Author : Carl Joseph Stepnowsky
Publisher :
ISBN 13 :
Total Pages : 296 pages
Book Rating : 4.:/5 (318 download)
Book Synopsis Determinants of Adherence with Nasal Cpap Therapy by : Carl Joseph Stepnowsky
Download or read book Determinants of Adherence with Nasal Cpap Therapy written by Carl Joseph Stepnowsky and published by . This book was released on 2000 with total page 296 pages. Available in PDF, EPUB and Kindle. Book excerpt: Obstructive sleep apnea is a prevalent medical condition with potentially serious medical and psychosocial consequences. Nasal continuous positive airway pressure (CPAP) is the treatment-of-choice for this condition and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture and decrease daytime sleepiness. Patient nonadherence has been shown to be approximately 50% at one year, therefore limiting the effectiveness of nasal CPAP therapy. Previous studies examining the determinants of adherence to CPAP have limited the variables studied to disease status, patient (sociodemographic), and treatment variables, with no reliable predictors found. The current study investigated the relationship between Social Cognitive Theory (SCT) and Transtheoretical Model (TM) variables and objectively measured CPAP adherence over a one month time period. SCT variables included measures of self-efficacy, outcome expectations, social support and knowledge. TM variables included measures of stage of change, decisional balance index (a summary of the pros and cons of engaging in the behavior) and processes of change. Measures were taken at CPAP fitting, one week post-fitting, and one month post-fitting. Fifty-one patients that were prescribed CPAP as part of their clinical care at the VASDHS agreed to be studied. CPAP pressure was used as a covariate in all regression analyses. SCT measured at time 1 was not predictive (R2 = 0.330, p = 0.092), while measured at time 2 was predictive of CPAP adherence at one month (R2 = 0.234, p = 0.019). TM measured at time 1 was not predictive (R2 = 0.003, p = 0.769) while measured at time 2 was predictive of CPAP adherence at one month (R2 = 0.209, p = 0.001). The Decisional Balance Index (from TM) individually accounted for a significant amount of variance in objective CPAP adherence in the above analyses. Future behavioral interventions designed to increase CPAP adherence may prove to be effective if based on these models.