Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-6-2022

Graduate Advisor

Nancy Magnuson, DSN, APRN, PCNS, FNP-BC, Chairperson

Committee

Nancy Magnuson, DSN, APRN, PCNS, FNP-BC, Chairperson

Susan Dean-Baar, PhD, RN, CENP, FAAN, Committee Member

Kelly Compas, AGACNP-BC, Committee Member

Abstract

Abstract

Problem. Adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA) is about 30-60%. There are many risks of untreated OSA including poor sleep quality, decreased cognitive function, impaired memory, and uncontrolled hypertension which can lead to heart attack and stroke. This project aimed to identify common barriers that Veterans experience when prescribed CPAP devices and to give recommendations to providers that can address nonadherence. Methods. This quality improvement project used a cross-sectional, descriptive design. Telephone interviews using literature-based questions were conducted to identify common barriers and motivators. A convenience sample included 12 Veterans and three key informants. The sample included adherent and nonadherent CPAP users who are enrolled in Home-Based Primary Care (HBPC) through a Veterans Affairs (VA) medical center. Results. Qualitative data were analyzed and sorted into four main themes: barriers, motivators, source of CPAP education, and effects of OSA on health. The most reported barrier was uncomfortable masks. The most reported motivator was improved sleep. Fifty percent (n=6) of participants could not recall receiving education at the time their device was prescribed. Implications. Benefits of CPAP use and the risks of untreated OSA should be emphasized to nonadherent users. Consistent education and follow-up should be provided to Veterans.

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