Department of Family Medicine, Womack Army Medical Center, NC, 28310, USA.
Department of Medicine, Womack Army Medical Center, NC, 28310, USA.
Mil Med. 2021 Jan 25;186(Suppl 1):239-245. doi: 10.1093/milmed/usaa306.
The incidence of obstructive sleep apnea in military personnel has increased over 500% since the early 2000s. Adherence to continuous positive airway pressure (PAP), an efficacious treatment, has been suboptimal. This article presents a behavioral intervention model for enhancing PAP therapy adherence and describes how the model was received by military personnel.
The study population comprised 254 out of 280 military personnel (93% men, mean age 39 years) who attended a 90-minute behavioral intervention class within the first 8 weeks of PAP use. They were coached on the Knowledge, Skills, Attitudes (KSA) model of PAP therapy success: Knowledge about obstructive sleep apnea and PAP treatment; Skills to develop a habitual loop for nightly PAP use; and Attitudes that address readiness, barriers, and solutions for sustaining PAP use. Participants completed a voluntary, anonymous postclass survey that inquired of their perception of various elements of the class. Data were analyzed using descriptive statistics and a paired sample t-test.
In participants' self-rating of how much they know about PAP treatment before and after the class, their ratings indicated that they experienced a significant increase in knowledge (P < 0.0001). On the postclass survey, 77% of the participants (N = 195/254) "agree a lot" or "strongly agree" that the class gave them tools to have a successful treatment and 78% (N = 198/254) noted that it was a valuable educational experience. The Knowledge portion was rated by 79% (N = 201/254) of the participants as "quite a lot" or "extremely" beneficial. The Skills segment was rated as "quite a lot" or "extremely" beneficial by 72% (N = 183/254) of the participants. The Attitudes discussion was perceived as "quite a lot" or "extremely" beneficial by 70% (N = 178/254) of the participants. Participants' free-text responses to "what was most helpful" were generally positive.
A KSA model of behavioral intervention for enhancing PAP therapy adherence was well received by participants. Future research will assess the impact of this intervention on adherence as measured by objective indicators.
自 21 世纪初以来，军事人员阻塞性睡眠呼吸暂停的发病率增加了 500%以上。持续气道正压通气（PAP）治疗的依从性一直不理想，而这种治疗方法是有效的。本文介绍了一种提高 PAP 治疗依从性的行为干预模型，并描述了该模型如何在军事人员中得到应用。
研究对象为 280 名接受 PAP 治疗的军事人员中的 254 名（93%为男性，平均年龄 39 岁），他们在使用 PAP 的头 8 周内参加了 90 分钟的行为干预课程。该课程向他们传授了 PAP 治疗成功的知识、技能、态度（KSA）模型：阻塞性睡眠呼吸暂停和 PAP 治疗的知识；养成夜间使用 PAP 的习惯循环的技能；以及处理维持 PAP 使用的准备情况、障碍和解决方案的态度。参与者完成了一份自愿的匿名课后调查，询问他们对课程各个方面的看法。使用描述性统计和配对样本 t 检验对数据进行分析。
在参与者自我评估参加课程前后对 PAP 治疗的了解程度时，他们的评分表明他们的知识水平显著提高（P<0.0001）。在课后调查中，77%的参与者（N=195/254）“非常同意”或“强烈同意”该课程为他们提供了成功治疗的工具，78%（N=198/254）认为这是一次有价值的教育体验。79%（N=201/254）的参与者认为知识部分“非常有益”或“极其有益”。72%（N=183/254）的参与者认为技能部分“非常有益”或“极其有益”。70%（N=178/254）的参与者认为态度讨论“非常有益”或“极其有益”。参与者对“最有帮助的是什么”的自由文本回答通常是积极的。
提高 PAP 治疗依从性的 KSA 行为干预模型得到了参与者的好评。未来的研究将评估该干预措施对客观指标衡量的依从性的影响。
