoporosis service.

Perspectives

The most effective contribution to osteoporosis work that nurses can make is preventative health education strategies and health promotion programmes (Allanach 2000, Davis & White 2000, Sedlak et al. 2000a). The main challenge facing nurses with regard to osteoporosis management, however, lies with the facilitation of these preventative strategies (Marchigiano 1999). Obeid (2001) suggests that nurses, at the very least, can offer a comprehensive ‘health consultation’ to women, in order to increase the accessibility of health options that have a significant health gain, without a demonstrable increase in workload. Horan et al. (1998) have developed an Osteoporosis Self-Efficacy Scale to aid nurse researchers who are developing lifestyle-related preventative health education programmes. Not all nurses will have the skills or resources to develop comprehensive preventative health education programmes, such as the one presented in our study. They are, however, well placed to consider and develop at least some of the measures detailed in our study, especially given the urgency of the current osteopenia (reduced bone mass) and osteoporosis situation. Nurses seeking to challenge and change their organiza- tional working practices are advised to consider the methods and approaches used in this study. PAR works well with most organizational change strategies and works particularly well within participatory and empowering health promotion frameworks. Action research helps to form communities of reflective practitioners who, together, can engage in cycles of research that lead to professional growth and improved practice (Coulter 2002). This study is an example of the benefits that health professionals can draw from adopting a participatory, collaborative and multiprofessional approach to practice.

Dr Dean Whitehead
Flinders University

Read the Original

This page is a summary of: A preventative health education programme for osteoporosis, Journal of Advanced Nursing, July 2004, Wiley,
DOI: 10.1111/j.1365-2648.2004.03058.x.
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