Nursing Interventions of Women with Osteoporosis

This article discusses the nursing interventions for women with osteoporosis. It covers the significance of the study, educational and medical interventions, and critical review of evidence. The study is limited to English language published between 2014 and 2018 and focused on women between the age of 55 years and above.

Running Head: Nursing Interventions
NURSING INTERVENTIONS OF THE WOMEN WITH OESTOPROSIS
Name:
Academic Affiliation:
Date:

Nursing Interventions 2
The significance of the study
Osteoporosis refers to a skeletal medical condition of decreased bone’ density and
strength, resulting in bone fragility. Osteoporosis makes the bones to be porous and compressible
like a sponge, weakening and making it susceptible to breakages from minor falls or bumps
(Aggarwal & Masuda, 2018). These type of fractures that results from the reduced bone strength
are referred to as ‘fragility fractures’ and are always found among many people across the world.
Research shows that one out of two women and one out of five men above the ages of 50 are
susceptible to the fragility fractures around many parts of the body such as the wrist, hips, spine
among many others.
A normal bone comprises of collagen, protein, and calcium that offers its strength. Bones
have numerous functions such as the provision of the support, structure protection of the internal
organize storage of calcium and other mineral elements and contain bone marrow that act as
blood cells producers. This means that any medical condition that affects the functionality of the
bone renders the body to numerous diseases, functionality, and even death. Above the ages of 35
years, the is an imbalance on the amount of bone being removed, and the amount of that is laid
down as a result of the aging process, a process known as ‘bone thinning’. The bones from the
outside look the same, however, from the inside the cortical shell reduces, and the struts become
thinner hence leading to the probability of fractures (Vipey et al., 2015). As indicated earlier,
osteoporosis occurs in both women; however, it is much common among older women due to the
high rate of bone loss during the menopause period and when the sex hormones level drop down.
During the adolescent, the human’s bone structure is always strong with enough mass to
sustain the body weight and any bump, however, after some ages of 55 years, the estrogen

Nursing Interventions 3
hormone that protects the bone loss is reduced. After the menopause, the ovaries stop producing
the estrogen leading to high-risk factors among the women thus making an average of about 34%
women against 17% of men worldwide (Nixon et al., 2016). Over 200 million of women quality
of life is seriously jeopardized with the increasing rate of osteoporosis in the world and with the
high rate of aging population, there is need to have health interventions to provide guidance and
care for them. In the European Union, osteoporosis cost above € 37 billion with some victims
projected to increase shortly. The high population of sufferers puts many countries in the world
to have large expenditure on the health conditions hence the formations of numerous
organizations such as National Osteoporosis Foundation (NOF), and International Osteoporosis
Foundations (IOF) (Shams-White et al., 2018). Such organizations, work worldwide to create
awareness of the knowledge about osteoporosis with an aim to reduce the prevalence among the
populations.
The diagnosis of osteoporosis occurs through the measure of bone loss by the use of Dual
Energy X-ray, and DXA test that always takes about 15 minutes. A T-score that ranges between -
2.5 and lower requires intervention depending on the doctor's interpretation.
Figure 1 shows changes in bone mass against age, obtained from (Vipey et al., 2015)

Nursing Interventions 4
Question for the Literature Review
What are the nursing interventions of women with osteoporosis?
Search Strategy
Evidence will be conducted through the use of Medline, CINNAL and Scopus database
systems that are accessible from the University of Wollongong Library. Other sources search
such as Google scholars were used to collect the required information. Based on the search
question, the nursing interventions on women with osteoporosis, search terms were derived:
Osteoporosis, nursing interventions and osteoporosis among women.
The study is limited in the English language published between 2014 and 2018 and
focused on women between the age of 55 years and above. The study found 25 nursing journal
articles of which 15 met the selection criteria and were analyzed to come up with the full
literature review on the topic.
Summary of the evidence
The studies are examined based on the following two interventions: educational and
medical. The educational intervention focuses on the self-efficacy while the medical
interventions focus on the use of drugs and estrogen replacement therapy.
Osteoporosis educational intervention
Health education plays a significant role in the public as it aims at preventing the spread
of diseases and the improvement of people’s lives through the dissemination of information.
Health education entails combinations of learning experiences that are undertaken by different
stakeholders in promoting a healthy lifestyle. The study conducted by Stupar, Radojčić, Tadić,

