Evaluation of Osteoporosis Educational Program on Elders Who Sustained an Osteoporotic Fracture

Nurses and other healthcare practitioners need to analyze the research conducted in their fields and determine its importance in resolving problems affecting their patients. Progress in healthcare relies on research to find better assessment and intervention approaches. Continued involvement in research provides additional evidence that can be used to support guidelines and protocols in clinical procedures. This essay provides a critical analysis of the article, Evaluation of Osteoporosis Education Program on Elders Who Sustained an Osteoporotic Fracture that presents the finings of research by Merav Ben-Natan, Heyman Neomi, and Ben Israel Joshua. It will evaluate the background, problem statement, hypothesis, research questions, literature review, research designs, and ethical considerations related to this article.


The problem studied in this research is the relationship between the lack of effective health education and the outcomes observed among the elderly suffering from osteoporosis, based on their health beliefs. Despite research finding a low adherence to drugs among patients with osteoporosis little is known about the effects of educational programs in promoting drug adherence. This study sought to assess the impact of educational programs in osteoporosis on the knowledge of the disease in seniors with osteoporotic fractures, and their health beliefs and will to continue with the treatment. The authors explained the purpose of the research was important in nursing and healthcare because it addressed the challenges experienced while providing health education to elderly patients. The authors intended to assess the problems affecting the patients that contributed to reduced adherence to health education. The main concept in this research is assessing the importance of educational programs in influencing patients’ adherence behavior. The author defines these concepts by stating some of the main factors affecting adherence to treatment among geriatric patients and the effects of knowledge deficit on the importance of osteoporotic treatment.

Since the authors were investigating the effects of educational programs on the knowledge of osteoporosis, the research question and hypothesis were based on the same. The researchers’ hypothesis stated that provision of education in osteoporosis improved the beliefs on osteoporosis among the elderly and their intent to adhere to treatment. The PICOT format has five sections that address the population of interest, the intervention implemented, an alternative approach, the outcome, and the time taken to obtain the results. In the case of this research, the population of interest were the elderly patients with osteoporotic fractures; the intervention implemented was the use of health education versus no education; and the outcomes expected was improved adherence to treatment and recovery from fractures over time.

This research then selected ‘elders who sustained an osteoporotic fracture’ as the independent variable, while ‘evaluation of osteoporosis educational programs’ was selected as the dependent variable. The hypothesis is directional as it determines the steps that the article will take in proving the effects of the dependent variable in improving the independent variable (LoBiondo-Wood & Haber, 2013).

Literature Review

The literature review in this study is organized to introduce the concept of osteoporosis and show the association between the independent and dependent variables. The authors explain the increased risks of osteoporosis among the elderly and the increased incidence among women. By showing the high rates of hip fractures as a consequence of osteoporosis in the elderly and other related risks such as associated morbidity and mortality, the authors emphasize the importance of adhering to drug therapies.

The authors have used several research studies to support their claims. The use of current literature is important as it ensures that the researchers have considered updated evidence from recent studies. It also reduces the risks of assessing concepts that have already been proven by other studies (LoBiondo-Wood & Haber, 2013). They used studies conducted by other researchers such as studies that determined the importance of health education on modifying osteoporosis beliefs on health among patients (Sedlak et al., 2007; Hazavehei, Taghdisi & Saidi, 2007; Shojaeizadeh et al., 2012). Only recent studies were used, published 5-10 years ago. These studies formed the primary resources in the literature review. Considering that the researchers in the reviewed articles had conducted the research themselves, the evidence obtained from their work was more reliable compared to evidence collected from secondary sources. Secondary sources were used in the study to support the evidence obtained from the primary sources. One of the secondary sources used by the authors was the empirical evidence supporting the use of health models from a systematic review conducted by McLeod and Johnson (2011). The author used this resource to show the importance of using educational health models on changing patient behavior. The author did not analyze the studies used by summarized their results and conclusions. A critique of the literature is important because it examines the strengths and weaknesses of the evidence (LoBiondo-Wood & Haber, 2013). The literature review shows a relationship between the provision of osteoporotic health education and improvement in drug therapy adherence.

