Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Department of Medicine, College of Medicine, Wasit University, Kut, Iraq.
Rheumatology (Oxford). 2020 Feb 1;59(2):379-385. doi: 10.1093/rheumatology/kez249.
Older women are at particular risk of osteoporosis. Among women with osteoporosis, fractures of the vertebra (vertebral fracture) are common, hard to detect and associated with risk of further fracture. Identifying vertebral fracture in a timely manner allows instigation of preventive measures to reduce the risk of further fracture. Although detection of vertebral fracture requires spinal radiograph, many women do not receive referral. To begin development of a screening tool to identify women in need of referral we undertook a qualitative study to characterize women's experiences of vertebral fracture, using Eccleston's 'Ten Neglected Bodily Senses'.
Four qualitative focus groups were conducted with women who had been diagnosed with vertebral fracture (n = 19, age 60-91 years). Data were audio-recorded, transcribed and analysed thematically using the 'Ten Neglected Bodily Senses'.
Women's experiences of vertebral fractures related to seven senses: pain, movement, fatigue, balance, pressure, appetite and breathing. Pain was the dominant sense and all participants explained how pain increased with activity, reaching a crescendo, and described strategies to minimize this disruption. Most participants had become physically shorter, making some feel 'squashed', putting pressure on other body parts. Some described appetite loss or a sense of restricted breathing. Participants experienced a sense of being 'pulled' forwards, impacting on balance and exacerbating fear of falling.
The study found senses that have not been previously described in the experiences of women with vertebral fracture. These will be used to inform the design of a new screening tool for use in primary care.
老年女性尤其容易患骨质疏松症。在骨质疏松症患者中，椎体骨折（脊椎骨折）较为常见，难以察觉，且与进一步骨折的风险相关。及时发现椎体骨折可以采取预防措施来降低进一步骨折的风险。尽管检测椎体骨折需要进行脊柱 X 光检查，但许多女性并未接受转介。为了开发一种筛选工具来识别需要转介的女性，我们进行了一项定性研究，使用 Eccleston 的“十大被忽视的身体感觉”来描述女性的椎体骨折体验。
对已被诊断为椎体骨折的女性（年龄 60-91 岁，n=19）进行了四项定性焦点小组讨论。使用“十大被忽视的身体感觉”对音频记录、转录和分析数据进行主题分析。
女性的椎体骨折体验与七种感觉有关：疼痛、运动、疲劳、平衡、压力、食欲和呼吸。疼痛是主导感觉，所有参与者都解释了疼痛如何随着活动而增加，达到高潮，并描述了减轻这种干扰的策略。大多数参与者的身高变矮，使一些人感到“压扁”，对身体其他部位施加压力。一些人描述了食欲下降或呼吸受限的感觉。参与者感到被“拉”向前，影响平衡并加剧对跌倒的恐惧。
该研究发现了之前在椎体骨折女性的体验中未描述过的感觉。这些感觉将用于为初级保健中使用的新筛选工具的设计提供信息。
