Tang Nan, Jiang Lingjie, Lei Mingxing, Su Qingqing, Song Jie, Kong Dan, Cui Xiang, Gao Yuan
Medical School of Chinese PLA, PLA General Hospital, Beijing, 100853, China.
Department of Nursing, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.
BMC Geriatr. 2025 Jul 29;25(1):559. doi: 10.1186/s12877-025-06236-6.
Osteoporotic secondary fractures are associated with high mortality and poor prognosis. However, little is known about subsequent fracture prevention behaviors in the home environment, especially regarding the experiences, perceptions, and decisions of patients and family caregivers.
A purposive sampling method was used to select 20 elderly patients with osteoporotic subsequent fractures and 10 family caregivers from a tertiary hospital in Beijing for semi-structured interviews. The interviews were transcribed verbatim and analyzed using thematic analysis.
Participants described three interconnected themes: internalized negative age stereotypes, attitude-driven osteoporosis management deficiencies, and family caregiving challenges under Confucian culture. Internalized negative age stereotypes profoundly affected elderly individuals' attitudes and behaviors toward fragility fractures and health management through a dual mechanism of decreased behavioral autonomy and negative outcome expectations. Meanwhile, attitude-driven osteoporosis management deficiencies significantly increased the risk of subsequent fractures. The effectiveness of family caregiving under Confucian culture varied according to differences in cognition, beliefs, and cultural identity.
This qualitative study provides new insight into the dilemma of subsequent fragility fracture prevention among elderly individuals. Starting from cultural concepts and proactive health education, helping the elderly establish a positive attitude toward aging can enhance their awareness of subsequent fracture prevention and treatment, as well as their initiative and confidence in health management. Meanwhile, perpetuating the beneficial effects of Confucian culture and enhancing community support for family caregiving may contribute to improved health management of elderly individuals with fragility fractures.
骨质疏松性继发骨折与高死亡率和不良预后相关。然而，对于家庭环境中后续骨折预防行为，尤其是患者及家庭照顾者的经历、认知和决策，我们知之甚少。
采用目的抽样法，从北京一家三级医院选取20例患有骨质疏松性继发骨折的老年患者和10名家庭照顾者进行半结构式访谈。访谈内容逐字转录，并采用主题分析法进行分析。
参与者描述了三个相互关联的主题：内化的负面年龄刻板印象、态度驱动的骨质疏松管理不足以及儒家文化下的家庭照顾挑战。内化的负面年龄刻板印象通过行为自主性降低和负面结果预期的双重机制，深刻影响了老年人对脆性骨折和健康管理的态度及行为。同时，态度驱动的骨质疏松管理不足显著增加了后续骨折的风险。儒家文化下家庭照顾的效果因认知、信念和文化认同的差异而有所不同。
这项定性研究为老年个体后续脆性骨折预防的困境提供了新的见解。从文化观念和积极的健康教育入手，帮助老年人树立对衰老的积极态度，可以提高他们对后续骨折预防和治疗的意识，以及他们在健康管理方面的主动性和信心。同时，延续儒家文化的有益影响并加强社区对家庭照顾的支持，可能有助于改善脆性骨折老年个体的健康管理。