Nursing Interventions 5
and Pavlov-Dolijanović on the Osteoporosis-related knowledge among 132 Serbian
postmenopausal women aimed at identifying the effect of education of osteoporosis on women.
The role of osteoporosis education among women is to provide information to affect the beliefs,
attitudes and intervention behavior with a major aim to reduce the prevalence of bone fracture
(Stupar et al., 2017).
Numerous shows that inadequate knowledge about osteoporosis and risk factors increase
the chances of prevalence by about 39% as the women are unable to determine their risks of
developing the disease and changing the health-related behaviors (Toh eta l., 2015). The
education of osteoporosis prevention can be divided into two: that is knowledge of osteoporosis
measurement and the prevention behavior. During the education, women are taught more about
osteoporosis with a major focus on the bone anatomy, self-management principles, personal goal
setting, pain management, relaxation, nutrient, posture, working with doctors and medication,
osteoporosis risk factors, measurement of bone density, and support from groups among many
others.
Self-efficacy
Self-efficacy refers to personal confidence in performing a particular behavior in
numerous situations (Ki-Soo et al., 2017). In studies conducted on the role of education on the
osteoporosis, whereby the all the participants were all women from various profession and
institutions, self-efficacy was found as the major contributor to the management of the diseases.
Janiszewska, Kulik, Żołnierczuk-Kieliszek, Drop, Firlej and Gajewska, conducted a study on
151 women who have undergone educational training and conclude that self-efficacy is
instrumental in the treatment.in health education, self-efficacy entails different factors such as

Nursing Interventions 6
knowledge, attitude skills, and behavior change (Janiszewska et al., 2017). Among these factors,
behavior change is the fundamental of self-efficacy and has been used among many programs
and interventions. Self-efficacy is influenced by four main sources that are: mastery experience,
vicarious experience, verbal persuasion, and physiological and emotional states.
Mastery experience influences self-efficacy through all the successful experiences, while
repeated failures reduce/lowers self-efficacy (Elders et al., 2017). The osteoporosis education,
allows women to have experiences in keeping the calcium, vitamin and other nutrients intake
diary or even having regular weight-bearing exercises to prevent osteoporosis. The success of
these educational experiences and mastery of the techniques increase the self-efficacy of the
participants that eventually help them to reduce while at home or even after the education
system.
The vicarious experiences help in improving self-efficacy through seeing people of the
similar condition who are strong. Through osteoporosis education, groups are always formed to
enhance the participant’s belief about the effect of doing various activities that have made other
people manage the condition. The verbal persuasion is used by health education professionals to
disseminate reliable and persuasive information. The verbal encouragement during the
educational intervention increases the self-efficacy of the women to achieve the set goals in
managing the medical condition. Lastly, the physiological and emotional status helps in
increasing the positive mood of depressed women.
Studies show that self-efficacy creates the behavior change leading to increased rate of
weight-bearing exercise and calcium intake increases the strength of the bone. However, some

Nursing Interventions 7
studies also report that weight-based exercise is less effective among the older women who feel
too old to perform the activities hence are only left with nutrition intervention.
Nutrition and osteoporosis
A healthy diet is important throughout the life in building the strong bones and reduction
of the strength. Women are always taught to feed adequately during childhood and after the
menopause period to provide a better chance of the bones to withstand a loss in the old age.
Calcium foods such as milk, cheese, baked beans, and rice among many others makes the bones
strong (Bharathi & Baby, 2017). Vitamin D foods such as sunlight, grilled salmon, soya milk,
boiled chicken egg help to regulate the way the body uses calcium in the body. Women are
taught how to select rich foods to enhance their dietary intake through calcium and vitamin rich
food choosers.
Exercise and osteoporosis
Exercise helps in building strong bones during the early years and helps in increasing the
strength of the bones through life. Bone is living tissues that are affected by the forces and loads
put upon it by becoming stronger. Constant and frequent body movement causes the muscles to
pull on the bones, increasing the strength hence reducing the probability of experiencing any fall.
During education, women are taught on what kind of exercise is right for them since the choice
of the wrong exercise might lead to fracture (Svege et al., 2016). For example, a woman with
high fracture risk is prone to fragility hence jogging exercise is not recommended. Therefore nay
choice of exercise must be tailored according to each patient’s situation as discusses by doctors
and physiotherapist.

