Role of the Nurse Educator in Preventing Teenage Osteoporosis

The risk of osteoporosis among the teenage population has become a major health concern because of the high intake of carbonated beverages and the low consumption of dairy products such as milk. Soft drink consumption by teenagers is twice the consumption of milk. In addition to the already unhealthy high sugar content, these beverages increase the excretion of calcium in a calcium depleted diet. Therefore, the nurse plays a pivotal role in educating the teenage population about the risks and consequences associated with the unhealthy intake of carbonated beverages. Strategies the nurse should implement in osteoporosis prevention include teenage education regarding prevention and early detection, positive role modeling, and self-care implementation, specifically, diet and exercise.
The high levels of sugar contained in some carbonated beverages increase excretion of calcium through homeostatic processing. Teenage boys and girls alike consume twice as many soft drinks as compared to milk and research indicates that this trend is contributing to an earlier onset of teenage osteoporosis (Hightower, 2000). When reduction in bone mass is sufficient to compromise normal function, osteoporosis develops (Martini, 2006). As the human body ages, it naturally loses bone thickness and strength. Usually, osteoporosis is detected between the ages of 30 and 40 and affects women sooner than men; however, due to lack of proper diet and education, the disease is progressing at an alarming rate among teenagers. When education is absent or delayed, the nurse misses the opportunity to prevent the next generation from developing osteoporosis.
Teenage education regarding prevention, early detection, and self-care should focus on well-balanced diets and well-planned exercise regimes. Prevention includes reducing sugar and caloric intake, encouraging water to quench thirst instead of soft drinks, and going to the gym instead of playing video games. In order to effectively present this educational strategy at the local public school, the nurse educator could include visual aids provided by the National Dairy Council. Prior to the nurse’s presentation to the class of teenage students, the nurse educator should first analyze the dietary profile of one of the students in the class (Borchardt, 2000; Hunt, 1998). This preparation by the nurse is a good strategy to get the students more involved. An important goal of the presentation is to educate the teenagers on the importance of the proper intake of calcium and vitamin D through healthy food choices because unhealthy diets leave the adolescent at a much higher risk for osteoporosis later in life. Exercise that promotes bone strength, such as weightlifting, must also be emphasized and encouraged.
Positive role modeling is an important aspect of the educational strategy. This can be achieved by the individual nurse being fit and healthy himself. According to Bandura’s Social Learning Model described by (Borchardt 2000), individuals learn by observation. In the same way children learn from observing their parents, the teenager can learn from positive role models to become an agent of his own care. Role modeling is not a responsibility of the nurse alone, but rather involves all those who have an impact on the adolescent. This includes the parent who carefully plans meals, the physical education teacher who encourages the students to be fit, or the nurse educator who is passionate about the prevention of this disease. When a student displays interest, enthusiasm, and ownership as a result of positive role modeling, his motivation is increased and he is much more likely to participate and remain compliant with healthy expectations (Fitzgerald, 2003).
The American teenagers’ eating and exercise behaviors are not the only obstacles in this silent disease (Berarducci, 2004). One of the most difficult hurdles to overcome for the teenagers is the commercialization of carbonated beverages, fast foods, and candy bars. This pressure has enormous impact. For example, grocery stores are set-up for the compulsive shopper with candy bars and soda pops strategically close to the checkout line. It is through education that teenagers can begin to recognize these influences and question their eating and exercise habits. Information can be provided for teens and their families on self-care in brochures and pamphlets given during the presentation. This should include information on free or sliding scale clinics where providers evaluate clients, and the nurse offers educational sessions regarding healthy diets and exercise classes (Hightower, 2000; Curry, Hogstel, Davis & Frable, 2002). The consequences of having a poor diet and exercise routine must be honestly and thoroughly presented so that teenagers do not remain unconcerned or defenseless in the face of this disease and its long term effects on their health.
Osteoporosis due to poor diet and insufficient exercise is a preventable disease. The staggering increase in consumption of carbonated beverages and the decreased consumption of calcium have caused a rise in the incidence of osteoporosis in the teenage population. Education is crucial for teenagers if they are to develop healthy habits to reverse this trend. When the nurse encourages osteoporosis-preventative behaviors and promotes healthy lifestyle strategies, prevention of osteoporosis is the focus. This is much preferable to coping with the long term consequences of this disease. Prevention through education is best accomplished by a well-educated, healthy and fit nurse who really wants to see the teenage population improve their diet and exercise habits so they can live longer and healthier lives.











