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Self‐Care Behaviors in Osteoporosis: A Cross‐Cultural Study Using Multidimensional Analysis of Textual Data

ABSTRACT

Introduction

Osteoporosis is a chronic skeletal condition that significantly affects daily life and may benefit from adequate self-care. The Middle-Range Theory of Self-Care of Chronic Illness conceptualizes self-care as a naturalistic process encompassing maintenance, monitoring, and management, also shaped by contextual and cultural factors. Despite this theoretical framework, limited evidence exists on how people with osteoporosis conceptualize and enact self-care in different cultural contexts. Italy and Spain provide comparable yet distinct settings for exploring cultural influences on self-care practices. This study aims to explore and compare self-care behaviors among Italian and Spanish people with osteoporosis.

Design

A cross-national qualitative study was conducted using an Automatic Analysis of Textual Data approach within the Exploratory Multidimensional Data Analysis framework.

Methods

Forty people with osteoporosis (38 women and 2 men; mean age 68.6 years, SD = 5.74) were recruited, equally distributed between Italy (n = 20) and Spain (n = 20). Data were analyzed using Labbé's intertextual distance and correspondence analysis to examine lexical similarities, differences, and semantic structures of self-care narratives.

Results

Although moderate intra-national lexical similarity was observed within each national group, substantial inter-national differences emerged between Italian and Spanish participants in the discursive construction of self-care. Italian participants described self-care as a medically mediated and system-oriented process, closely linked to professional guidance, diagnostic procedures, and prescribed treatments. In contrast, Spanish participants framed self-care as embodied, routine-based, and emotionally expressive, grounded in daily practices and bodily awareness. These findings indicate that participants relied on distinct cultural and epistemic models when interpreting and organizing self-care experiences.

Conclusion

This study highlights clear cross-cultural differences in how people with osteoporosis narrate and conceptualize self-care. Methodologically, it illustrates the potential of multidimensional analysis to support systematic and transparent comparison of qualitative datasets. The findings are consistent with the Middle-Range Theory of Self-Care and suggest that greater attention to cultural contexts may inform the development of self-care interventions that are more responsive to individuals' lived experiences.

Clinical Relevance

Recognizing how cultural contexts influence how people with osteoporosis understand and practise self-care may help nurses tailor communication and educational support to individuals' everyday experiences, supporting more responsive and culturally sensitive care.

The Experience of Self‐Care in People With Osteoporosis: A Qualitative Descriptive Study

ABSTRACT

Introduction

Osteoporosis requires long-term self-care engagement, yet little is known about how individuals experience and manage self-care in everyday life. Understanding these experiences is essential to inform tailored nursing interventions. The objective of the study was to explore and describe the experience of self-care maintenance, monitoring, and management in people with osteoporosis.

Design

A qualitative descriptive study.

Methods

We conducted semi-structured interviews. Data were analyzed using Mayring's qualitative content analysis with a deductive approach based on Riegel's theory of self-care. We reported data in accordance with the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist.

Results

Participants (1 Male, 19 Females; Aged 55–80) Identified Four Themes of self-care: maintenance (e.g., Medication Adherence, Physical Activity), monitoring (e.g., Symptom Recognition, Test Interpretation), management (e.g., Lifestyle Reflections, Prevention), and general self-care. Key factors included motivation, trust in healthcare professionals, and integration of health behaviors into daily life. Barriers were low self-efficacy, poor symptom recognition, and inconsistent adherence.

Conclusion

Self-care in osteoporosis is a multidimensional and dynamic process influenced by individual beliefs, contextual factors, and support from healthcare professionals. Recognizing the variability in patients' self-care behaviors is essential to develop personalized education and support. Strengthening general health behaviors may enhance disease-specific self-care. This understanding can guide healthcare professionals in designing more effective, tailored care strategies.

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