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J Eval Clin Pract. 2013 Feb;19(1):173-84. doi: 10.1111/j.1365-2753.2011.01797.x. Epub 2011 Dec 16.

A mixed method evaluation of a group-based educational programme for CPAP use in patients with obstructive sleep apnea.

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1
School of Health Sciences, Jönköping University, Jönköping, Sweden. anders.brostrom@hhj.hj.se

Abstract

RATIONALE, AIMS AND OBJECTIVES:

Continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) has a low long-term adherence. Educational interventions are few and sparsely described regarding content, pedagogical approach and participants' perceptions. The aim was to describe adherence to CPAP treatment, knowledge about OSA/CPAP, as well as OSA patients' perceptions of participating in a group-based programme using problem-based learning (PBL) for CPAP initiation. EDUCATIONAL PROGRAMME: The PBL programme incorporated elements from theories and models concerning motivation and habits. Tutorial groups consisting of four to eight patients met at six sessions during 6 months.

METHODS:

A sequential explanatory mixed method design was used on 25 strategically selected patients. Quantitative data regarding, clinical variables, OSA severity, CPAP use, and knowledge were collected at baseline, after 2 weeks and 6 months. Qualitative data regarding patients' perceptions of participation were collected after 6 months by semi-structured interviews using a phenomenographic approach.

RESULTS:

72% of the patients were adherent to CPAP treatment after 2 weeks and 6 months. All patients improved their baseline knowledge about OSA and CPAP after 2 weeks and sustained it after 6 months. Anxiety and fear, as well as difficulties and needs were motivational factors for participation. Patients described the difficulties of behavioural change, an awareness that improvements do not occur immediately, a realization of the importance of both technical and emotional support and the need for a healthier lifestyle.

CONCLUSION AND PRACTICE IMPLICATIONS:

A group-based programme using PBL seems to facilitate adaptive and developmental learning and result in acceptable CPAP adherence levels.

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