Role of the Nurse Educator in Preventing Teenage Osteoporosis

Intervention #1
Teenage education regarding prevention and early detection of osteoporosis.
Disadvantage #1
Because osteoporosis is a pediatric disease with geriatric consequences, failure to educate the teenage population is a disadvantage. This disease is silent and remains dormant for several years with no signs or symptoms until a disabling fracture occurs. “The key to prevention of osteoporosis is early detection and prevention within the vulnerable, at-risk population” (Hunt, 1998 p. 56). Health promotion has always been an integral part of nursing, and has become increasingly important. In fact, most state Nursing Practice Acts mandate patient education. Since osteoporosis develops during adolescence, the nurse needs to target this age group at the public schools with aggressive presentations in the classrooms. Without education about the risk factors and prevention of osteoporosis to this vulnerable population now, the next generation has acquired the disease, increased the risk, and the window of opportunity to prevent this debilitating disease has closed.
Disadvantage #2
The nurse educator who is compassionate about his/her desire to help prevent teenage osteoporosis should take the prime opportunity and major responsibility to initiate osteoporosis prevention education. The education must emphasize health promotion and disease preventions, not on treating the disease. “It is imperative that nurses possess the required knowledge base and resources to adequately provide instruction to healthcare consumers in an effort to promote wellness, manage illness, and prevent disease” (Beraducci,2004, p. 121). In addition, the nurse educator needs greater access to knowledge and information about the identifiable behaviors of those at risk for developing osteoporosis, and the pathogenesis of osteoporosis to be effective in their presentations at the public schools. If the nurse is not well educated the outcomes will be as debilitating as the disease.

Intervention #2
Self-care implementation, specifically, diet and exercise.
Disadvantage #1
Positive role modeling is an important and effective aspect of the educational strategy. The reflection of the nurse’s personal values will impact the teenagers, and help pave the way for. When the nurse educator’s lifestyle cannot be viewed as healthy, the teaching opportunity has lost its effectiveness. “Awareness of one’s self-care patterns, and implementing strategies to maintain or change these patterns, can be an important step in helping others achieve a high level of wellness” (Borchardt, 2000, p. 30). By taking the leading role in delivering healthcare messages, the nurse educator needs to view him/her self as healthy, or more importantly, the classroom full of teenagers needs to have that perspective of the nurse. When the nurse instructs about the importance of the combination of diet and exercise, the nurse needs to be that healthy living example. “We as nurses and health educators are expected to provide good examples of healthy lifestyles” (Borchardt, 2000, p. 30). When the nurse is viewed as unhealthy through the eyes of the students, the opportunity to promote wellness has been lost.
Disadvantage #2
Lifestyles and diet are closely related. The selection of food is heavily influenced by one’s socioeconomic status. The foods of choice are usually cheap, energy-dense, and nutrient poor. These choices have adverse effects on the growth of the child. There is a great deal of evidence compiled that shows that childhood socioeconomic status contributes to disease later in life, such as osteoporosis (Caballero, 2005). “A growing body of evidence shows that childhood socioeconomic status (SES) is predictive of disease risk in later life, with those from the most disadvantaged backgrounds more likely to experience poor adult-health outcomes” (Lukar, 2007, p. 137). Nutrients, like calcium, in the teenager’s diet will help prevent osteoporosis. Because of cost, carbonated beverages are being purchased instead of dairy products, contributing to the calcium-deficient teenager. The insufficient consumption of calcium in the adolescent diet is leaving them predisposed to osteoporosis. It has been determined that socioeconomic status affects lifestyles, and lifestyles affect diets (Hightower, 2000).














References

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