Motivational Interviewing (MINT) Improves Continuous Positive Airway Pressure (CPAP) Acceptance and Adherence: A Randomized Controlled Trial
Motivational Interviewing (MINT) Improves Continuous Positive Airway Pressure (CPAP) Acceptance and Adherence: A Randomized Controlled Trial
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DOI：
10.1037/a0026302
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发表时间：
2012-02-01
影响因子：
5.9
通讯作者：
Douglas, James
中科院分区：
文献类型：
--
作者：
Olsen, Sara;Smith, Simon S.;Douglas, James
目的：持续气道正压通气（CPAP）治疗阻塞性睡眠呼吸暂停（OSA）的依从性差。我们评估了动机访谈干预（动机访谈护士治疗[MINT]）的有效性，以及最佳实践标准护理，以提高新诊断为OSA的患者对CPAP治疗的接受度和依从性。方法：从三级睡眠障碍中心招募了106名新诊断为阻塞性睡眠呼吸暂停综合症并建议进行持续气道正压通气治疗的澳大利亚成年人（69%男性）。参与者被随机分配接受3次动机访谈干预（MINT：n = 53;平均年龄= 55.4岁）或不干预（对照组; n = 53;平均年龄= 57.74岁）。主要结局是1个月、2个月、3个月和12个月随访时两组间客观CPAP依从性的差异。结果如下：MINT组中的50名（94%）参与者和对照组中的50名（94%）参与者符合所有入选和排除标准，并被纳入主要分析。3个月时，MINT组每晚使用CPAP的小时数为4.63小时，对照组为3.16小时（p = 0.005）。这表明MINT组的依从性比对照组高出近50%。MINT组患者更有可能接受CPAP治疗。结论：MINT是一种简单、手动、有效的干预措施，与单独的标准治疗相比，可提高CPAP接受率和客观依从率。
Objective: Adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnoea (OSA) is poor. We assessed the effectiveness of a motivational interviewing intervention (motivational interview nurse therapy [MINT]) in addition to best practice standard care to improve acceptance and adherence to CPAP therapy in people with a new diagnosis of OSA. Method: One hundred six Australian adults (69% male) with a new diagnosis of OSA and a clinical recommendation for CPAP treatment were recruited from a tertiary sleep disorders center. Participants were randomly assigned to receive either 3 sessions of a motivational interviewing intervention (MINT: n = 53; mean age = 55.4 years) or no intervention (control; n = 53; mean age = 57.74 years). The primary outcome was the difference between the groups in objective CPAP adherence at 1-month, 2-month, 3-month, and 12-month follow-ups. Results: Fifty (94%) participants in the MINT group and 50 (94%) participants in the control group met all inclusion and exclusion criteria and were included in the primary analysis. The number of hours of CPAP use per night in the MINT group at 3 months was 4.63 hr and was 3.16 hr in the control group (p = .005). This represents almost 50% better adherence in the MINT group relative to the control group. Patients in the MINT group were substantially more likely to accept CPAP treatment. Conclusions: MINT is a brief, manualized, effective intervention that improves CPAP acceptance and objective adherence rates compared to standard care alone.