Nursing Interventions 8
Osteoporosis Medical intervention
The high rate of osteoporosis among the post-menstrual results from the estrogen
deficiency that accelerate the bone turnover, thus enhancement of the parathyroid hormones
(PTH) increase the intake of calcium and vitamin among the women; promoting the osteoclast
process. Study conducted by Ciumărnean, Milaciu, Alb, Moldovan and Sâmpelean,
conducted a research on 4235 participants and found out that increase on the drug’s use
increased the bone mineral density.
Estrogen replacement
Due to the roles of estrogen receptors in the osteoclast apoptosis, estrogen replacement
therapy is a significant way of preventing osteoporosis among the post-menopausal women.
Numerous studies indicate that lumbar spine, femoral neck, and total hip-bone mass density
changes through the hormonal replacement therapy are hence reducing the bone turnover
(Costello, Sprung & Coulter, 2017). However, due to high-risk factors such as thromboembolic
disorders, stroke, and endometrial cancers among others, the process is not recommended as a
first measure of osteoporosis treatment.
Selective estrogen receptor modulators such as lasofoxifene, raloxifene and bazedoxifene
are also used to improve the estrogen in the body. These are FDA approved non-steroid synthetic
drugs that reduce vertebral fracture among the osteoporosis women by increasing the trabecular
bone mass in the axial skeleton.
Oral drugs

Nursing Interventions 9
Oral bio phosphates are one of the long-term interventions used among women especially
those that are post-menstrual period. Bio phosphate act by interfering with particular paths of
the intracellular in osteoclast leading to cellular toxicity. The bio-phosphate binds to
hydroxyapatite thus absorbed by bone preventing osteoplastic (Ciumărnean et al., 2017, p.36).
Different drugs such as ‘antiresoptives’ are designed to slow down the activity of the cell that
breakdown the old bone(osteoclasts), while other drugs such as ‘anabolic’ drugs stimulate the
creation of new bones(osteoblasts). Since these drugs work differently, the combination of the
use yields a good result among the women.
Critical review evidence
Most of the chosen journals had a cross-sectional study on the impact of education among
the osteoporosis women, and the articles were purposively chosen to provide the required
information on the topic (Wu, Yu & Zhou, 2017). Majority of the studies reported positive
experiences of the women after the osteoporosis interventions that make them relevant among
the large population in the world.
Strength and limitations
The literature review was based on the nursing interventions on osteoporosis among
women, and more than half of the studies were conducted with more than 100 participants in
different countries, generalizing to be valid. However, there is attrition bias in some studies that
made to identify the participants in the researches.
The relevance and impact of finding and identified gaps

Nursing Interventions 10
The evidence retrieved from these studies offer common nursing interventions strategies
among the osteoporosis women across the world (Yousef, 2017). Health partners and
osteoporosis patients thus have added information on the best strategies in nursing practices and
managing osteoporosis conditions. However, the limitations of the evidence are that it limited on
the nursing interventions on women rather than the whole population, since osteoporosis affects
all ages.
Conclusion
Through the use of different search database systems, 15 articles found relevant to the
topic were analyzed to identify the nursing interventions among the osteoporosis women.
Despite the limitations of references, the found articles provide enough information and the
major were education programs and medical treatment. Most of the participants in the studies
showed positive experience from the various interventions.
Critical Appraisal
The study on the nursing intervention of women with osteoporosis is significant
following the high rate of women suffering from the medical condition. From the studies carried
out by several researchers such as Stupar, Radojčić, Tadić, and Pavlov-Dolijanović and many
others on the Osteoporosis-related knowledge among 132 Serbian postmenopausal women
indicate that a lot of money is spent in treating and managing the disease. The method used in
both primary and secondary data collection; mixed methods ensures that the researchers were
accessible to the relevant information. Janiszewska, Kulik, Żołnierczuk-Kieliszek, Drop, Firlej
and Gajewska, used qualitative and quantitative research methods of data collection and analysis.

