Factors influencing patient delay in individuals with obstructive sleep apnoea: a study based on an integrated model

• Published in: Annals of medicine (Helsinki) Vol. 54; no. 1; pp. 2816 - 2828
• Main Authors: Zhang, Hui, Liang, Chunguang, Zhang, Xin, Yu, Haitao, Yan, Xiangru, Wang, Liying, Tong, Tong, Zhang, Huiying, Dai, Hongliang, Tong, Huijuan
• Format: Journal Article
• Language: English
• Published: Taylor & Francis 31.12.2022; Taylor & Francis Group
• Subjects: Health ecological model; patient delay; Public Health; sleep disorder; theory of planned behaviour
• ISSN: 0785-3890; 1365-2060
• DOI: 10.1080/07853890.2022.2132417

Obstructive sleep apnoea (OSA) is the most common sleep-related breathing disorder, yet it remains undiagnosed in a large proportion of adults. This study aims to investigate the status of patient delay and provider delay in OSA patients and examine related factors affecting patient delay in OSA individuals in China. A cross-sectional design was conducted on a sample of 309 OSA patients (aged from 18 to 76, median age of 47 years, 84.8% male) in Northeast China. Participants were required to complete the sociodemographic questionnaire, the symptom characteristics questionnaire, the help-seeking attitude scale (HSAS), the social support rating scale and the chronic disease self-efficacy scales (CDSES) to test the hypothesis. Binary logistic regression analysis was conducted to explore factors that account for the patient delay. The median patient delay among OAS patients in this study was 22 months, the median provider delay was one month, and the median total delay was 26 months. As shown by multivariate analysis results, patients who have snored for over 6 years (OR = 3.377, 95%CI: 1.175-9.702) were more likely to experience prolonged patient delays. Per capita monthly family income above 3000 RMB (OR = 0.172, 95%CI: 0.052-0.571), taking up residence in cities or towns (OR = 0.484, 95%CI: 0.248-0.946), higher self-recognition of the disease (OR = 0.793, 95%CI: 0.647-0.972), higher objective support (OR = 0.825, 95%CI: 0.739-0.921) and stronger self-efficacy (OR = 0.674, 95%CI: 0.525-0.867) were significantly associated with shorter patient delays. Patient delay is common in Chinese OSA patients. The upstream factors affecting the patient delay in individuals with OSA include income, place of residence, and objective support; midstream factors include self-recognition of the disease and self-efficacy; downstream factors include years of snoring. KEY MESSAGES Despite being a high-prevalence disease, many obstructive sleep apnoea (OSA) patients are not clearly diagnosed and treated. The factors affecting the delay in seeking medical treatment in individuals with OSA included income, place of residence, objective support, self-recognition of the disease, self-efficacy and years of snoring. Investigations into OSA patients' care-seeking behaviours can better reflect the secondary prevention of OSA, and it is crucial to pay attention to the delayed phase of patients.