Skip to main content
Erschienen in: Osteoporosis International 8/2020

28.03.2020 | Original Article

Having caregiving responsibilities affects management of fragility fractures and bone health

verfasst von: J.E.M. Sale, L. Frankel, J. Paiva, J. Saini, S. Hui, J. McKinlay, S. Sharma, L. Cheng, E. Bogoch

Erschienen in: Osteoporosis International | Ausgabe 8/2020

Einloggen, um Zugang zu erhalten

Abstract

Summary

In this secondary analysis of six qualitative studies, we found that approximately one-quarter of individuals with fragility fracture were serving as informal caregivers. The caregiving role appeared to be a cause of the fracture for some and was prioritized over bone health, acting as a barrier to bone health management.

Introduction

Among fragility fracture patients serving as informal caregivers, our objective was to examine how caregiving responsibilities were associated with, and possibly impacted by, the fracture experience and the resulting management of bone health.

Methods

We conducted a secondary analysis (amplified analysis) of six qualitative studies to understand caregiver responsibilities and the relationship between these responsibilities and patients’ management of the fracture and bone health. The primary studies and the secondary analysis were conducted from a phenomenological approach. Eligible individuals in the primary studies were English-speaking men and women who were 45+ years old recruited from three settings (local, provincial, and national).

Results

Without being prompted to talk about their experience of caregiving, 33 of 145 (23%) individuals reported they were providing care to a family member or friend at the time of their fracture or during recovery post-fracture. The experience of having caregiving responsibilities was related to the fracture and bone health in two ways: (1) the caregiving role appeared to be a cause of the fracture in some participants and (2) caregiving was prioritized over participants’ own bone health and was a barrier to bone health management.

