Devoted or negotiated routes of adherence: Narratives of patients with obstructive sleep apnoea using a continuous positive airway pressure device.
Margareta Møkleby, Anne Marit Mengshoel
PMID 31367450WHAT IT FOUND
Patients with severe daytime symptoms viewed CPAP as a relief and used it consistently.
Those with mild or no symptoms negotiated use based on self-image and social context, often skipping it to avoid feeling ill or unattractive.
Key findings
01Patients who experienced significant daytime sleepiness and health impacts before diagnosis were motivated by immediate symptom relief and viewed CPAP as a natural part of daily life.
02Patients with absent or mild symptoms often struggled with the diagnosis, viewing the device as a symbol of illness or aging, which led them to negotiate use based on social situations and self-image.
03For some patients, family concern was a stronger motivator for adherence than personal symptom relief.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only seven participants, limiting the transferability of findings. The sample did not include non-users of CPAP, so it cannot explain why some patients never start or completely abandon the therapy. The interviewer was a nurse at the clinic, which may have influenced participants' willingness to speak freely, although they did not have a prior therapeutic relationship with her. The analysis focused on the content of the stories rather than the structure or purpose of the narration.
Declared interests
No conflict of interest declared.
The easy way to misread this
Do not interpret the two storylines as fixed patient types or predictors of success. These are descriptive narratives from a very small sample, not evidence that patients with mild symptoms will inevitably be non-adherent or that severe symptoms guarantee adherence.