The Effect of Nursing Intervention on Compliance with Continuous Positive Airway Pressure
|School||Tianjin Medical University|
|Keywords||OSAHS CPAP Adherence Quality of life Early morning blood pressure Health Education Follow-up|
OSAHS patients of the purpose of an investigation CPAP adherence to treatment, analyzes factors. Explore music therapy and relaxation training, as well as strengthening health education and follow-up care interventions for patients with OSAHS CPAP treatment compliance, quality of life and early morning blood pressure. Method 1 telephone survey 2005.7-2009.9 in the General Hospital of Tianjin Medical University, Department of Respiratory Medicine, the sleep apnea Laboratory accept CPAP titration in patients with OSAHS use of the CPAP machine, and to investigate the causes of poor patient compliance is poor compliance. Logistic regression analysis Compliance of factors. 2 2009.10-2010.10 to accept CPAP titration and willing to accept CPAP family therapy 45 OSAHS patients were randomly divided into intervention and control groups, and, in the time of enrollment, payment records, and used to record CPAP use of time and early morning blood pressure values. The control group pressure titration night to give regular oral health education, to 1,3,6 months when CPAP treatment follow-up. Intervention group in addition to interventions for the control group, the pressure titration that night but also to the patients play light music and teach patients relaxation training to adapt to the CPAP, the morning of the next day to give patients with soft music CD and written health education materials, and tell patients with machine when listening to soft music, helps to fall asleep. Given telephone follow-up of patients in the 1, 2, 3 weeks of CPAP treatment, patients are encouraged to use music therapy and muscle relaxation training, to assist in the completion of the psychological and physiological adaptation, while helping to solve the technical problems encountered in the CPAP use. The two groups were collected into the group and 1,3,6-month follow-up CPAP use, quality of life and blood pressure and other indicators of value. Using analysis of variance, t test were compared between the two groups, each index changes. 1210 patients, 193 patients were surveyed. 51.81% of the patients adhere to CPAP family therapy; 15.03% of patients discontinued CPAP family therapy; 33.16% of the patients who had not received family therapy. Poor compliance in the first few due to the pressure suited to CPAP titration night, \Logistic regression found that factors affect the CPAP compliance with the AHI (P = 0.013). 2 control group and intervention group at 1, 3, and 6 months of CPAP use were 4.67 ± 0.53 h / d VS 6.32 ± 0.73 h / d, 3.97 ± 0.38h/dVS6.19 ± 0.63 h / d, 3.49 ± 0.36 h / d vs 6.31 ± 0.45 h / d, 3 point in time the two groups there are differences (P lt; 0.05) Control and intervention groups in the intervention quality of life before and after 6 months of each dimension and total scores change: daytime sleepiness 0.69 ± 0.49 vs. 1.60 ± 0.46; daytime symptoms 0.50 ± 0.62VS 1.24 ± 0.66; the nocturnal symptoms 0.89 ± 0.48VS1. 96 ± 0.53; emotional 0.30 ± 0.77 vs 0.66 ± 0.52; the social interaction 0.34 ± 0.75 vs 0.88 ± 0.55; Total 0.58 ± 0.33 vs 1.42 ± 0.30. In addition to the emotional dimension (P = 0.77) and social dimensions (P = 0.10), other dimensions and the total score before and after the change in the difference between the two groups were different (P lt; 0.05). Improvement of the quality of life of the intervention group than the control group. 4 in the control group, 19 patients with hypertension, 17 patients in the intervention group. The decline in the value of the control group and intervention group patients with hypertension morning systolic and diastolic blood pressure before and after the intervention were 1.33 ± 3.95 vs 6.07 ± 1.79mmHg, 2.51 ± 4.96 vs 11.01 ± 4.25 mmHg two indicators between the two groups were different ( P lt; 0.05). The intervention group systolic and diastolic blood pressure reduction than the control group. Conclusion OSAHS patients with CPAP treatment compliance is poor. The medical staff should improve patient pressure titration night ventilator adaptation, to enhance early health education and follow-up efforts to improve CPAP adherence to treatment. Music therapy and relaxation training can ease the discomfort and tension in the OSAHS patients for the first time with a machine, making it easy to adapt to and accept the CPAP, CPAP titration night, application of these two methods. Patients with oral and written health education, the strengthening early follow-up can improve CPAP adherence to treatment of patients with OSAHS. Of OSAHS patients health education and follow-up, patients Church music therapy and relaxation training can improve CPAP treatment compliance in patients with OSAHS, and can improve the the OSAHS patients quality of life, improve daytime sleepiness and other symptoms, and night symptoms, social interaction state; also effectively reduced the early morning blood pressure in patients with hypertension OSAHS. I hope our intervention methods in clinical practice to promote the use of the OSAHS patients benefit from it.