Lived experiences of postmenopausal Omani women with osteoporosis: a hermeneutic phenomenological study

Abstract

Background: Osteoporosis is a globally significant clinical public health problem associated with age-related fractures. Despite the impact of the condition on women’s lives, most studies to date have focused on its clinical manifestations, drug efficacy, and medical treatment. Furthermore, most data are from Western countries, with no data from the Middle East. Direct access to lived experiences is a powerful tool for gaining insights into a disease. This study, based on qualitative interviews with postmenopausal Omani women with osteoporosis, aims to uncover their personal experiences of living with the condition. Research Questions: This study sought to answer three questions: What does it mean to be a postmenopausal Omani woman who has osteoporosis? What is the impact of Omani culture on these women? How do postmenopausal Omani women with osteoporosis perceive the support and care provided by healthcare professionals? Methods: A qualitative research design informed by hermeneutic (interpretative) phenomenological methodology was adopted. A purposive sample of 15 postmenopausal Omani women with osteoporosis and fragility fractures was recruited from primary and secondary care facilities in Muscat, Oman. Semi-structured one-to-one interviews were conducted over Zoom and telephone due to coronavirus disease 2019 (COVID-19) restrictions. All interviews were audio-recorded and thematically analysed with the use of Ajjawi and Higgs’ framework. Results: The mean age of the participants was 63 years. Key themes related to their lived experiences with osteoporosis were constructed from the data analysis: the impact of cultural and religious practices on participants’ lives, attitudes towards healthcare professionals and services, and treatment regimens. The participants’ religious, social, and cultural lives were negatively impacted by osteoporosis and fragility fractures, which prevented some from praying on a praying mat, attending celebrations such as close family marriages, and gathering with their relatives and neighbours. Participants played significant care-giving roles as wives, mothers, and grandmothers but many were unable to perform household chores, such as cooking, due to the osteoporosis and fractures. Some participants had strong faith in religious practices such as Muslim prayers and recitations of Quranic verses in coping with their osteoporosis pain and suffering as they perceived them to be ‘powerful medicines’. They perceived healthcare professionals through their communication styles and information they provided. Those not satisfied indicated that their doctors had poor communication styles, showed insufficient interest in them, and asked few questions during their appointments. Professionals at inpatient hospital wards were perceived as more caring and empathetic than those at outpatient clinics. Treatment abroad was preferred by these women, though some were highly satisfied with their treatment from Omani hospitals. Beliefs about and usage of traditional herbal remedies for the management of fragility fractures differed between educated and less educated women. Conclusion: This study explored postmenopausal Omani women’s experiences of living with osteoporosis and fragility fractures including the impact of the disease on social and cultural life. It contributes to knowledge and our understanding about the use of cultural and religious practices of Muslim women in relieving pain related to osteoporosis and fragility fractures. The results of this study could be used for planning future research, improving clinical practice, and policy development in the osteoporosis field.  

Date of Award	1 Aug 2024
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Terence O'Neill (Supervisor), Jane Brooks (Supervisor) & Emma Stanmore (Supervisor)