title: Challenges and motivating factors related to positive airway pressure therapy for post-TIA and stroke patients.
abstract: Challenges adapting to continuous positive airway pressure (CPAP) therapy are largely unexplored in patients with stroke or transient ischemic attack. This study, nested within a randomized controlled trial of CPAP use, employed qualitative methods to explore challenges and motivators related to CPAP at two time points: prior to initiating therapy and at a 1-month follow up. Emergent thematic analysis, an inductive, qualitative approach, revealed variations in how patients experienced and adapted to CPAP across five phases: (a) interpreting the sleep apnea diagnosis, (b) contemplating CPAP therapy, (c) trying CPAP therapy, (d) making mid-course adjustments, and (e) experiencing benefits from CPAP therapy. Patients all had mild to moderate sleep apnea, and frequently did not experience sleep apnea symptoms. A salient motivator for adhering to CPAP therapy for these patients was the desire to reduce the risk of subsequent cerebrovascular events. Self-determination theory guided the interpretation of results.
authors.affiliation: a Veterans Affairs Health Services Research and Development Center on Implementing, Evidence-Based Practice, Roudebush VA Medical Center , Indianapolis , IN.
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Matthias
authors.forename: Neale R
authors.initials: NR
authors.lastname: Chumbler
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Bravata
authors.forename: H Klar
authors.initials: HK
authors.lastname: Yaggi
authors.forename: Jared
authors.initials: J
authors.lastname: Ferguson
authors.forename: Charles
authors.initials: C
authors.lastname: Austin
authors.forename: Vincent
authors.initials: V
authors.lastname: McClain
authors.forename: Mary I
authors.initials: MI
authors.lastname: Dallas
authors.forename: Cody D
authors.initials: CD
authors.lastname: Couch
authors.forename: Nicholas
authors.initials: N
authors.lastname: Burrus
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Miech
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D045422:Continuous Positive Airway Pressure / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D020521:Stroke / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D013997:Time Factors