Bone Abstracts

Background: Osteoporosis and its associated osteoporotic fractures can have far-reaching effects on a persons quality of life, including impacts on physical, psychological, social, and spiritual wellbeing. However, these biopsychosocial-spiritual impacts have not been comprehensively reviewed. Understanding them is essential for identifying and addressing unmet consultation needs and informing person-centred care.

Objective: This scoping review aimed to identify, map and summarise qualitative literature on the biopsychosocial-spiritual impacts of living with osteoporosis.

Methods: Multiple databases were searched from inception to October 2025, supplemented by reference list screening, citation tracking, and targeted grey literature searches. Qualitative and mixed methods primary studies exploring lived experiences of osteoporosis and/or osteoporotic fractures beyond the acute recovery phase were included. Titles, abstracts and full texts were independently screened by two reviewers, with the remainder screened by one reviewer following high inter-reviewer agreement (≥80%). Data were extracted, coded, deductively mapped to the biopsychosocial-spiritual model, and analysed using qualitative content analysis.

Results: Thirty-eight studies involving a total of 786 participants aged 36 to 99 years were included. Impacts spanned all biopsychosocial-spiritual domains. While biological (n37 studies) and psychological (n35 studies) impacts were most frequently reported across studies, social (n33 studies) and spiritual (n26 studies) impacts were still substantial but less consistently explored. Most commonly reported biological impacts included pain, reduced mobility and changes in body shape (e.g. stooped posture). Psychological impacts centred on fear of future fractures, low mood, frustrations with reduced independence, and diminished self-esteem (due to changes in appearance). Social impacts included increased dependency, strained relationships with others, social isolation, and restrictions on work and hobbies. Spiritual impacts encompassed disrupted religious or cultural practices (e.g. inability to pray, attend faith centres or cultural gatherings), changes to self-identity and meaning, and coping through rituals. Many experiences mapped to multiple domains, reflecting the interrelated and complex nature of living with osteoporosis.

Conclusion: This scoping review highlights the multidimensional impacts of osteoporosis and the complexity of associated care needs. The findings emphasise the importance of holistic, person-centred care that extends beyond physical health, and provide a foundation for future research to explore and address unmet needs in routine osteoporosis care.