Attitudes, Health Knowledge, Osteoporosis, Patient Education as Topic, Practice, Spinal Cord Injuries (SCI)
Conditions
Keywords
spinal cord injury, osteoporosis, osteoporosis awareness, health knowledge, attitudes, practice, health literacy, patient education, bone density, fracture prevention, rehabilitation
Brief summary
Osteoporosis is a common and serious complication of spinal cord injury (SCI), substantially increasing the risk of fragility fractures. Despite this elevated risk, awareness of osteoporosis among individuals living with SCI is not well understood. This cross-sectional observational study assessed the level of osteoporosis awareness in adults with chronic traumatic SCI and examined which demographic, injury-related, and healthcare-related factors were independently associated with awareness. Ninety-four adults with chronic traumatic SCI completed the Turkish version of the Osteoporosis Awareness Scale, along with a structured questionnaire covering education, injury characteristics, healthcare utilization, and personal health-seeking behaviors. The study aimed to identify modifiable factors linked to higher awareness in order to inform future educational interventions and improve osteoporosis prevention and management in this high-risk population.
Detailed description
Background: Individuals with spinal cord injury (SCI) experience rapid and severe sublesional bone loss, with fracture rates several-fold higher than in the general population. Patient awareness is an important determinant of preventive behavior, screening participation, and treatment adherence, yet the factors shaping osteoporosis awareness in the SCI population have not been systematically investigated, and no such data exist for the Turkish SCI population. Objectives: The study aimed to (1) assess osteoporosis awareness among individuals with chronic SCI using a validated instrument; (2) examine bivariate associations between potential predictors and awareness; and (3) identify factors independently associated with awareness through multivariable regression. Design and Setting: This was a single-center, cross-sectional observational study conducted at a tertiary physical medicine and rehabilitation center between January and December 2023. Participants: Ninety-four adults with documented traumatic SCI of at least 12 months' duration were enrolled through consecutive sampling. Individuals with significant cognitive impairment, acute illness requiring hospitalization, or inability to complete questionnaires in Turkish were excluded. Only traumatic SCI cases were included. Measures: Osteoporosis awareness was assessed using the Turkish version of the Osteoporosis Awareness Scale (31 items; total score range 31 to 124). Additional data included age, sex, education level, injury level and completeness, ASIA Impairment Scale grade, injury duration, fracture history, regular follow-up, receipt of osteoporosis education, personal research, bone density testing history, and use of bone-relevant medications. Statistical Analysis: Bivariate analyses used t-tests, one-way ANOVA, and correlation coefficients, with effect sizes reported. Multiple linear regression with nine predictors identified factors independently associated with awareness. Regression diagnostics and a sensitivity analysis were performed to confirm robustness.
Interventions
None listed
Sponsors
Afyonkarahisar Health Sciences University
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Documented traumatic spinal cord injury * Injury duration of at least 12 months (chronic SCI) * Age 18 years or older * Able to provide informed consent and complete questionnaires in Turkish
Exclusion criteria
* Significant cognitive impairment precluding reliable questionnaire completion * Acute medical illness requiring hospitalization * Inability to communicate in Turkish * Non-traumatic etiology of spinal cord injury
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Level of osteoporosis awareness | At a single time point (baseline assessment) | Osteoporosis awareness was measured using the total score of the Turkish version of the Osteoporosis Awareness Scale (OAS), a 31-item instrument rated on a 4-point Likert scale, with total scores ranging from 31 to 124. Higher scores indicate greater osteoporosis awareness. The scale was administered once, at study enrollment. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Factors independently associated with osteoporosis awareness | At a single time point (baseline assessment) | Demographic, injury-related, and healthcare-related factors independently associated with OAS total scores, assessed by multiple linear regression. Candidate factors included age, sex, education level, injury duration, ASIA Impairment Scale grade, fracture history, regular osteoporosis-related follow-up, personal research, and receipt of osteoporosis education. |
| Osteoporosis-related healthcare utilization and health-seeking behaviors | At a single time point (baseline assessment) | Proportions of participants reporting regular osteoporosis-related follow-up, prior receipt of osteoporosis education, personal research on osteoporosis, prior bone density (DXA) testing, and awareness of DXA scanning, assessed by structured questionnaire. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORERSİN BEŞTAŞ, MD
Afyonkarahisar Health Sciences University, Faculty of Medicine
Outcome results
None listed