Women's perceptions of future risk after low-energy fractures at midlife

Low-energy fractures experienced by women at midlife and beyond place them at increased risk of future fractures and may be early indicators of low bone density. We report here on women's postfracture narratives to provide insight into how family physicians might tailor their messages to patients in communicating risk.

An interview guide was used in face-to-face interviews with women aged 40 years and older. Patients were asked to describe their fracture experience and recovery during the subsequent year. Interviews were audiorecorded and transcribed verbatim. Analysis was done initially using an immersion-crystallization approach.

Twenty-two women participated in this research. The analysis showed women's reactions to information about their risk fell into 3 groups. The first took a laissez faire approach, preferring to wait and see what the future held. The second group recognized some of the things they should be doing but were inconsistent in maintaining changes or seeking relevant information. The third group saw information about future risk as salient and important to their daily lives. They actively sought out information, including discussions with their family physicians.

Discovering whether patients have had an injury and, if so, how they perceive future risk is important because the invisibility of this health hazard calls for vigilance early on in women's lives. Family physicians can help patients move from perceiving the fractures as isolated accidents to understanding them as indicators of future risk by discussing the importance of bone health in the short and long term.