Spousal Involvement in Adherence to CPAP Treatment

描述（由申请人提供）：持续气道正压（CPAP）治疗依从性差仍然是有效管理阻塞性睡眠呼吸暂停（OSA）的最大障碍。虽然改善CPAP依从性的成功干预措施可能最终包括各种组成部分，但对于与“配偶”（指所有家庭伴侣）一起生活的患者，配偶可能是任何成功干预的组成部分。然而，我们对配偶参与对CPAP依从性的特征和影响知之甚少。因此，本R15项目将研究配偶参与在坚持CPAP中的作用，其长期目标是开发以夫妻为基础的干预措施，以促进CPAP的使用。有两个目的是为了了解配偶参与CPAP依从性的本质。目的：目的1探讨配偶参与对持续呼吸pap依从性的影响，并试图分离配偶支持的有益类型和有害类型。133对夫妇（CPAP患者和OSA患者及其配偶）将在CPAP治疗开始后随访3个月。由于更大的每日CPAP使用可优化临床获益，本研究中CPAP依从性将主要通过3个月和1周的平均每日使用来评估。夫妻的二元应对和耐心的情感反应的配偶参与也将被检查。目标2侧重于深入了解夫妇使用CPAP治疗的经历，夫妇如何应对CPAP，以及将CPAP纳入日常生活的促进因素和障碍。将对20-25对夫妇进行面对面的开放式访谈，包括不同程度的CPAP依从性的OSA患者及其配偶，以获得广泛的参与者观点。意义/创新：本研究将CPAP依从性的概念背景从单个患者的独家关注扩展到患者及其配偶的更广泛的双视角。创新的方法方法被用于理解配偶参与CPAP依从性的本质，例如将夫妇作为一个单位招募和来自双方的二元评估。虽然已知在解决其他情况下是有效的，但在OSA中使用配偶参与的社会支持计划尚未经过测试。下一步：该项目将提供数据，使我们能够更好地了解配偶参与对CPAP依从性的作用，并为开发有效和可持续的干预措施提供信息，以提高CPAP的依从性。

DESCRIPTION (provided by applicant): Poor adherence to continuous positive airway pressure (CPAP) treatment remains the single largest impediment to effective management for obstructive sleep apnea (OSA). While successful interventions to improve CPAP adherence may ultimately include a variety of components, for patients living with "spouses" (refers to all domestic partners) the spouse will likely be integral to any successful intervention. However, we know very little about the characteristics and impact of spousal involvement on CPAP adherence. Thus, this R15 project will examine the role of spousal involvement in adherence to CPAP, with the long-term goal of developing a couple-based intervention to promote CPAP use. Two aims are directed toward developing understanding of the nature of spousal involvement in CPAP adherence. Aims: Aim 1 addresses the impact of spousal involvement on CPAP adherence and will attempt to isolate the types of spousal support that are beneficial versus types that are detrimental. One hundred and thirty-three (133) couples (CPAP na¿ve OSA patients and their spouses) will be followed for 3 months after CPAP treatment initiation. Because greater daily CPAP use optimizes clinical benefits, CPAP adherence in this study will be primarily assessed as average daily use at 3-months and at 1-week. Couple's dyadic coping and patient affective response to spousal involvement will also be examined. Aim 2 focuses on developing an in-depth understanding of the couple's experiences with CPAP therapy, how the couples cope with CPAP, and the facilitators and barriers to incorporating CPAP into daily life. In-person open-ended interviews will be conducted with 20-25 couples, including OSA patients with various levels of CPAP adherence and their spouses to obtain a wide range of participant perspectives. Significance / Innovation: This study will expand the conceptual context of CPAP adherence from an exclusive focus on individual patients to a broader dyadic perspective for both patients and their spouses. Innovative methodological approaches are used to understand the nature of spousal involvement in CPAP adherence, such as recruiting the couple as a unit and dyadic evaluation from both partners. While known to be effective in addressing other conditions, the use of social support programs engaging spouses is untested in OSA. Next Steps: This project will provide data that will allow us to better understand the role of spousal involvement in CPAP adherence, and serves to inform the development of an effective and sustainable intervention that will improve CPAP adherence.