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Promoting CPAP adherence in clinical practice: A survey of Swedish and Norwegian CPAP practitioners' beliefs and practices
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.ORCID iD: 0000-0003-1884-5696
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
Division of Health Care Analysis, Faculty of Health Sciences, Department of Health and Society, Linköping University, Linköping, Sweden.
Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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2018 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, p. 1-10Article in journal (Refereed) Epub ahead of print
Abstract [en]

The benefits of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnea are well established, but adherence tends to be low. Research exploring CPAP practitioners' beliefs around determinants of CPAP adherence, and the actions they use in clinical practice to promote CPAP adherence is lacking. This study aimed to: (i) develop and validate a questionnaire to assess beliefs and current practices among CPAP practitioners; (ii) explore practitioners' beliefs regarding the main determinants of patient adherence, and the actions practitioners most commonly use to promote CPAP adherence; and (iii) explore the associations between perceived determinants and adherence-promotion actions. One-hundred and forty-two CPAP practitioners in Sweden and Norway, representing 93% of all Swedish and 62% of all Norwegian CPAP centres, were surveyed via a questionnaire exploring potential determinants (18 items) and adherence-promotion actions (20 items). Confirmatory factor analysis and second-order structural equational modelling were used to identify patterns of beliefs, and potential associations with adherence-promotion actions. Patients' knowledge, motivation and attitudes were perceived by practitioners to be the main determinants of CPAP adherence, and educating patients about effects, management and treatment adjustments were the most common practices. Knowledge was shown to predict educational and informational actions (e.g. education about obstructive sleep apnea and CPAP). Educational and informational actions were associated with medical actions (e.g. treatment adjustment), but knowledge, attitude and support had no association with medical actions. These findings indicate that a wide variety of determinants and actions are considered important, though the only relationship observed between beliefs and actions was found for knowledge and educational and informational actions. 

Place, publisher, year, edition, pages
John Wiley & Sons, 2018. p. 1-10
Keywords [en]
Adherence, Continuous positive airway pressure, Obstructive sleep apnea, Patient education
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Nursing
Identifiers
URN: urn:nbn:se:hj:diva-39057DOI: 10.1111/jsr.12675Scopus ID: 2-s2.0-85042564274OAI: oai:DiVA.org:hj-39057DiVA, id: diva2:1193579
Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-03-27

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Broström, AndersPakpour, Amir H.

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