Conclusion

Fragility fracture is associated with, and potentially leads to an impairment of, an important social role in patients providing physical and emotional support and supervision for dependents as caregivers. Further, an important cause of fragility fracture can occur in the act of caregiving.
Literatur
1.
Zurück zum Zitat Macleod M, Chesson RA, Blackledge P et al (2005) To what extent are carers involved in the care and rehabilitation of patients with hip fracture? Disabil Rehabil 27:1117–1122CrossRef Macleod M, Chesson RA, Blackledge P et al (2005) To what extent are carers involved in the care and rehabilitation of patients with hip fracture? Disabil Rehabil 27:1117–1122CrossRef
2.
Zurück zum Zitat Nahm E-S, Resnick B, Orwig D, Magaziner J, Degrezia M (2010) Exploration of informal caregiving following hip fracture. Geriatr Nurs 31:254–262CrossRef Nahm E-S, Resnick B, Orwig D, Magaziner J, Degrezia M (2010) Exploration of informal caregiving following hip fracture. Geriatr Nurs 31:254–262CrossRef
3.
Zurück zum Zitat Williams MA, Oberst MT, Bjorklund BC, Hughes SH (1996) Family caregiving in cases of hip fracture. Rehabil Nurs J 21:124–131 138CrossRef Williams MA, Oberst MT, Bjorklund BC, Hughes SH (1996) Family caregiving in cases of hip fracture. Rehabil Nurs J 21:124–131 138CrossRef
4.
Zurück zum Zitat Lin P-C, Hung SH, Liao M-H et al (2006) Care needs and level of care difficulty related to hip fractures in geriatric populations during the post-discharge transition period. J Nurs Res 14:251–259CrossRef Lin P-C, Hung SH, Liao M-H et al (2006) Care needs and level of care difficulty related to hip fractures in geriatric populations during the post-discharge transition period. J Nurs Res 14:251–259CrossRef
5.
Zurück zum Zitat Hollander MJ, Liu G, Chappell NL (2009) Who cares and how much? The imputed economic contribution to the Canadian healthcare system of middle-aged and older unpaid caregivers providing care to teh elderly. Healthc Q 12:42–49CrossRef Hollander MJ, Liu G, Chappell NL (2009) Who cares and how much? The imputed economic contribution to the Canadian healthcare system of middle-aged and older unpaid caregivers providing care to teh elderly. Healthc Q 12:42–49CrossRef
6.
Zurück zum Zitat Mental Health Commission of Canada (2015) Informing the future: mental health indicators for Canada. Calgary, Canada, MHCC. Ref Type: Report Mental Health Commission of Canada (2015) Informing the future: mental health indicators for Canada. Calgary, Canada, MHCC. Ref Type: Report
7.
Zurück zum Zitat Sinha M (2013) Portrait of caregivers, 2012: spotlight on Canadians: results from the General Social Survey. Catalogue no. 89-652-X - no. 001, 1-21. Ref Type: Report Sinha M (2013) Portrait of caregivers, 2012: spotlight on Canadians: results from the General Social Survey. Catalogue no. 89-652-X - no. 001, 1-21. Ref Type: Report
8.
Zurück zum Zitat National Alliance for Caregiving, AARP Public Policy Institute (2015) Caregiving in the U.S. 2015. 1–87. Greenwald & associates. Ref Type: Report National Alliance for Caregiving, AARP Public Policy Institute (2015) Caregiving in the U.S. 2015. 1–87. Greenwald & associates. Ref Type: Report
9.
Zurück zum Zitat Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733CrossRef Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733CrossRef
10.
Zurück zum Zitat Leslie WD, Metge CJ, Azimaee M, Lix LM, Finlayson GS, Morin SN, Caetano P (2011) Direct costs of fractures in Canada and trends 1996-2006: a population-based cost-of-illness analysis. J Bone Miner Res 26:2419–2429CrossRef Leslie WD, Metge CJ, Azimaee M, Lix LM, Finlayson GS, Morin SN, Caetano P (2011) Direct costs of fractures in Canada and trends 1996-2006: a population-based cost-of-illness analysis. J Bone Miner Res 26:2419–2429CrossRef
11.
Zurück zum Zitat Local Health Integration Networks (2008) Aging at home strategy. Ref Type: Report Local Health Integration Networks (2008) Aging at home strategy. Ref Type: Report
12.
Zurück zum Zitat MacCourt P, Krawczyk M (2012) Supporting the caregivers of seniors through policy: the caregiver policy lens. 1-46. Vancouver, B.C., British Columbia Psychogeriatric Association. Ref Type: Report MacCourt P, Krawczyk M (2012) Supporting the caregivers of seniors through policy: the caregiver policy lens. 1-46. Vancouver, B.C., British Columbia Psychogeriatric Association. Ref Type: Report
13.
Zurück zum Zitat Schwandt TA (2001) Dictionary of qualitative inquiry. Sage Publications, Inc., Thousand Oaks Schwandt TA (2001) Dictionary of qualitative inquiry. Sage Publications, Inc., Thousand Oaks
14.
Zurück zum Zitat Sokolowski R (2000) Introduction to phenomenology. Cambridge University Press, Cambridge Sokolowski R (2000) Introduction to phenomenology. Cambridge University Press, Cambridge
15.
Zurück zum Zitat Giorgi A (1997) The theory, practice, and evaluation of the phenomenological method as a qualitative research procedure. J Phenomenol Psychol 28:235–260CrossRef Giorgi A (1997) The theory, practice, and evaluation of the phenomenological method as a qualitative research procedure. J Phenomenol Psychol 28:235–260CrossRef
