Department of Neurology, Feinberg School of Medicine, Northwestern University, Abbott Hall, Rm 523, 710 N. Lake Shore Dr., Chicago, IL 60611, USA.
J Clin Sleep Med. 2012 Apr 15;8(2):147-53. doi: 10.5664/jcsm.1766.
Continuous positive airway pressure (CPAP) improves sleep and quality of life for both patients with obstructive sleep apnea (OSA) and their spouses. However, few studies have investigated spousal involvement in treatment adherence. Aims of this observational study were to assess perceptions of spousal involvement and evaluate associations between involvement and adherence.
Spousal involvement in CPAP adherence was assessed in 23 married male OSA patients after the first week of treatment. At 3 months, 16 participants completed a second assessment of spousal involvement. Types of involvement assessed included positive (e.g., encouraging), negative (e.g., blaming), collaboration (e.g., working together), and one-sided (e.g., asking). An interpersonal measure of supportive behaviors was also administered at 3 months to evaluate the interpersonal qualities of spousal involvement types. Objective CPAP adherence data were available for 14 participants.
Average frequency of spousal involvement ratings were low for each involvement type and only negative spousal involvement frequency decreased at 3 month follow-up (p = 0.003). Perceptions of collaborative spousal involvement were associated with higher CPAP adherence at 3 months (r = 0.75, p = 0.002). Positive, negative and one-sided involvement were not associated with adherence. Collaborative spousal involvement was associated with moderately warm and controlling interpersonal behaviors (affiliation, r = 0.55, p = 0.03, dominance r = 0.47, p = 0.07).
Patients reported low frequency but consistent and diverse perceptions of spousal involvement in CPAP over the first 3 months of treatment. Perceptions of collaborative spousal involvement were the only type associated with adherence and represent moderately warm and controlling interpersonal behavior. Interventions to increase spousal collaboration in CPAP may improve adherence.
持续气道正压通气（CPAP）可改善阻塞性睡眠呼吸暂停（OSA）患者及其配偶的睡眠和生活质量。但是，很少有研究调查配偶在治疗依从性方面的参与情况。本观察性研究的目的是评估配偶参与度的认知，并评估参与度与依从性之间的关系。
在治疗的第一周后，对 23 名已婚的 OSA 男性患者的配偶的 CPAP 依从性进行了配偶参与度评估。在 3 个月时，16 名参与者完成了配偶参与度的第二次评估。评估的参与类型包括积极（例如，鼓励）、消极（例如，责备）、协作（例如，共同努力）和单方面（例如，询问）。在 3 个月时还进行了一项人际支持性行为的措施，以评估配偶参与类型的人际品质。有 14 名参与者可提供客观的 CPAP 依从性数据。
每种参与类型的配偶参与度评分的平均频率都较低，仅负面配偶参与度评分在 3 个月随访时下降（p = 0.003）。协作性配偶参与的认知与 3 个月时更高的 CPAP 依从性相关（r = 0.75，p = 0.002）。积极、消极和单方面的参与与依从性无关。协作性配偶参与与中等温暖和控制的人际行为相关（亲和性，r = 0.55，p = 0.03；支配性，r = 0.47，p = 0.07）。
患者报告称，在治疗的头 3 个月中，他们对配偶在 CPAP 中的参与度的认知频率较低，但具有一致性和多样性。协作性配偶参与认知是唯一与依从性相关的类型，代表了中等温暖和控制的人际行为。增加 CPAP 中配偶协作的干预措施可能会提高依从性。
