Research On Self-management Related Knowledge Beliefs And Practice In Patients With Obstructive Sleep Apnea

Objective:1.The Australian English version of the apnea belief scale(ABS),was introduced,hanced and revised to form a Chinese version of the apnea belief scale with reliable reliability and validity.2.To analyse the knowledge,beliefs and self-management behavior of patients with obstructive sleep apnea(OSA)in terms of their current status,influencing factors and correlations.To investigate the mediating effect of beliefs between knowledge and self-management behavior of OSA patients,in order to provide a basis for clinical cognitive and behavioral interventions for OSA patients.Methods:1.First,contact the author of the source scale to obtain the authorization,and translate it into Chinese based on the modified version of Brislin two-person translation and back-translation model.The Chinese version of the Apnea Beliefs Scale was formed by item analysis and reliability and validity test.2.A total of 161 patients with OSA who met the inclusion and exclusion criteria from July 2021 to December 2022 in a tertiary hospital in Shenyang were conveniently selected.The general questionnaire,Apnea Knowledge Questionnaire,the Chinese version of the Apnea Beliefs Scale,and the Self-Management Behavior Questionnaire for Patients with Obstructive Sleep Apnea were used to study the self-managementrelated knowledge and beliefs of OSA patients.SPSS 25.0 was used for statistical analysis.Mean ± standard deviations,quartiles,frequencies,and percentages were used to describe the data.The Mann-Whitney U test,Kruskal-Wallis H test,Spearman’s correlation coefficient method,and linear regression were used to analyse the data.The difference was considered statistically significant at P<0.05.Results:1.The Chinese version of the apnea beliefs scale has 20 items.Exploratory factor analysis Kaiser Meyer Olkin measure is 0.708,and the Bartlett’s spherical test was significant(χ2=1044.074,df=190,P<0.001),and six dimensions(continuous positive airway pressure acceptance,outcome Expectedness,willingness,health,confidence,perceived impact of OSA)were explored,and the cumulative variance interpretation rate was 62.191%.The average content validity of the scale is 0.93,and the content validity of each item is between 0.8 and 1.0.The validity of the standard is above 0.665.The aggregate table Cronbach’s α coefficient is 0.765,and the retest reliability is 0.879,and the Cronbach’s α coefficient are above 0.6 in each subdimension.2.The 161 OSA patients scored 7(4,8)in knowledge,with the question "What is(are)the general rule(s)sleep apnea patients should remember?" having the highest scoring rate(78%),and "The type of sleep apnea that is caused when air passages in or near the throat become blocked,is called "having the lowest scoring rate(27%).The 161 OSA patients scored 72(59,85)in belief,with the items "I want to improve my health" scored highest(4.5±0.53)and "I don’t think I have sleep problems" scored the lowest(2.16±0.91).The 161 OSA patients scored 59(49.5,74)in self-management behavior,with the highest score for "using nasal spray,nasal drops,etc.or other drugs as prescribed by the physician"(4.7±0.78)and"understanding the meaning of various sleep-related indicators"(2.35±1.03).3.Factors influencing knowledge,beliefs,and self-management behaviors among patients with OSA:univariate analysis showed statistically significant differences in knowledge,beliefs,and self-management behavior scores by gender,age,education,work status,monthly household income,payment method,and severity of OSA degree(P<0.05);the scores of knowledge and self-management behaviors of OSA patients in different places of residence were statistically significant(P<0.05);The scores of beliefs and self-management behaviors of OSA patients with different residence status and marriage were statistically significant(P<0.05).Patients without a history of continuous positive airway pressure use had higher beliefs scores than those with a history of use(P<0.05).The self-management behavior scores of sleepy subjects were lower than those of non-sleepy subjects(P<0.05).There were no significant differences in body mass index,alcohol consumption with or without smoking,presence or absence of nasal diseases,degree of snoring,years of snoring,knowledge,beliefs,or selfmanagement behavior scores between patients with and without a family history of OSA(P>0.05).Multiple linear regression analysis showed that age,education,place of residence,work status,monthly household income,and OSA were independent factors influencing the knowledge score of OSA patients(P<0.05).Gender,age,educational background,work status,monthly household income,marriage,severity of OSA,and history of continuous positive airway pressure were independent factors affecting the belief score of OSA patients(P<0.05).OSA severity monthly household income,education,place of residence,and gender were independent factors affecting the scores of self-management behavior of OSA patients(P<0.05).4.Knowledge and beliefs,beliefs and self-management behavior,and knowledge and self-management behavior were all positively correlated in 161 patients with OSA(r=0.426～0.524,all P<0.05).5.The analysis of mediating effect showed that knowledge in OSA patients had a positive predictive effect on self-management behavior(β=0.583,t=-3.785,R2=0.370,P<0.001),knowledge also had a positive predictive effect on belief(β=0.481,t=6.895,R2=0.326,P<0.001),among which belief had a partial mediating effect on knowledge and self-management behavior(β=0.394,t=-3.322,R2=0.320,P<0.001),the mediating effect accounted for 32.51%.Conclusions:1.The Chinese version of apnea beliefs scale has good reliability and validity,the scale items are concise,simple content,easy to understand,and high feasibility.2.The 161 patients with OSA had low levels of knowledge and beliefs and moderate to low levels of self-management behavior.knowledge,beliefs and selfmanagement behavior were all positively correlated in two ways.There was a mediating effect of beliefs between knowledge and self-management behavior.In the future,in order to improve the overall level of knowledge,beliefs and self-management behavior of OSA patients,it is important to improve their knowledge level,and to adopt individualised and precise cognitive interventions to further improve their beliefs and self-management behavior,taking into account their different characteristics.