Burcea Romica, Mihaltan Florin Dumitru
Rosiori de Vede Pneumology Hospital, Romania.
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Maedica (Bucur). 2024 Dec;19(4):704-710. doi: 10.26574/maedica.2024.19.4.704.
Continuous positive airway pressure therapy (CPAP) is the gold standard for the treatment of obstructive sleep apnea syndrome (OSAS). This therapy eliminates daytime sleepiness and prevents cardiovascular complications of OSAS. Given that CPAP is a chronic therapy and that in most cases it must be used for life, good adherence to treatment is essential for the patient to feel its benefits. Psychological factors play an important role in the compliance of OSAS patients with CPAP therapy. Self-esteem (SE) can be defined as a person's positive or negative attitude toward the self in totality.
We conducted a prospective, observational, non-randomized study on an essay of 380 observations with 95 patients. After the evaluation period, based on the average time of CPAP used, the patients were divided into two groups: a first group consisting of 50 patients who were considered adherent to the instituted therapy and a second group comprising 45 patients who were considered non-adherent to the instituted therapy. The aim of this article is to assess the role of self-esteem in the adherence of patients with OSAS to CPAP therapy. Determinants of self-esteem at the beginning of treatment (To) were evaluated. The secondary objectives of the study consisted of investigating the existence of other predictors for the evolution of OSA such as self-esteem and clinical/demographic/paraclinical parameters.
In the present study, the adherence of patients with OSAS to CPAP therapy was 52.63%. The self-esteem score was higher in adherent patients than non-adherent ones. The main factors associated with increased self-esteem levels included good adherence to therapy, education, patient income, absence of alcohol and tobacco consumption, absence of nocturnal symptoms, use of Auto-CPAP, use of nasal mask, absence of other pulmonary pathology, absence of psychological type D.
Psychological factors play an important role in the compliance of OSAS patients with CPAP therapy. Along with other factors, self-esteem may be one of the predictive factors for patients' adherence to CPAP therapy.
持续气道正压通气治疗（CPAP）是治疗阻塞性睡眠呼吸暂停综合征（OSAS）的金标准。该疗法可消除日间嗜睡并预防OSAS的心血管并发症。鉴于CPAP是一种长期治疗方法，且在大多数情况下必须终身使用，良好的治疗依从性对于患者感受其益处至关重要。心理因素在OSAS患者对CPAP治疗的依从性中起着重要作用。自尊（SE）可定义为一个人对自身整体的积极或消极态度。
我们对95例患者进行了380次观察的前瞻性、观察性、非随机研究。在评估期后，根据CPAP的平均使用时间，将患者分为两组：第一组由50例被认为坚持既定治疗的患者组成，第二组由45例被认为不坚持既定治疗的患者组成。本文旨在评估自尊在OSAS患者对CPAP治疗依从性中的作用。评估了治疗开始时（T0）自尊的决定因素。该研究的次要目标包括调查OSA进展的其他预测因素，如自尊以及临床/人口统计学/辅助临床参数。
在本研究中，OSAS患者对CPAP治疗的依从性为52.63%。依从患者的自尊得分高于不依从患者。与自尊水平升高相关的主要因素包括良好的治疗依从性、教育程度、患者收入、不饮酒和吸烟、无夜间症状、使用自动CPAP、使用鼻面罩、无其他肺部疾病、无D型心理。
心理因素在OSAS患者对CPAP治疗的依从性中起着重要作用。与其他因素一起，自尊可能是患者对CPAP治疗依从性的预测因素之一。
