Effects of a self-determination theory-based intervention on CPAP treatment of patients with obstructive sleep apnea
- Author:
Rey Josef B. Felipe
1
;
Jonathan D. Cura
2
,
3
Author Information
1. Lung Center of the Philippines
2. St. Luke'
3. s Medical Center, Quezon City
- Publication Type:Journal Article
- Keywords:
Obstructive Sleep Apnea;
Continuous Positive Airway Pressure;
Adherence;
Self-determination Theory
- MeSH:
Continuous Positive Airway Pressure;
Personal Autonomy;
Sleep Apnea, Obstructive
- From:
Philippine Journal of Nursing
2020;90(1):51-60
- CountryPhilippines
- Language:English
-
Abstract:
PURPOSE: With continuous positive airway pressure (CPAP) being the treatment of choice for Obstructive Sleep Apnea (OSA), adherence rates to CPAP are still low without a clear consensus of causes. The Self-Determination Theory (SDT) is a general theory of human motivation that emphasizes the extent to which behaviors are relatively autonomous based on the psychological needs that are critical to supporting the process of internalization and the development of optimal motivation. This study sought to determine whether the implementation of an SDT-based intervention is effective in improving: (1) perceived competence, (2) treatment self-regulation, (3) CPAP treatment adherence, and (4) Apnea–hypopnea index (AHI) of OSA patients.
METHODS. Using a true experimental pretest-posttest design, 30 purposively selected participants were randomly allocated to experimental and control groups. The SDT-based intervention included group sessions, individual sessions, and follow up phone calls in three weeks. Written permission to conduct the study was obtained from the Institutional Review Board of the University of the East - Ramon Magsaysay Memorial Medical Center, Inc. (UERMMMCI) and the Lung Center of the Philippines. Participation was voluntary and all participants had the right to refuse or discontinue their participation at any time during the study. Data were analyzed using two way repeated-measures ANOVA, student's T-test, and chi-square.
RESULTS AND CONCLUSION: The participants in the experimental group have increased adherence rates from Time 1 (60%) to Time 2 (92.9%) and Time 3 (85.7%). Although, when compared to the control group, no significant difference was noted across the different periods of measurement (p=0.70810, p=0870, p=0.2403). There were higher proportions of patients who eventually became adherent in the experimental group compared to the control group immediately after and 5 weeks after the intervention (p=0.0001). The experimental group had significantly better improvement in AHI compared to the control group immediately after (p=0.0152) and 5 weeks after the intervention (p=0.0022). Considering the importance of CPAP adherence in effectively treating OSA, measures to improve adherence such as SDT-based intervention could be usefully incorporated into OSA patients' treatment plans.
- Full text:PJN JAN JUNE 2020 FINAL-53-62.pdf