Research Design

The researchers use a single group quasi-experimental design. This design was used because the same dependent variable was being assessed in one group of osteoporotic participants. As such, only the group of participants selected received the intervention and were assessed for improvements. Using this approach reduced the need to seek additional participants to be used as a control experiment (Lobiondo-Wood & Haber, 2013). The research design was appropriate to answer the research questions and test the hypothesis. The researchers planned to determine the effects of providing osteoporosis education on improving drug use among elderly patients. They also planned to implement the independent variable by educating the elderly about the importance of adhering to treatment, morbidity, and mortality rates associated with poor drug adherence, and methods of dealing with drug side effects to promote drug use. The researchers intended to use a questionnaire and divided into five subscales that represented the beliefs to be implemented during osteoporosis management. A Likert scale with higher ratings indicating positive health beliefs were  used to analyze the questionnaires.

Ethics/ Ethical Considerations

Ethical considerations are the principles that researchers are required to follow to promote human dignity, morals, and values (LoBiondo & Haber, 2013). Informed consent was obtained as the researchers explained to the participants the role of the research and informed them that participation was voluntary. Names, social security number, and other sensitive data about the participants were not included in the study to protect their identity. Although the participants were informed that the survey was voluntary, the article does not state provision of information about the risks associated with the research. The benefits of the study were explained to the participants. Some of the benefits include better adherence of elderly patients with osteoporosis to treatment and improved health education strategies. The researchers obtained ethical clearance from the Helsinki committee before implementing the study. I think the research was conducted ethically as the researchers obtained ethical clearance the geriatric facility where the study was conducted and requested the participants for their consent before starting the research.


The researchers stated the problem, research questions, and hypothesis addressed in the article, which provides adequate guidance for healthcare practitioners and other researchers interested in the research. Another strength identified was the use incorporation of primary sources in the literature review and effective implementation of the research design. Weaknesses seen in this article included the lack of primary source critique in the literature review and a discussion of threats that would affect the participants in the study.




Hazavehei S.M., Taghdisi M.H. & Saidi M. (2007). Application of the Health Belief Model for osteoporosis prevention among middle school girl students, Garmsar, Iran. Education for Health (Abingdon, England) 20 (1), 23. Retrieved from http://www.educationforhealth.net

LoBiondo, G., & Haber, J. (2013). Nursing research in Canada: Methods, critical appraisal, and utilization (3rd ed.). Toronto, Canada: Elsevier.

Ben-Natan M., Neomi H., Joshua B. I. (2014). Evaluation of osteoporosis educational program on elders who sustained an osteoporotic fracture. International Journal of Caring Sciences, 7(2), 602-609. Retrieved from https://www.semanticscholar.org/paper/Evaluation-of-Osteoporosis-Educational-Program-on-Ben-Natan-Matthews/cfdd23335db3237851a21d6d1ca38a1c00e02817

Sedlak C.A., Doheny M.O., Estok P.J., Zeller R.A. & Winchell J. (2007). DXA, health beliefs, and osteoporosis prevention behaviors. Journal of Aging and Health 19: 742– 756. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17827447

Shojaeizadeh D., Sadeghi R., Tarrahi M.J., Asadi M., Safari H. & Lashgarara B. (2012). The effect of educational intervention on prevention of osteoporosis through health belief model (HBM) in volunteers of Khorramabad city’s health centers in 2010- 2011. Annals of Biological Research 3, 300- 307. Retrieved from https://www.researchgate.net/publication/259648065_The_effect_of_educational_intervention_on_prevention_of_osteoporosis_through_Health_Belief_Model_HBM_in_volunteers_of_Khorramabad_city’s_Health_Centers_in_2010-2011