Tell-Show-Do法对阻塞性睡眠呼吸暂停综合征患者持续正压通气治疗依从性的影响

摘要

Objective To evaluate the influence of Tell-Show-Do method on the compliance to continuous positive airway pressure (CPAP) treatment in the patients with obstructive sleep apnea syndrome (OSAS). Methods Among the OSAS patients in the First Affiliated Hospital of General Hospital of the Chinese People's Liberation Army from June 2013 to June 2015, 100 patients were screened out for participating in the experiment by adopting the Venham clinical levels of anxiety and cooperative behavior rating scale. The patients were randomly divided into observation group (n=52) and control group (n=48) and were all treated by CPAP. Before treatment, the observation group adopted Tell-Show-Do meth-od, while the control group applied conventional treatment options. The Frankl compliance score and Houpt score after the first visiting were recorded in the observation and control groups. The treatment compliance of appliance wearing was evaluated after 1, 2, 4 weeks of treatment. Results The number of cases with Frank score of 4 points in the obser-vation group was significantly higher than that in the control group [38 (73.08%) vs 21 (43.75%), P<0.05]. The number of cases with Houpt behavior score of 6 points in the observation group was significantly higher than that in the control group [30 (57.69%) vs 16 (33.34%), P<0.05]. The treatment time at 1, 2, 4 weeks in the observation group were significantly longer than those in the control group (P<0.05). Conclusion The Tell-Show-Do method can effectively improve the treatment com-pliance at first visiting and subsequent visiting in the patients with OSAS treated by CPAP. It has great clinical application val-ue and is worth promotion.%目的：探讨讲-示-做（Tell-Show-Do）法对阻塞性睡眠呼吸暂停综合征患者持续正压通气治疗依从性的影响。方法选取2013年6月至2015年6月在解放军总医院第一附属医院就诊的阻塞性睡眠呼吸暂停综合征患者，采用Venham临床焦虑及合作行为级别评定量表，筛选出100例行持续正压通气治疗的患者参加试验，随机数字表法分为观察组(n=52)和对照组(n=48)。观察组治疗前采用Tell-Show-Do法，对照组采用常规法进行正压通气前治疗介绍。首次就诊后分别记录两组患者Frankl依从性评分和Houpt行为治疗效果评分；开始治疗后1、2、4周复诊时评价患者使用正压通气治疗依从性。结果观察组患者的治疗依从性评分良好者为38例(73.08%)，明显高于对照组的21例(43.75%)，差异有统计学意义(P<0.05)；观察组患者的Houpt行为治疗效果良好者为30例(57.69%)，明显高于对照组的16例(33.34%)，差异有统计学意义(P<0.05)；观察组患者开始治疗后1、2、4周时完成正压通气平均时间均长于对照组，差异均有统计学意义(P<0.05)。结论 Tell-Show-Do法可有效提高阻塞性睡眠呼吸暂停综合征患者正压通气首诊时治疗依从性和复诊后治疗依从性，值得临床推广。