Nursing Interventions 11
The inclusion and exclusion of participants were based on age above 45 years, thus this exluded
young woman of 18-30 years, of which some suffered osteoporosis too.
The results of most of the studies corre late osteoporosis with post-menopause age; an
age that shows most of the women's estrogens levels have reduced to minimum. This means that
the rate of bone strength is reduced leading to a high probability of fracture. Most of the studies
indicate d the use of education as the main intervention of nursing of women with osteoporosis.
Education ensures that all women know the right food to take and avoid, improve their self-
efficacy and adopt relevant medical interventions such estrogen replacement and drug use.

Nursing Interventions 12
References
Aggarwal, L., & Masuda, C. (2018). Osteoporosis: A quick update. Journal of Family
Practice, 67(2), 59–65. Retrieved from http://search.ebscohost.com/login.aspx?
direct=true&db=aph&AN=127851780&site=ehost-live
Bharathi R., & Baby D. (2017). Effect of Dietary Calcium and Phosphorus Intakes on Bone
Health Status of Aged and Elderly Rural Women. Indian Journal of Gerontology, 31(4),
412–422. Retrieved from http://search.ebscohost.com/login.aspx?
direct=true&db=aph&AN=126429858&site=ehost-live
Ciumărnean, L., Milaciu, M. V., Alb, M. G., Moldovan, R. T., & Sâmpelean, D. P. (2017). The
Efficiency in Postmenopausal Osteoporosis Treatment. Balneo Research Journal, 8(2),
33–39. Retrieved from http://search.ebscohost.com/login.aspx?
direct=true&db=aph&AN=123263477&site=ehost-live
Costello, B. T., Sprung, K., & Coulter, S. A. (2017). The Rise and Fall of Estrogen Therapy: Is
Testosterone for “Manopause” Next? Texas Heart Institute Journal, 44(5), 338–340.
https://doi.org/10.14503/THIJ-17-6360
Elders, P. J. M., Merlijn, T., Swart, K. M. A., van Hout, W., van der Zwaard, B. C., Niemeijer,
C. van Schoor, N. M. (2017). Design of the SALT Osteoporosis Study: a randomised
pragmatic trial, to study a primary care screening and treatment program for the
prevention of fractures in women aged 65 years or older. BMC Musculoskeletal
Disorders, 18, 1–10. https://doi.org/10.1186/s12891-017-1783-y

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Janiszewska, M., Kulik, T., Żołnierczuk-Kieliszek, D., Drop, B., Firlej, E., & Gajewska, I.
(2017). General self-efficacy level and health behaviours in women over the age of 45
years who have undergone osteoporosis treatment. Menopausal Review / Przeglad
Menopauzalny, 16(3), 86–95. https://doi.org/10.5114/pm.2017.70584
Ki-Soo Park, Jun-Il Yoo, Ha-Young Kim, Sunmee Jang, Yongsoon Park, Yong-Chan Ha, Ha,
Y.-C. (2017). Education and exercise program improves osteoporosis knowledge and
changes calcium and vitamin D dietary intake in community dwelling elderly. BMC
Public Health, 17, 1–8. https://doi.org/10.1186/s12889-017-4966-4
Nixon, A., Doll, H., Kerr, C., Burge, R., & Naegeli, A. N. (2016). Interpreting change from
patient reported outcome (PRO) endpoints: patient global ratings of concept versus
patient global ratings of change, a case study among osteoporosis patients. Health &
Quality of Life Outcomes, 14, 1–12. https://doi.org/10.1186/s12955-016-0427-5
Shams-White, M. M., Chung, M., Fu, Z., Insogna, K. L., Karlsen, M. C., LeBoff, M. S.Weaver,
C. M. (2018). Animal versus plant protein and adult bone health: A systematic review
and meta-analysis from the National Osteoporosis Foundation. PLoS ONE, 13(2), 1–24.
https://doi.org/10.1371/journal.pone.0192459
Stupar, N. V., Radojčić, L., Tadić, I., & Pavlov-Dolijanović, S. (2017). Osteoporosis-related
knowledge among Serbian postmenopausal women. Vojnosanitetski Pregled: Military
Medical & Pharmaceutical Journal of Serbia, 74(5), 445–449.
https://doi.org/10.2298/VSP150716107V
Svege, I., Fernandes, L., Nordsletten, L., Holm, I., & Risberg, M. A. (2016). Long-Term Effect
of Exercise Therapy and Patient Education on Impairments and Activity Limitations in

