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阻塞性睡眠呼吸暂停患者的持续气道正压通气依从性。

Continuous positive airway pressure adherence in people with obstructive sleep apnoea.

机构信息

Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.

出版信息

J Clin Nurs. 2022 Dec;31(23-24):3477-3484. doi: 10.1111/jocn.16174. Epub 2021 Dec 28.

Abstract

OBJECTIVES

This cross-sectional study aimed to identify whether five factors of the health belief model were related to continuous positive airway pressure adherence in Thai people with obstructive sleep apnoea.

BACKGROUND

Obstructive sleep apnoea is a disorder impacting health, social wellbeing and the economy. Continuous positive airway pressure is a gold standard of treatment; however, poor adherence to treatment is an important issue that is related to a multiplicity of psychological and behavioural factors.

METHODS

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies was used to report the study. Purposive sampling was used to recruit 94 patients newly diagnosed with sleep apnoea and using CPAP devices from a sleep clinic. Participants completed a demographic record, the Thai versions of the Functional Outcomes of Sleep Questionnaire, the Perceived Barriers Questionnaire and the Self-Efficacy Measure for Sleep Apnea. CPAP adherence was measured by using information downloaded from the smart card of the devices. Data were analysed using descriptive statistics and logistic regression.

RESULTS

Only 54.3% of participants adhered to CPAP treatment using standard protocols. Perceived seriousness of their condition was significantly associated with CPAP adherence, whereas perceived susceptibility, benefits, barriers and self-efficacy were not.

CONCLUSIONS

We found a low rate of CPAP adherence among participants. The only factor related to CPAP adherence was perceived seriousness.

RELEVANCE FOR THE CLINICAL PRACTICE

With a low rate of CPAP adherence, healthcare professionals, especially nurses, should encourage patients to use CPAP regularly by providing them with support and education regarding the severity of the disease if untreated and the benefits of CPAP treatment on the disease. Healthcare professionals should be aware of psychological factors impacting patients' perception of sleep apnoea and CPAP treatment. Interventions dealing with these factors should be developed and implemented in practice.

摘要

目的

本横断面研究旨在探讨健康信念模型的五个因素是否与泰国阻塞性睡眠呼吸暂停患者持续气道正压通气(CPAP)治疗的依从性有关。

背景

阻塞性睡眠呼吸暂停是一种影响健康、社会福利和经济的疾病。CPAP 是治疗阻塞性睡眠呼吸暂停的金标准;然而,治疗依从性差是一个重要问题,与多种心理和行为因素有关。

方法

采用观察性研究的强化报告标准(STROBE)检查表报告研究。采用目的抽样法,从睡眠诊所招募了 94 名新诊断为睡眠呼吸暂停并使用 CPAP 设备的患者。参与者完成了人口统计学记录、泰国版睡眠功能结果问卷、感知障碍问卷和睡眠呼吸暂停自我效能测量。CPAP 依从性通过从设备的智能卡中下载信息来测量。使用描述性统计和逻辑回归分析数据。

结果

只有 54.3%的参与者按照标准方案使用 CPAP 治疗。对病情严重程度的认知与 CPAP 治疗的依从性显著相关,而对易感性、益处、障碍和自我效能的认知则没有。

结论

我们发现参与者的 CPAP 治疗依从率较低。唯一与 CPAP 治疗依从性相关的因素是感知严重性。

临床意义

CPAP 治疗的依从率较低,医护人员,特别是护士,应通过向患者提供有关未治疗疾病的严重程度和 CPAP 治疗对疾病的益处的支持和教育,鼓励患者定期使用 CPAP。医护人员应了解影响患者对睡眠呼吸暂停和 CPAP 治疗认知的心理因素。应在实践中制定和实施针对这些因素的干预措施。

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