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The impact of osteoporosis on quality-of-life: The OFELY cohort.

Schoen, Delores C.

Orthopaedic Essentials: Research Update

Delores C. Schoen, PhD, RN,C, FAAN, Adjunct Professor, The Pennsylvania State University School of Nursing, University Park, PA.

To provide the best outcomes for patients and their families, nurses must rely on the implementation of clinical practice guidelines that are based on research evidence. Evidence-based practice is the integration of clinical practice, research evidence, clinical expertise, and patient and family expectations. It ensures that the nursing care provided will be scientifically based while maximizing quality outcomes in a cost-effective manner. Despite the importance of evidence-based practice to nursing, only a small percentage of nurses actually practice evidence-based care. Typical barriers are a lack of time, difficulty interpreting the research literature, and a lack of administrative support. Facilitating evidence-based practice is now an active area of study, and several promising theoretical models about research use have been published within the last few years. The purpose of this column is to assist with the transition to evidence-based care by providing a brief review of individual research articles and discussing the nursing interventions they imply.

The articles reviewed are from several different journals and reflect the diversity of patients and care settings within orthopaedic nursing. Here I review articles that discuss (1) issues related to patients who are Islamic, (2) comparisons of patient with osteoarthritis who are African American and White, (3) managing chronic pain in patients with arthritis, (4) comparisons of pain measures in patients with fibromyalgia, and (5) the effect of osteoporosis on quality of life.

The impact of osteoporosis on quality-of-life: The OFELY cohort.

Martin, A. R., Sornay-Rendu, E., Chandler, J. M., Duboeuf, F., Girman, C. J., & Delmas, P. D. (2002). Bone, 31(1), 32–36.

Severe osteoporosis manifests itself in different ways, including skeletal fractures, kyphosis, and pain. However, some individuals may show no outward signs of osteoporosis and may even be unaware of their condition due to the asymptomatic nature of low bone mineral density (BMD). Decreased health-related quality-of-life and functional status have been described primarily in terms of fracture-related pain and disability in women with severe osteoporosis, caused by vertebral fractures. The authors state that it is possible that health-related quality of life is also affected in women with osteoporosis who have never been diagnosed with fractures because their fear of future fractures induces them to make adaptations in their lifestyle to prevent falls and fractures. An osteoporosis-targeted quality-of-life survey instrument was developed to assess the effect of osteoporosis on women within a community. The questionnaire focused on three domains: physical difficulty, adaptations to one’s daily life, and fears about the future.

The results of the study have implications for healthcare providers. Women with prior fractures, height loss, and/or kyphosis reported greater physical difficulties, more need to make adaptations to their lives, and greater fears than women reporting no such changes. The Physical Difficulty domain scores, however, did not differ significantly based on BMD alone. Thus, the negative effect of osteoporosis on quality of life was more related to the physical manifestations of osteoporosis than to bone density levels. The study is important in demonstrating the effect of osteoporosis-related factors on quality of life, although the major focus still continues to be education about osteoporosis, prevention, and early detection.

© 2003 National Association of Orthopaedic Nurses