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People With Hip Osteoarthritis: Secondary Outcome Analysis of a Randomized Clinical
Trial. Physical Therapy, 96(6), 818–827. https://doi.org/10.2522/ptj.20140520
Toh, L. S., Lai, P. S. M., Wu, D. B.-C., Wong, K. T., Low, B. Y., & Anderson, C. (2015). The
Development and Validation of the Osteoporosis Prevention and Awareness Tool
(OPAAT) in Malaysia. PLoS ONE, 10(5), 1–19.
https://doi.org/10.1371/journal.pone.0124553
Viprey, M., Caillet, P., Canat, G., Jaglal, S., Haesebaert, J., Chapurlat, R., & Schott, A.-M.
(2015). Low Osteoporosis Treatment Initiation Rate in Women after Distal Forearm or
Proximal Humerus Fracture: A Healthcare Database Nested Cohort Study. PLoS
ONE, 10(12), 1–10. https://doi.org/10.1371/journal.pone.0143842
Wu, J., Yu, M., & Zhou, Y. (2017). Association of collagen type I alpha 1 +1245G/T
polymorphism and osteoporosis risk in post-menopausal women in Australia: a meta-
analysis. International Journal of Rheumatic Diseases, 20(7), 903–910.
https://doi.org/10.1411/1756-185X.13052
Yousef, F. M. (2017). Associations Factors Affecting on Osteoporosis in Postmenopausal
Women in Saudi Arabian, Jeddah. International Journal of Pharmaceutical Research &
Allied Sciences, 6(2), 204–212. Retrieved from http://search.ebscohost.com/login.aspx?
direct=true&db=aph&AN=143234366&site=ehost-live
Appendix: Critical Analysis for the chosen Articles

Nursing Interventions 15
Description Research design Outcomes
R
ef
er
en
ce
de
ta
ils
Research
Aims/
objectives
Nature of
interventio
n
Study
populatio
n
Researc
h design
type
Data
collectio
n
methods
Finding
s/
results
Concl
usions
Assumpt
ion ions
Limit
ation
ons
Your
judg
ment
1.
Jou
rnal
Gen
eral
self
-
effi
cac
y
leve
l
and
heal
N
a
m
e
of
au
th
or
s:
Ja
ni
sz
e
w
To estimate
the effect of
self-efficacy
on the
behavior
change
among
women with
osteoporosis
Educationa
l Program
151
participan
ts(Wome
n above
45 years)
Quantit
ative
study
Statistica
l
analysis
of X2
test
73.5%
of the
respond
ents
showed
very
low and
low
generali
zed self-
efficacy
level.
On the
other
The
gener
alized
self-
effica
cy
level
and
the
health
behav
iors
are
not
The
sampl
e was
less
to
make
a
gener
al
concl
usion
The
infor
mati
on
gaine
d
provi
ded a
basis
unde
rstan
ding
of
the

Nursing Interventions 16
th
beh
avi
ors
in
wo
me
n
ove
r
the
age
of
45
year
s
wh
o
hav
e
und
erg
one
sk
a,
M
.,
K
ul
ik
,
T.
,
Ż
oł
ni
er
cz
u
k-
K
ie
lis
ze
k,
D.
hand,
only
22.5%
of the
examine
d were
characte
rized by
high
and
very
high
generali
zed self-
efficacy
level.
satisfa
ctory
topic

