Patient education combined in a music and habit-forming intervention for adherence to continuous positive airway (CPAP) prescribed for sleep apnea.
Patient education combined in a music and habit-forming intervention for adherence to continuous positive airway (CPAP) prescribed for sleep apnea.
复制标题
患者教育结合音乐和习惯形成干预，以坚持持续正压通气 (CPAP) 治疗睡眠呼吸暂停。
DOI：
10.1016/j.pec.2008.08.008
复制
发表时间：
2009
影响因子：
3.5
通讯作者：
Whitman,Robert
中科院分区：
文献类型：
--
作者：
Smith,CarolE;Dauz,Emily;Clements,Faye;Werkowitch,Marilyn;Whitman,Robert
多达50%的阻塞性睡眠呼吸暂停患者在发病后1-3周内停止坚持持续气道正压通气（CPAP）的处方药物治疗。因此，一个基于理论的干预，使用音乐来支持习惯的形成，旨在提高持续气道正压通气坚持在发病。干预材料包括CPAP夜间使用的指导，记录夜间使用的日记和撰写CPAP的好处或问题。此外，一个录音带，轻轻地说，舒适地放置CPAP面罩的指示，使用深呼吸和肌肉放松沿着慢慢降低的音乐克里思，在睡前听every night. METHODS这种音乐干预的效果进行了测试，在一项随机，安慰剂对照试验的97例患者，53名男性（55%）和44名女性（45%）。中度至重度呼吸暂停/低通气评分（根据睡眠实验室数据）和OSA的医学诊断是研究入选所必需的。与安慰剂对照组相比，在CPAP开始的第一个月结束时，更大比例的实验患者是依从的（χ2=14.67，p<0.01;大的差异，Phi=0.39）。3个月（X2=0.065，p=0.79）和6个月（X2= 0.118，p=0.73）时CPAP依从性无差异。患者的日记数据和满意度调查结果表明，干预被评为有益的和指导形成的放松，习惯性的CPAP夜间use.CONCLUSIONThe干预有很强的效果，提高坚持CPAP在1 month.Practice IMPLICATIONS坚持治疗的开始是至关重要的，音频音乐干预很容易管理。需要针对干扰长期CPAP依从性的问题的其他干预措施。
OBJECTIVEAs many as 50% of patients diagnosed with obstructive sleep apnea stop adhering to the prescribed medical treatment of continuous positive airway pressure (CPAP) within 1–3 weeks of onset. Thus, a theory-based intervention using music to support habit formation was designed to improve CPAP adherence at onset. The intervention materials included directions for CPAP nightly use, a diary for recording nightly use and writing about CPAP benefits or problems. In addition, an audiotape with softly spoken instructions for placing the CPAP mask comfortably, using deep breathing and muscle relaxation along with the slowly decreasing music tempo was provided to listen to at bedtime each night.METHODSEffects of this music intervention were tested in a randomized, placebo-controlled trial of 97 patients with 53 males (55%) and 44 females (45%). Moderate to severe apnea/hyponea scores (per sleep laboratory data) and medical diagnosis of OSA were required for study inclusion.RESULTSCompared to placebo controls, a greater proportion of experimental patients were adhering (χ2=14.67, p<0.01; a large difference, Phi=0.39) at the end of the first month of CPAP onset. There were no differences in CPAP adherence at 3 (X2=0.065, p=0.79) and 6 (X2=.118, p=0.73) months. Patients’ diary data and satisfaction survey results indicated the intervention was rated as helpful and guided formation of a relaxing, habitual routine of CPAP nightly use.CONCLUSIONThe intervention had a strong effect for improving adherence to CPAP at 1 month.PRACTICE IMPLICATIONSAdherence at the onset of treatment is critical and the audio music intervention was easily administered. Other interventions that target problems interfering with longer-term CPAP adherence are needed.