TITLE:
Widening the perspectives of fracture prevention in osteoporosis by identifying subgroups based upon psychological aspects and health behaviour
AUTHORS:
Helene V. Hjalmarson, Göran Jutengren, Margareta Möller
KEYWORDS:
Fracture Prevention; Health Behaviour; Sense of Coherence; Activity-Specific Balance Confidence; Cluster Analysis
JOURNAL NAME:
Health,
Vol.5 No.7B,
July
16,
2013
ABSTRACT: The potential importance of psychological aspects in relation to risk factors for fractures and preventing
unhealth behaviour has rarely been investigated in the field of osteoporosis. This study explores some psychological aspects and health behaviour of people detected to have osteoporosis at
the time of a forearm fracture. Moreover, it
aims at revealing subgroups within this population with clinical
relevance for managing secondary prevention actions. Data collection was
based on questionnaires and physical tests. Eighty-five individual were
analysed. The results confirm
earlier research on a similar population having relatively good self-reported
health behaviour. The individuals reported high quality of life, high amount
of physical activity and low alcohol intake. A majority reported good osteoporosis
knowledge, a high sense of coherence (mean = 74) and high activity-specific balance confidence (mean = 81). Furthermore, hierarchical cluster
analysis indicated a typology
of two subgroups where 75% matched a health-resilient group while 25% matched a health-vulnerable group. The vulnerable group had a significantly lower sense of coherence
SOC (p = 0.02) and activity-specific
balance confidence, ABC (p = 0.001).
This pattern was confirmed from behavioural aspects but only regarding one
traditional risk factor namely the history of fractures. The
health-vulnerable group achieved a significantly
weaker physical profile, less reported time spent outdoors and lower
quality of life. The differences found between the subgroups indicate that this typology, as a complement to models based upon relative risk like
FRAX, can be relevant for widening perspectives in future research
and clinical practice of fracture prevention in osteoporosis.