Nursing Interventions 17
oste
opo
rosi
s
trea
tme
nt.
Me
nop
aus
al
Rev
iew
/
Prz
egla
d
Me
nop
auz
aln
y
Vol
,
D
ro
p,
B.
,
Fi
rl
ej,
E.
,
&
G
aj
e
w
sk
a,
I.
N
u
m
be

Nursing Interventions 18
um
e:
16
Nu
mb
er:3
r
of
pa
rti
ci
pa
nt
s
.
Y
ea
r
of
P
u
bl
ic
at
io
n:
2
0
1

Nursing Interventions 19
7
C
o
u
nt
ry
:
S
o
ut
h
E
as
te
rn
P
ol
an
d.
P
ar
ti
ci

Nursing Interventions 20
p
a
nt
s
1
5
1
2.
Ost
eop
oro
sis-
rela
ted
kno
wle
dge
am
ong
Ser
bia
n
post
A
ut
h
or
s:
St
u
pa
r,
N.
V.
,
R
ad
oj
či
To
determine
the level of
knowledge
about
osteoporosis
and
osteoporosis
related risk
factors in
postmenopa
usal women
in Serbia
Education
Program
132
women
who are
post-
menopaus
al
Primary
Researc
h
Analysis
of
Osteopor
osis
Knowled
ge
Assessm
ent Tool
- Shorter
Version
(OKAT-
S
. Their
knowled
ge
varied
from
27.94%
to
74.26%
of the
correct
answers
, with
the
average
OKAT-
S score
The
results
are
impor
tant
for
the
nursin
g
interv
ention
on
wome
n with
osteop
orosis
The
Serbi
an
versio
n of
the
questi
onnai
re
OKA
T-S
reveal
ed
gener
ally
poor
The
infor
mati
on
was
signi
fican
t on
educ
ation
the
popu
latio
n
about
the

Nursing Interventions 21
me
nop
aus
al
wo
me
n.
Voj
nos
anit
etsk
i
Pre
gle
d.
Na
me
of
jour
nal:
Mili
tary
Me
ć,
L.
,
T
ad
ić,
I.,
&
P
av
lo
v-
D
ol
ij
an
o
vi
ć
Y
ea
r
of
of 4.5
(SD =
2.55),
which
was
50% of
the
maximu
m
possible
score.
Only 2
particip
ants
(1.47%)
filled
the all
OKAT-
S items
correctl
y, while
11
(8.09%)
know
ledge
on
osteo
poros
is
amon
g
postm
enopa
usal
wome
n in
Serbi
a.
Devel
oping
effect
ive
interv
entio
ns
and
osteo
poros
is

Nursing Interventions 22
dic
al
&
Pha
rma
ceut
ical
Jou
rnal
of
Ser
bia
Vol
um
e:
74
Nu
mb
er:5
P
u
bl
ic
at
io
n:
2
0
1
7.
C
o
u
nt
ry
of
p
u
bl
ic
at
io
of them
did not
have the
proper
answer
to any
question
. A
reduced
bone
density
(T-score
below -
1) was
registere
d in
40.91%
of the
women,
previous
fracture
s in 49
(34.51%
publi
c
health
progr
ams
could
be
helpf
ul in
gener
al
educa
tion
towar
ds
under
standi
ng
osteo
poros
is and
risk
factor

Nursing Interventions 23
n:
S
S
er
bi
a
), and
more or
less 3
falls
registere
d in
9.59%
or
4.79%,
respecti
vely
s
3.
The
Effi
cien
cy
in
Pos
tme
nop
aus
al
Ost
Ci
u
m
ăr
ne
an
,
L.
,
M
il
ac
To evaluate
the efficacy
of
bisphosphon
ates
compared
with that of
Denosumab
by analyzing
different
parameters
Drug
medication
:bio
phosphate
4535
participan
ts
Mixed
Researc
h
method
ology
Randomi
zed
studies
that
directly
compare
d
bisphosp
honates
to
Denosu
mab
In all 7
studies
the
changes
in
lumbar
spine
bone
mineral
density
were
statistic
Both
therapies
have a
similar
reductio
n of
bone
turnover
markers.
The
study
used
large
numb
er of
sampl
es
that
made
the
analy
The
stydy
was
comp
rehen
sive
since
it
revie
wed
more
than

