Spousal Involvement in Adherence to CPAP Treatment

描述（由申请人提供）：持续气道正压通气（CPAP）治疗依从性差仍然是有效治疗阻塞性睡眠呼吸暂停（OSA）的最大障碍。虽然改善CPAP依从性的成功干预最终可能包括各种组成部分，但对于与“配偶”（指所有家庭伴侣）生活在一起的患者，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CPAP依从性的特征和影响知之甚少。因此，这个R15项目将研究配偶参与在坚持CPAP中的作用，其长期目标是开发一种基于夫妇的干预措施，以促进CPAP的使用。两个目标是针对发展的性质，配偶参与CPAP坚持的理解。目的：目标1解决了配偶参与对CPAP依从性的影响，并将尝试分离有益的配偶支持类型与有害的类型。将对133对夫妇（CPAP初治OSA患者及其配偶）在CPAP治疗开始后随访3个月。由于更大的CPAP日使用量优化了临床获益，因此本研究中的CPAP依从性将主要评估为3个月和1周时的平均日使用量。夫妻的二元应对和病人的情感反应，配偶参与也将被检查。目标2的重点是深入了解这对夫妇的CPAP治疗经验，夫妇如何科普CPAP，以及将CPAP融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，包括具有不同CPAP依从性水平的OSA患者及其配偶，以获得广泛的参与者观点。意义/创新：这项研究将扩大CPAP依从性的概念范围，从对个体患者的专门关注到对患者及其配偶的更广泛的二元视角。创新的方法论的方法被用来理解的性质，配偶参与持续气道正压通气的坚持，如招募夫妇作为一个单位，从双方的合作伙伴和二元评价。虽然知道是有效的解决其他条件，社会支持计划的使用，使配偶参与是未经测试的阻塞性睡眠呼吸暂停综合症。后续步骤：该项目将提供数据，使我们能够更好地了解配偶参与CPAP依从性的作用，并为制定有效和可持续的干预措施提供信息，以提高CPAP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.