Acceso usuarios
Palma de Mallorca, España
El presente trabajo revisa los factores asociados a la adherencia al tratamiento con CPAP (Continuous Positive Airway Pressure) para el Síndrome de Apneas-Hipopneas Obstructiva del Sueño (SAHOS) así como las intervenciones psicológicas desarrolladas a partir de los estudios de los factores asociados, y describe de forma breve la colaboración del psicólogo clínico con el equipo de neumología de un hospital público español para aumentar la adherencia al tratamiento en pacientes en riesgo de incumplimiento o abandono. De los diversos estudios se concluye que los factores psicológicos contribuyen significativamente a explicar la adherencia al tratamiento con CPAP y que las intervenciones educativas, de apoyo y especialmente la terapia cognitivo-conductual aumentan la adherencia al tratamiento con CPAP en mayor proporción que la intervención habitual.
Theoretical Framework: associated factors adherence to CPAP treatment for OSA are reviewed, with particular attention to studies on psychological variables, as well as the effectiveness of interventions developed from these studies. Method: The review was conducted through PubMed, Cochrane, and Psicodoc, using the terms "CPAP", "adherence," "compliance," "interventions" and "treatment." It has been taken into account for the selection of papers the date of publication, scientific quality and relevance of the topic in the overall content of the article.
Results: psychological variables such as selfefficacy, risk perception, outcome expectancies, decisional balance and perceived severity are better predictors of adherence than biomedical indexes that measure disease severity (Sage et al,2001; Olsen et al., 2008). Educational interventions, support and especially behavioral therapy increase the use of CPAP in greater proportion than the usual intervention (Wozniak, Lasserson and Smith, 2014). Interventions have been designed to try to influence these psychological variables that have been shown effective in increasing adherence to CPAP (Aloia et al, 2011; Richards et al., 2007). Conclusions: psychological variables contribute to adherence to CPAP, and there have been design interventions based on these studies that have increased adherence to treatment, although still waiting to be replicated. Methodological issues to address are the selection of the sample, the temporal measurement of variables and adherence, and discrimination of the contribution in adherence of the different components of the interventions. The clinical psychologist is an added value to the pulmonary medicine and nursery team for the multidisciplinary approach of adherence to CPAP