16.
Zurück zum Zitat Giorgi A (2008) Concerning a serious misunderstanding of the essence of the phenomenological method in psychology. J Phenomenol Psychol 39:33–58CrossRef Giorgi A (2008) Concerning a serious misunderstanding of the essence of the phenomenological method in psychology. J Phenomenol Psychol 39:33–58CrossRef
17.
Zurück zum Zitat Wertz FJ (2005) Phenomenological research methods for counseling psychology. J Couns Psychol 52:167–177CrossRef Wertz FJ (2005) Phenomenological research methods for counseling psychology. J Couns Psychol 52:167–177CrossRef
18.
Zurück zum Zitat Heaton J (2008) Secondary analysis of qualitative data. Hist Soc Res 33:33–45 Heaton J (2008) Secondary analysis of qualitative data. Hist Soc Res 33:33–45
19.
Zurück zum Zitat Hinds PS, Vogel RJ, Clarke-Steffen L (1997) The possibilities and pitfalls of doing a secondary analysis of a qualitative data set. Qual Health Res 7:408–424CrossRef Hinds PS, Vogel RJ, Clarke-Steffen L (1997) The possibilities and pitfalls of doing a secondary analysis of a qualitative data set. Qual Health Res 7:408–424CrossRef
20.
Zurück zum Zitat Jasper MA (1994) Issues in phenomenology for researchers of nursing. J Adv Nurs 19:309–314CrossRef Jasper MA (1994) Issues in phenomenology for researchers of nursing. J Adv Nurs 19:309–314CrossRef
21.
Zurück zum Zitat Bogoch ER, Elliot-Gibson V, Beaton DE et al (2006) Effective initiation of osteoporosis diagnosis and treatment for patients with a fragility fracture in an orthopaedic environment. J Bone Joint Surg (Am Vol) 88(1):25–34 Bogoch ER, Elliot-Gibson V, Beaton DE et al (2006) Effective initiation of osteoporosis diagnosis and treatment for patients with a fragility fracture in an orthopaedic environment. J Bone Joint Surg (Am Vol) 88(1):25–34
22.
Zurück zum Zitat Jaglal SB, Hawker G, Cameron C, Canavan J, Beaton D, Bogoch E, Jain R, Papaioannou A, Osteoporosis Research, Monitoring and Evaluation Working Group (2010) The Ontario Osteoporosis Strategy: implementation of a population-based osteoporosis action plan in Canada. Osteoporos Int 21:903–908CrossRef Jaglal SB, Hawker G, Cameron C, Canavan J, Beaton D, Bogoch E, Jain R, Papaioannou A, Osteoporosis Research, Monitoring and Evaluation Working Group (2010) The Ontario Osteoporosis Strategy: implementation of a population-based osteoporosis action plan in Canada. Osteoporos Int 21:903–908CrossRef
23.
Zurück zum Zitat Kvale S, Brinkmann S (2009) Interviews: learning the craft of qualitative research interviewing. Sage Publications Ltd., Thousand Oaks Kvale S, Brinkmann S (2009) Interviews: learning the craft of qualitative research interviewing. Sage Publications Ltd., Thousand Oaks
24.
Zurück zum Zitat Novick G (2008) Is there a bias against telephone interviews in qualitative research? Res Nurs Health 31:391–398CrossRef Novick G (2008) Is there a bias against telephone interviews in qualitative research? Res Nurs Health 31:391–398CrossRef
25.
Zurück zum Zitat Sturges JE, Hanrahan KJ (2004) Comparing telephone and face-to-face qualitative interviewing: a research note. Qual Res 4:107–118CrossRef Sturges JE, Hanrahan KJ (2004) Comparing telephone and face-to-face qualitative interviewing: a research note. Qual Res 4:107–118CrossRef
26.
Zurück zum Zitat NVivo 11 (2016) Victoria, Australia, Qualitative Solutions and Research Pty Ltd. Ref Type: Computer Program NVivo 11 (2016) Victoria, Australia, Qualitative Solutions and Research Pty Ltd. Ref Type: Computer Program
27.
Zurück zum Zitat Malterud K (2001) Qualitative research: standards, challenges, and guidelines. Lancet 358:483–488CrossRef Malterud K (2001) Qualitative research: standards, challenges, and guidelines. Lancet 358:483–488CrossRef
28.
Zurück zum Zitat Kvale S (1996) Interviews: an introduction to qualitative research interviewing. Sage Publications, Thousand Oaks Kvale S (1996) Interviews: an introduction to qualitative research interviewing. Sage Publications, Thousand Oaks
29.
Zurück zum Zitat Carter SM, Little M (2007) Justifying knowledge, justifying method, taking action: epistemologies, methodologies, and methods in qualitative research. Qual Health Res 17:1316–1328CrossRef Carter SM, Little M (2007) Justifying knowledge, justifying method, taking action: epistemologies, methodologies, and methods in qualitative research. Qual Health Res 17:1316–1328CrossRef
30.
Zurück zum Zitat Gearing RE (2004) Bracketing in research: a typology. Qual Health Res 14:1429–1452CrossRef Gearing RE (2004) Bracketing in research: a typology. Qual Health Res 14:1429–1452CrossRef
31.
Zurück zum Zitat Paoletti I (2002) Caring for older people: a gendered practice. Discourse Soc 13:805–817CrossRef Paoletti I (2002) Caring for older people: a gendered practice. Discourse Soc 13:805–817CrossRef
32.
