A mixed method evaluation of a group-based educational programme for CPAP use in patients with obstructive sleep apnea
Article first published online: 16 DEC 2011
© 2011 Blackwell Publishing Ltd
Journal of Evaluation in Clinical Practice
Volume 19, Issue 1, pages 173–184, February 2013
How to Cite
Broström, A., Fridlund, B., Ulander, M., Sunnergren, O., Svanborg, E. and Nilsen, P. (2013), A mixed method evaluation of a group-based educational programme for CPAP use in patients with obstructive sleep apnea. Journal of Evaluation in Clinical Practice, 19: 173–184. doi: 10.1111/j.1365-2753.2011.01797.x
- Issue published online: 25 JAN 2013
- Article first published online: 16 DEC 2011
- Accepted for publication: 20 October 2011
- CPAP treatment;
- obstructive sleep apnoea
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.