Page 399 - Encyclopedia of Nursing Research

366 n OUTCOMe MeASUReS

Vitamin D is a secosterol, more of a osteoporosis disease management program
hormone than a vitamin. Vitamin D is syn- managed by nurse practitioners. Chang
O thesized by the skin’s exposure to the sun’s (2007; Chang, yang, Chung, Chen, & Cheng,
ultraviolet rays. Some foods contain vitamin 2010) investigated the knowledge, beliefs,
D, and many foods are fortified with vitamin and behaviors of relatives of those with oste-
D in the United States. Vitamin D regulates oporosis. Doheny, zellar, and estok (2010)
serum calcium, aiding in the absorption of explored the knowledge of participants with
calcium into bones. experts debate the level regard to smoking and osteoporosis. Other
of vitamin D that constitutes a deficiency, work by nurses explored the effectiveness
although most minimum proposed levels of educational programs (Nieto-Vazquez,
range between 20 ng/ml and 30 mg/ml. Tejeda, Colin, & Matos, 2009). The lack of
There is also a debate regarding the appro- nursing investigation into issues related to
priate dosage of supplements necessary to osteoporosis is disappointing, and much of
replace vitamin D. Often, the recommended the work by nursing has focused on falls and
dosage is 400 to 600 IU daily, but recent stud- the prevention of fractures rather than the
ies have found that taking a minimum of 800 disease itself.
IU of vitamin D is effective and safe as well as The prevention and treatment of osteo-
doses up to 50,000 IU biweekly. Vitamin D is porosis are closely connected to the science
stored in fat, and deficits need to be replaced of nursing. Health promotion is a key to pre-
as often as 50,000 IU/week as a loading dose venting the disease. Lifestyle modification
of vitamin D is prescribed. is an essential aspect in the management of
Pharmaceutical treatment options for osteoporosis, and nursing practice is well
osteoporosis are increasing; they include prepared to provide teaching and manage-
bisphosphonates, calcitonin, estrogen or hor- ment. Future nursing research could focus
mone therapy, estrogen agonist/antagonist, on the life span aspect of intervention to pre-
and parathyroid hormone. Biphosphonates vent osteoporosis as well as the maintenance
are available in forms that can be given daily, or restoration of function in those who suffer
weekly, monthly, or yearly. Side effects are from the disease and its consequences. The
similar for all oral bisphosphonate medi- nursing profession, integral to health care
cations, with the primary concerns being from the cradle to the grave, needs to increase
gastrointestinal problems, difficulty swal- osteoporosis awareness and to research the
lowing, esophageal irritation, and gastric prevalence, prevention, and adaptation of
ulcer. Calcitonin is a daily nasal spray, one of individuals to this chronic disease.
the earliest forms of therapy. Hormone ther-
apy, although effective in increasing bone Evelyn Duffy
density, has risks that might outweigh the Geraldine A. Britton
benefits. The estrogen agonists/antagonists Sheri Stucke
offer another option and may also reduce the Rosemary Collier
risk of invasive breast cancer. Parathyroid Sarah H. Gueldner
hormone, teriparatide, is an injectable treat-
ment. Currently, its use is only recommended
for 2 years with follow-up therapy using
biphosphonates. OutcOme measures
Recent nursing research has investi-
gated the knowledge regarding osteopo-
rosis in individuals with recent fractures Outcome measures are broadly used in clin-
(Giangregorio et al., 2010). Greene and ical research as well as in health services
Dell (2010) investigated the outcome of an research, also referred as outcomes research.