Ye Lichuan, Malhotra Atul, Kayser Karen, Willis Danny G, Horowitz June A, Aloia Mark S, Weaver Terri E
Boston College, William F. Connell School of Nursing, Chestnut Hill, MA, USA.
University of California San Diego School of Medicine, La Jolla, CA, USA.
Sleep Med Rev. 2015 Feb;19:67-74. doi: 10.1016/j.smrv.2014.04.005. Epub 2014 May 9.
Poor adherence to continuous positive airway pressure (CPAP) treatment is associated with substantial health care costs, morbidity and mortality, and has been a leading obstacle in the effective management of obstructive sleep apnea (OSA). Successful interventions to improve CPAP adherence may ultimately include a variety of components. For patients living with spouses (refers to all domestic partners), the spouse will likely be an integral component to any successful intervention. Developing understanding of the role of spouses in adherence to CPAP has been identified to be a critical research need. This review expands the investigation of CPAP adherence to a broader context, from an exclusive focus on individual patients to a dyadic perspective encompassing both patients and their spouses. A conceptual framework based on social support and social control theories is proposed to understand spousal involvement in CPAP adherence. Methodologies for future investigations are discussed, along with implications for developing interventions that engage both patients and their spouses to improve CPAP use.
持续气道正压通气(CPAP)治疗依从性差与高昂的医疗保健成本、发病率和死亡率相关,并且一直是阻塞性睡眠呼吸暂停(OSA)有效管理的主要障碍。成功改善CPAP依从性的干预措施最终可能包括多种要素。对于与配偶共同生活的患者(指所有同居伴侣)而言,配偶很可能是任何成功干预措施不可或缺的一部分。已确定深入了解配偶在CPAP依从性方面的作用是一项关键研究需求。本综述将CPAP依从性的研究范围扩大到更广泛的背景,从单纯关注个体患者转变为涵盖患者及其配偶的二元视角。提出了一个基于社会支持和社会控制理论的概念框架,以理解配偶在CPAP依从性方面的参与情况。讨论了未来研究的方法,以及对开发让患者及其配偶都参与进来以改善CPAP使用的干预措施的影响。