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      Les perceptions des femmes tunisiennes selon le modèle des croyances liées à la santé et leurs pratiques relativement à l'ostéoporose Translated title: Perceptions of Tunisian women based on the health beliefs model and their practices related to osteoporosis

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          Abstract

          Introduction

          L'étude a pour objectif de décrire les croyances des femmes et leurs pratiques liées à la santé et à l'ostéoporose, afin d'élaborer des interventions efficaces et ciblées pour la prévention de cette maladie dans le contexte tunisien.

          Méthodes

          Une étude descriptive transversale a été effectuée auprès de 100 femmes tunisiennes, âgées de 45 ans et plus, qui consultent au centre de santé de base d'une zone périurbaine de la région de Sousse (Tunisie). La collecte de l'information a été réalisée à l'aide de « l'échelle des croyances relatives à la santé sur l'ostéoporose» développée par Kim et ses collègues traduit en arabe et validé en Tunisie et le questionnaire de «Calcul des apports calciques quotidiens» développé par Fardellone Patrice. L'interprétation des résultants s'est basée sur le «Health Belief Model ».

          Résultats

          La perception des participantes pourrait être considérée comme au dessus de la moyenne pour la vulnérabilité de l'ostéoporose (58%), la gravité de la maladie, les avantages de la pratique de l'activité physique, les avantages de l'apport en calcium et la motivation à la santé; par contre, elle pourrait être considérée comme modérée concernant les obstacles à la prévention. Cependant, les pratiques exposant au risque de la maladie sont relativement fréquentes et ceci essentiellement en rapport avec des facteurs socio-économiques et culturels.

          Conclusion

          Les programmes de promotion doivent viser la création d'un environnement physique et social favorable à l'adoption des comportements à moindre risque et viser l'éducation ciblée de la population.

          Translated abstract

          Introduction

          The aim of this study is to describe beliefs and practices of women related to health and osteoporosis in order to develop effective and targeted interventions for the prevention of this disease in the Tunisian context.

          Methods

          A descriptive cross-sectional study was conducted among 100 Tunisian women, aged 45 and older, who consult the basic health center in the suburban area of Sousse region (Tunisia). The collection of information was carried out with «osteoporosis health belief scale "developed by Kim and his colleagues validated and translated into Arabic in Tunisia and the questionnaire of "daily calcium inputs calculation" was developed by Patrice Fardellone. The interpretation of the results was based on the "Health Belief Model".

          Results

          Perception participants considered above average for the vulnerability of osteoporosis (58%). The advantages severity of their benefits of calcium intake and health motivation could be considered moderate moderated. However, the practical exposure to disease risks is relatively frequent and essentially related to socio-economic and cultural factors.

          Conclusion

          The promotion programs should aim at creating a supportive physical and social environment for the adoption of safer behaviors and especially education must be targeted.

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          Most cited references34

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          The assessment of osteoporosis risk factors in Iranian women compared with Indian women

          Background Osteoporosis is an important public health problem in older adults. It is more common in postmenopausal women and not only gives rise to morbidity but also markedly diminishes the quality of life in this population. There is lack of information about the risk factor of osteoporosis in developing countries. In this study we aimed to assess the risk factors for osteoporosis in postmenopausal women from selected BMD centers of two developing Asian countries (Iran and India). Methods This study is a multicenter interview-based study conducted in selected hospitals and health centers from urban areas in Iran and India. The case group included postmenopausal osteoporotic women who were identified as patients with bone density higher than 2.5 SD below average of young normal bone density (in L1–L4) spine region interest and/or total femoral region) by using DEXA method. The controls were chosen from postmenopausal women with normal bone density (in L1–L4 spine and total femoral regions using DEXA method) matching in age groups was strategy of choice. The sample sizes included from Iran a total of 363 subjects (178 osteoporotic and 185 normal) and from India a total of 354 subjects (203 osteoporotic and 151 normal). Results The significant (p < 0.05) risk factors in present study population with their Odds Ratios (in parenthesis, respectively in Iran and India) were as follow: Lower education defined as less than class 12 or nil college (2.1) (2.7), duration of menopause greater than 5 years: (2.2) (1.4), Menarche age (after 14 years): (1.9) (1.6), Menopause age (before 45 years): (1.1) (2), Parity more than 3: (1.1) (1), Bone and joint problem (2.3) (2.2). Calcium supplementation (0.6) and HRT (0.4) were shown as protective factors and steroid therapy (3.3) was found as a risk factor in Iran. Calcium supplementation more than 1 year (0.3) was shown as a protective factor in India. Pure vegetarianism: (2.2) and Red meat consumption more than 4 times per week (1.4) was shown as a risk factor in Indian and Iranian subjects respectively. Regular consumption of Soya (0.3), almond (0.5), fish (0.5), fruits (0.4) and milk tea 4 cups per day and more (0.4) appeared to be significant protective factors in India. Regular consumption of cheese (0.5), milk (0.5), chicken (0.4), egg (0.6), fruit (0.4), tea 7 cups per day and more (0.3) were found to be significant protective factors in Iran. Exercises were shown as protective factor in Iran (0.4) and India (0.4). There were no significant differences in association of risk factors and osteoporosis between Iranian and Indian subjects. Conclusion Osteoporosis in Iranian and Indian subjects also appears to be associated with several known risk factors that well described in the literature. There were no significant differences in association of risk factors and osteoporosis between Iranian and Indian subjects. It was shown a protective role of certain nutritional dietary components and also exercises in both populations and can be exploited in preventive educational strategies on osteoporosis in these populations.
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            Development and evaluation of the Osteoporosis Health Belief Scale.

            The Osteoporosis Health Belief Scale was developed to measure health beliefs related to osteoporosis. It is a 35-item self-report questionnaire based on the Health Belief Model which is specifically designed to assess beliefs related to exercise behaviors and calcium intake of elderly subjects. The instrument consists of seven subscales: Seriousness, Susceptibility, Health Motivation, Calcium Benefits, Calcium Barriers, Exercise Benefits, and Exercise Barriers. The instrument was tested on a sample of 150 elderly individuals. The psychometric properties of the scales are discussed along with recommendations for its use in research and practice.
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              Who scientific group on the assessment of osteoporosis at primary health care level

              (2004)
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                15 February 2016
                2016
                : 23
                : 42
                Affiliations
                [1 ]Centre Hospitalo-universitaire Sahloul, Sousse, Tunisie
                [2 ]Département de Médecine Communautaire, Faculté de Médecine de Sousse, Tunisie
                [3 ]Ecole Supérieure des Sciences et Techniques de la Santé de Tunis, Tunisie
                Author notes
                [& ]Corresponding author: Amina Belgacem, Centre Hospitalo-universitaire Sahloul, Sousse, Tunisie
                Article
                PAMJ-23-42
                10.11604/pamj.2016.23.42.6643
                4862771
                27217868
                5a79abbd-6aa3-4bf7-b38c-fd7cee7c28d5
                © Amina Belgacem et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 March 2015
                : 07 December 2015
                Categories
                Research

                Medicine
                osteoporosis,beliefs,behaviors,osteoporosis prevention,physical activity,calcium intake
                Medicine
                osteoporosis, beliefs, behaviors, osteoporosis prevention, physical activity, calcium intake

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