Understanding Self-Care in People Living With Osteoporosis: A Situation-Specific Theory

Abstract

Introduction. Osteoporosis is a chronic disease associated with severe clinical consequences. Although self-care plays a pivotal role in preventing and managing adverse outcomes, a dedicated theoretical framework explaining self-care behaviours in people with osteoporosis is lacking. This study aimed to develop a situation-specific theory to capture the self-care process, its determinants, mediating mechanisms, and expected outcomes.

Methods. The theory was derived from the Middle-Range Theory of Self-Care of Chronic Illness (Riegel et al., 2012, 2025) and contextualized to the condition of osteoporosis. Its development was supported integrating a meta-synthesis with findings from qualitative studies as clinical insight.

Results. Self-care in osteoporosis was conceptualized as a dynamic, multidimensional process organized around the dimensions of self-care maintenance, monitoring, and management. Monitoring was identified as a prerequisite for management, with symptom recognition as a key element. Factors shaping self-care were organized across individual (micro), social (meso), and systemic (macro) level. Self-care self-efficacy was theorized as a central mediator. Ultimately, self-care is expected to influence fracture risk and health-related quality of life.

Discussion. The theory provides a comprehensive lens through which self-care in osteoporosis can be understood, assessed, and promoted. By acknowledging its nature, this framework may inform the design of individualized interventions and guide future research.