Decisive situations affecting partners' support to continuous positive airway pressure-treated patients with obstructive sleep apnea syndrome: a critical incident technique analysis of the initial treatment phase.

BACKGROUND AND RESEARCH
OBJECTIVE: Effective treatment of obstructive sleep apnea syndrome (OSAS) with continuous positive airway pressure (CPAP) can reduce morbidity and mortality, but adherence rates are low. The partner has an important role in supporting the patient, but this role may be adversely affected by difficulties during the early phase of the CPAP initiation. The aim of this study was to explore and describe decisive situations affecting partners' support to patients with OSAS and how the partners manage these situations during the initial phase of CPAP treatment. SUBJECTS AND METHODS: A qualitative descriptive design using critical incident technique was used. A total of 542 decisive situations affecting partners' support and 222 situations describing managing were collected by means of interviews with 25 strategically selected partners of patients with CPAP treated OSAS.
RESULTS: Adverse effects, limited effect, practical and psychosocial problems, limited presence, and inappropriate initiation emerged as negative influences on the partners' support. A well-functioning treatment, improvements, high motivation, and receiving support from others were identified as positive influences on the partners' support. The partner managed the situations by letting the patient handle the CPAP treatment by himself/herself, by handling the treatment together with the patient, or taking over the handling of CPAP treatment.
CONCLUSION: Increased knowledge about the different situations that affect the partners' support negatively or positively and how these situations are managed by partners can be used in educational situations involving both patients and partners during CPAP initiation.