Nursing Interventions 24
eop
oro
sis
Tre
atm
ent.
Na
me
of
the
Jou
rnal
:
Bal
neo
Res
ear
ch
Jou
rnal
,
Vol
um
iu
,
M
.
V.
,
A
lb
,
M
.
G.
,
M
ol
d
o
va
n,
R.
T.
,
&
after 1
year of
treatmen
t, which
included
data
regardin
g the
bone
mineral
density
(BMD)
and bone
turnover
markers
(BTM)
measure
d at
baseline
and after
12
months
ally
significa
nt in
favor of
Denosu
mab
sis to
be
diffic
ult
five
previ
ous
studi
es

Nursing Interventions 25
e :
8
Nu
mb
er:
2
S
â
m
pe
le
an
,
D.
P
Y
ea
r
of
P
u
bl
ic
at
io
n:
2
0
1

Nursing Interventions 26
7.
C
o
u
nt
ry
of
P
u
bl
ic
at
io
n:
P
ar
ti
ci
pa
nt
s
4
5

Nursing Interventions 27
3
5
4.
Eff
ect
of
Die
tary
Cal
ciu
m
and
Pho
sph
oru
s
Inta
kes
on
Bon
e
Hea
lth
B
ha
ra
th
i
R.
,
&
B
ab
y
D
C
o
u
nt
ry
: :
In
di
Provision of
Calcium and
phosphorus
dosage
189
women
aged 55
years and
above
Longitudi
nal study
Anthro
metric
measure
ment,
intervie
w
Osteopor
osis
prevalen
ce
among
Indian
women
who
were
under
calcium
and
phospho
rus was
1.7%,
the
prevalen
ce of
osteopor
osis
among
Medical
interven
tion on
the use
of
calcium
and
phospho
rus
element
s should
be
provide
d from
the
lower
age of
the
women
Calciu
m and
phosp
horus
have
signifi
cant
help
in
reduci
ng
proba
bility
of
osteop
orosis
Inadequ
ate
calcium
and
phospho
rus in
the body
is
related
to
frequenc
y of
osteopor
osis
among
Indian
women
The
resear
cher
did
not
inclu
de
impor
tant
cofou
nder
such
as
physi
cal
activi
ty
Relat
ed
calci
um ,
phos
phor
us
and
osteo
poros
is

Nursing Interventions 28
Stat
us
of
Age
d
and
Eld
erly
Rur
al
Wo
me
n.
Jou
rnal
:
Indi
an
Jou
rnal
of
Ger
ont
a
P
ar
ti
ci
pa
nt
s :
1
8
0
those
who
were not
under
calcium
and
phospho
rus was
6.0%.

Nursing Interventions 29
olo
gy
Vol
um
e :
31
Nu
mb
er:
4
5.
Ass
ocia
tion
of
coll
age
n
typ
e I
alp
ha 1
+12
W
u,
J.,
Y
u,
M
.,
&
Z
h
o
u,
Y.
To study
the impact
of collagen,
type 1 alpha
on
osteoporosis
Hormonal
therapy
150 post-
menopaus
e women
Primary
Researc
h
Analysis
of
longitudi
nal
cohort
Cumulat
ive
incidenc
e per 3
women
and the
data
availabil
ity,
identifie
d.
Cause:
reductio
The
result
provid
es
releva
nt
infor
matio
n on
how
collag
en can
be
The is
positive
relation
between
collagen
, alpha
and
osteopor
osis
The
study
used
small
sampl
e
size,
that
make
s it
diffic
ult to
gener
Colla
gen
is
signi
fican
t
amon
g the
wom
en
with
osteo
poros

Nursing Interventions 30
45
G/T
pol
ym
orp
his
m
and
oste
opo
rosi
s
risk
in
post
-
me
nop
aus
al
wo
me
n
Y
ea
r:
2
0
1
7
C
o
u
nt
ry
:
A
us
tr
al
ia
N
u
m
be
r
n of
estrogen
in the
body:
evidenc
e 150
prospect
ive
cohorts
in
Australi
an .Cou
ntry:
Osteopo
rosis to
estrogen
level
among
the
Australi
an
women
cohort
used
to
reduc
e
bone
fractu
re
amon
g the
postm
enopa
usal
wome
n
across
the
world.
alize
to the
whole
popul
ation
is

