Semester

Spring

Date of Graduation

2021

Document Type

Dissertation

Degree Type

PhD

College

School of Nursing

Committee Chair

Alvita Nathaniel

Committee Member

Ubolrat Piamjariyakul

Committee Member

Mary Jane Smith

Committee Member

Colleen Watkins

Abstract

BACKGROUND: Osteoporosis is a chronic disease resulting in low bone mass and increased bone fragility. Most often seen in women age 65 and older, osteoporosis is usually diagnosed following osteoporotic fracture. Despite numerous treatment options many women continue to remain untreated for osteoporosis and are at increased risk for subsequent fractures and complications. PURPOSE: The initial purpose of this classic grounded theory study was to explore the decision-making process women aged 65 and older experience when considering osteoporosis treatment following osteoporotic fracture. Following the tenth participant interview the researcher discovered a new main concern that emerged from participant interviews. Participants reported longing to return to a time prior to osteoporosis and fracture during which they reported higher levels of independence and freedom. Based on the emerging information the initial purpose of the study and spill question were altered to reflect the main concern of the participants: to develop a theory of reframing following osteoporotic fracture. METHODS: This classic grounded theory study utilized purposive sampling to recruit 12 women aged 65 and older with a recent osteoporotic fracture. Data from open-ended interviews were collected and analyzed. RESULTS: The grounded theory of reframing: a grounded theory study of postmenopausal women following osteoporotic fracture. The theory consists of three stages and a critical juncture. The first stage of the theory is resting in contentment. This stage occurs prior to osteoporotic fracture during which participants have varying degrees of pre-existing osteoporotic knowledge. The stage includes the properties of unsuspecting danger, underestimating risk, and looking the other way. Stage one is followed by the critical juncture, facing the threat, during which osteoporotic fracture occurs. The stage of adjustment follows the critical juncture. During this stage participants are either letting go of a previous life for one with osteoporosis or are blame shifting and diminishing the significance of osteoporosis and its relation to their current fracture. During the final stage, reframing, participants undergo an embodied revelation toward a new life with osteoporosis. Participants unable to view life through a new lens continue to long for a pre-fracture life which may no longer be attainable. CONCLUSIONS: Reframing: A grounded theory study of postmenopausal women following osteoporotic fracture explains from the participant perspective what is going on following osteoporotic fracture. This new grounded theory has profound implications for research, education, and clinical practice.

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