title: 'If it was osteoporosis, I would have really hurt myself.' Ambiguity about osteoporosis and osteoporosis care despite a screening programme to educate fragility fracture patients.
abstract: OBJECTIVE
  Behaviour change models suggest that people need clear information about their susceptibility to disease and knowledge of treatment recommendations in order to change their behaviour. The purpose of this qualitative study was to examine fracture patients' understanding of osteoporosis (OP) and OP care after being screened for, and educated about, OP in a fracture clinic.
  
  
  METHODS
  We conducted five focus groups with 24 patients (18 women, six men) aged 47-80 years old who were screened for OP through an urban fracture clinic. Participants were asked about their awareness of OP and their status of bone mineral density (BMD) testing and OP treatment.
  
  
  RESULTS
  Twenty participants vocalized at least one expression of ambiguity regarding OP and/or treatment recommendations conveyed by the screening programme staff. Participants were ambiguous about the cause of their fracture, the BMD test process and results, and the presentation of OP. They were also ambiguous about the amount and type of medication and supplements recommended.
  
  
  CONCLUSIONS
  Despite a standardized screening programme in which OP was addressed in fragility fracture patients, ambiguity about diagnosis, testing and treatment were described. Efforts to clarify information relayed to fracture patients about their condition and recommended care need to extend beyond the fracture clinic so that health care providers can promote long-term adherence to these recommendations.
authors.affiliation: Mobility Program Clinical Research Unit, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. salej@smh.toronto.on.ca
authors.forename: Joanna E M
authors.initials: JE
authors.lastname: Sale
authors.forename: Dorcas E
authors.initials: DE
authors.lastname: Beaton
authors.forename: Rebeka
authors.initials: R
authors.lastname: Sujic
authors.forename: Earl R
authors.initials: ER
authors.lastname: Bogoch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017144:Focus Groups; D050723:Fractures, Bone; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009864:Ontario; D010024:Osteoporosis / Q000628:therapy*; D010353:Patient Education as Topic