Nursing Interventions 31
of
pa
rti
ci
pa
nt
s:
2
5
0
95 %
confide
nce
intervals
(95 %
CI)
were
calculat
ed.
Number
of
particip
ants:
150
multivar
iable
models.
Results:
The
cumulat
ive
incidenc
e of

Nursing Interventions 32
osteopor
osis
depende
d on the
level of
estrogen
in the
body.
Description Research design Outcomes Your
judg
ment
Refe
renc
e
deta
ils
Resear
ch
Aims/
objecti
ves
Natu
re of
inter
venti
on
Stud
y
pop
ulati
on
Resea
rch
desig
n
type
Data
colle
ction
meth
ods
Findi
ngs/
result
s
Concl
usions
Assu
mpti
on
ions
Limita
tion on
6.
Associ
ations
Factors
Affecti
ng on
Aut
hor:
You
sef,
F.
To
find
out
factors
affecti
ng
Educ
ation
al
prog
rams
Cro
ss-
secti
onal
stud
Quest
ionna
ire
and
interv
Prim
ary
Rese
arch
Lack
of
knowl
edge
on
osteo
Educat
ion on
the
Postm
enopa
usal
Oste
opor
osis
is
high
amon
The
study
on
majore
d
among
The
colle
cted
infor
mati
on

Nursing Interventions 33
Osteop
orosis
in
Postme
nopaus
al
Wome
n in
Saudi
Arabia
n.
Journal
:
Interna
tional
Journa
l of
Pharm
aceutic
al
Resear
ch &
M
Yea
r:
201
7
Cou
ntry:
Sau
di
Ara
bia
Parti
cpan
ts:2
00
osteop
orosis
in
Postm
enopa
usal
wome
n
y iew porosi
s
factor
contri
buted
to
high
preval
ence
wome
n on
the
osteop
orosis
factors
is a
great
contri
butor
to the
reducti
on of
fractur
e
g
illiter
ate
wom
en
the
Postm
enopau
sal,
rather
than
all
ages
on
the
facto
rs
affec
ting
osteo
poro
sis
are
signi
fican
t to
the
gene
ral
publi
c

Nursing Interventions 34
Allied
Science
s.
Volum
e :6
Numbe
r :2
7.
Educati
on and
exercis
e
progra
m
improv
es
osteop
orosis
knowle
dge
Aut
hors
:
Ki-
Soo
Park
,
Jun-
Il
Yoo
,
Ha-
You
To
determ
ine the
effect
of
exerci
se and
educat
ion
progra
m on
osteop
orosis
Educ
ation
al
inter
venti
on
Cross
-
sectio
nal
study
Self-
admi
nistra
tor
and
quest
ionna
ire
80.5
% of
the
respo
ndent
s
show
ed
very
low
on
indul
gence
The
preval
ence
of
osteop
orosis
is low
among
educat
ed
wome
n
The
is
close
relati
onshi
p
betw
een
exerc
ise
and
educ
ation
The
study
focuse
d more
on the
second
ary
source
The
infor
mati
on
were
relev
ant
to
the
stud
y

Nursing Interventions 35
and
change
s
calciu
m and
vitami
n D
dietary
intake
in
commu
nity
dwellin
g
elderly.
Journal
: BMC
Public
Health
Volum
e:17
ng
Kim
,
Sun
mee
Jang
,
Yon
gsoo
n
Park
,
Yon
g-
Cha
n
Ha,
Ha,
Y.-
C.
Cou
ntry:
Chi
wome
n
with
exerci
se
and
result
ed
into
very
high
proba
bility
of
osteo
porosi
s .On
the
other
hand,
only
25.5
% of
the
exami
al
level
and
osteo
poros
is
amon
g
wom
en

Nursing Interventions 36
Numbe
r: 1
na ned
were
chara
cteriz
ed by
high