Abstract:
Adherence to Continuous Positive Airway Pressure (CPAP) for obstructive sleep apnoea (OSA) can be improved by behavioural interventions which modify patients\' beliefs and cognitions about OSA, CPAP, and themselves. We have conducted the first systematic review of the literature on beliefs and cognitions held before starting treatment, and personality (which influences the former) that predict the decision to purchase or start CPAP, or CPAP adherence one month or more after CPAP initiation. A systematic search and screen of articles identified 21 eligible publications from an initial 1317. Quality assessment performed using an adapted Newcastle-Ottawa Scale demonstrated that 13 (62%) studies were poor quality and only seven (33%) were high quality. Eighteen factors, such as self-efficacy (confidence) in using CPAP and value placed on health predicted CPAP adherence; however, for only six (33%), utility as an intervention target is known, from calculation of individual predictive power. Studies did not use new behavioural frameworks effective at explaining adherence behaviours, nor did they interview patients to collect in-depth data on barriers and facilitators of CPAP use. Future studies cannot have these limitations if high quality evidence is to be generated for intervention development, which is currently sparse as highlighted by this review.
摘要:
对阻塞性睡眠呼吸暂停(OSA)持续气道正压通气(CPAP)的坚持可以通过改变患者对OSA的信念和认知的行为干预来改善。CPAP,和自己。我们对开始治疗前持有的信念和认知的文献进行了第一次系统回顾,和个性(影响前者)预测购买或开始CPAP的决定,或CPAP依从性在CPAP开始后一个月或更长时间。对文章的系统搜索和筛选从最初的1317中确定了21种合格出版物。使用适应的纽卡斯尔-渥太华量表进行的质量评估表明,有13项(62%)研究质量较差,只有7项(33%)是高质量的。18个因素,如使用CPAP的自我效能(信心)和对健康的价值预测CPAP依从性;然而,只有六个(33%),效用作为干预目标是众所周知的,从个人预测能力的计算。研究没有使用新的行为框架来有效解释依从性行为,他们也没有对患者进行访谈以收集有关CPAP使用障碍和促进因素的深入数据.如果要为干预开发提供高质量的证据,未来的研究就不会有这些限制。正如这篇评论所强调的那样,目前这是稀疏的。