Understanding adherence to continuous positive airway pressure in patients with obstructive sleep apnea post‐stroke: A prospective study based on the Andersen model

• Published in: Nursing & health sciences Vol. 26; no. 2; pp. e13129 - n/a
• Main Authors: Yang, Hua‐Lu, Wang, Mian, Xu, Yan‐Fei, Mo, Bei‐Rong, Liu, Xian‐Liang, Redding, Sharon R.
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.06.2024; Blackwell Publishing Ltd
• Subjects: Adherence; Aged; Associate degrees; China; Continuous positive airway pressure; Continuous Positive Airway Pressure - methods; Continuous Positive Airway Pressure - psychology; Continuous Positive Airway Pressure - statistics & numerical data; Female; Health behavior; Health beliefs; Health services utilization; Humans; Male; Middle Aged; Nasal continuous positive airway pressure; Obstructive sleep apnea; Patient compliance; Patient Compliance - psychology; Patient Compliance - statistics & numerical data; predictors; Prospective Studies; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - psychology; Sleep Apnea, Obstructive - therapy; Stroke; Stroke - complications; Stroke - psychology; Surveys and Questionnaires; China; obstructive sleep apnea; predictors; continuous positive airway pressure; stroke; adherence
• ISSN: 1441-0745; 1442-2018
• DOI: 10.1111/nhs.13129

Adherence to continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) post‐stroke is often problematic, despite potential benefits. This study aimed to evaluate CPAP adherence in patients with OSA post‐stroke based on the Andersen behavioral model of health services utilization. A total of 227 eligible participants were recruited from a Chinese hospital. After baseline assessment, participants were followed for 6 months to determine short‐term CPAP adherence. Those with good short‐term adherence were followed for an additional 6 months to explore long‐term adherence and influencing factors. Short‐term CPAP adherence rate was 33%. Being married or living with a partner, having an associate degree or baccalaureate degree or higher, and stronger health beliefs independently predicted short‐term CPAP adherence. Only 25% of participants from the adherent group showed good long‐term adherence. The factor associated with long‐term CPAP adherence was participants not using alcohol. Adherence to CPAP is suboptimal among patients having OSA post‐stroke. Addressing unfavorable predisposing factors and modifying health beliefs are suggested.