Zurück zum Zitat Dixon-Woods M, Shaw RL, Agarwal S, Smith JA (2004) The problem of appraising qualitative research. Qual Saf Health Care 13:223–225CrossRef Dixon-Woods M, Shaw RL, Agarwal S, Smith JA (2004) The problem of appraising qualitative research. Qual Saf Health Care 13:223–225CrossRef
33.
Zurück zum Zitat Creswell JW (1998) Qualitative inquiry and research design: choosing among five traditions. Sage Publications, Thousand Oaks Creswell JW (1998) Qualitative inquiry and research design: choosing among five traditions. Sage Publications, Thousand Oaks
34.
Zurück zum Zitat Provencher C, Milan A, Hallman S (2018) D’Aoust C. Report on the demographic situation in Canada. Fertility: overview, 2012 to 2016. Catalogue no. 91-209-X ISSN 1718-7788. Statistics Canada. Ref Type: Report Provencher C, Milan A, Hallman S (2018) D’Aoust C. Report on the demographic situation in Canada. Fertility: overview, 2012 to 2016. Catalogue no. 91-209-X ISSN 1718-7788. Statistics Canada. Ref Type: Report
35.
Zurück zum Zitat Martin JA, Hamilton BE, Osterman MJK, et al (2017) National vital statistic reports - births: final data for 2015. Volume 66, Number 1. Ref Type: Report Martin JA, Hamilton BE, Osterman MJK, et al (2017) National vital statistic reports - births: final data for 2015. Volume 66, Number 1. Ref Type: Report
36.
Zurück zum Zitat Mittelman MS, Ferris SH, Shulman E et al (1995) A comprehensive support program: effect on depression in spouse-caregivers of AD patients. Gerontologist 35:792–802CrossRef Mittelman MS, Ferris SH, Shulman E et al (1995) A comprehensive support program: effect on depression in spouse-caregivers of AD patients. Gerontologist 35:792–802CrossRef
37.
Zurück zum Zitat Conti A, Garrino L, Montanari P, Dimonte V (2016) Informal caregivers’ needs on discharge from the spinal cord unit: analysis of perceptions and lived experiences. Disabil Rehabil 38:159–167CrossRef Conti A, Garrino L, Montanari P, Dimonte V (2016) Informal caregivers’ needs on discharge from the spinal cord unit: analysis of perceptions and lived experiences. Disabil Rehabil 38:159–167CrossRef
38.
Zurück zum Zitat Bremault-Phillips S, Parmar J, Johnson M et al (2016) The voices of family caregivers of seniors with chronic conditions: a window into their experience using a qualitative design. SpringerPlus 5:620CrossRef Bremault-Phillips S, Parmar J, Johnson M et al (2016) The voices of family caregivers of seniors with chronic conditions: a window into their experience using a qualitative design. SpringerPlus 5:620CrossRef
39.
Zurück zum Zitat Berglund E, Lytsy P, Westerling R (2019) Living environment, social support, and informal caregiving are associated with healthcare seeking behaviour and adherence to medication treatment: a cross-sectional population study. Health Soc Care Community 27:1260–1270PubMedPubMedCentral Berglund E, Lytsy P, Westerling R (2019) Living environment, social support, and informal caregiving are associated with healthcare seeking behaviour and adherence to medication treatment: a cross-sectional population study. Health Soc Care Community 27:1260–1270PubMedPubMedCentral
40.
Zurück zum Zitat Epstein RM, Street RL (2011) The values and value of patient-centred care. Ann Fam Med 9:100–103CrossRef Epstein RM, Street RL (2011) The values and value of patient-centred care. Ann Fam Med 9:100–103CrossRef
41.
Zurück zum Zitat Candy B, Jones L, Drake R et al (2011) Interventions for supporting informal caregivers of patients in the terminal phase of a disease. Cochrane Database Syst Rev 6 Candy B, Jones L, Drake R et al (2011) Interventions for supporting informal caregivers of patients in the terminal phase of a disease. Cochrane Database Syst Rev 6
42.
Zurück zum Zitat Lincoln YS, Guba EG (1985) Naturalistic inquiry. Sage Publications, Newbury ParkCrossRef Lincoln YS, Guba EG (1985) Naturalistic inquiry. Sage Publications, Newbury ParkCrossRef
43.
Zurück zum Zitat Brazil K, Thabane L, Foster G, Bedard M (2009) Gender differences among Canadian spousal caregivers at the end of life. Health Soc Care Commun 17:159–166CrossRef Brazil K, Thabane L, Foster G, Bedard M (2009) Gender differences among Canadian spousal caregivers at the end of life. Health Soc Care Commun 17:159–166CrossRef
44.
Zurück zum Zitat Navaie-Waliser M, Spriggs A, Feldman PH (2002) Informal caregiving: differential experiences by gender. Med Care 40:1249–1259CrossRef Navaie-Waliser M, Spriggs A, Feldman PH (2002) Informal caregiving: differential experiences by gender. Med Care 40:1249–1259CrossRef
Metadaten
Titel
Having caregiving responsibilities affects management of fragility fractures and bone health
verfasst von
J.E.M. Sale
L. Frankel
J. Paiva
J. Saini
S. Hui
J. McKinlay
S. Sharma
L. Cheng
E. Bogoch
Publikationsdatum
28.03.2020
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 8/2020
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-020-05385-1

Weitere Artikel der Ausgabe 8/2020

Osteoporosis International 8/2020 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.