The relationship between self-efficacy and psychological resilience in patients with Obstructive Sleep Apnoea Syndrome (OUAS) using Continuous Positive Airway Pressure (CPAP)

Obstructive Sleep Apnoea Syndrome (OSAS) is a chronic sleep disorder characterised by reduced airflow due to obstruction of the upper airway during sleep. The diagnosis is usually made by polysomnography and untreated OSAS can lead to serious consequences such as cardiovascular diseases, hypertension and diabetes. CPAP device is the gold standard method in treatment; it prevents apnoea events and improves quality of life by keeping the upper airway open. However, patients may experience various physical and psychological difficulties in CPAP use. Self-efficacy, the individual's belief in his/her capacity to cope with difficulties, plays a critical role in treatment compliance. Individuals with high psychological resilience are more successful in this process. The study was conducted in a descriptive correlational design between October 2023 and January 2024 in the Sleep Disorders Laboratory Service of Başakşehir Çam and Sakura City Hospital between October 2023 and January 2024 to examine the relationship between self-efficacy and psychological resilience of patients diagnosed with Obstructive Sleep Apnoea Syndrome (OSAS) using Continuous Positive Airway Pressure (CPAP). Prior to the research, the necessary ethical approval was obtained and voluntary participation was ensured by obtaining consent from the participants through the informed consent form. Data collection tools: Descriptive Information Form, Sleep Apnoea Self-Efficacy Scale (SEMSA) and Psychological Resilience Scale for Adults (HPAS). The cronbach alpha internal consistency of the SEMSA and HPAS scales were 0.895 and 0.887, respectively. Data analysis was performed using IBM SPSS Statistics for Windows, Version 22.0 programme. Frequency and percentage analyses were used to determine demographic characteristics, and mean and standard deviation values were calculated to examine scale scores. Whether the data showed normal distribution was evaluated by skewness and kurtosis values. The reporting of the study was carried out in accordance with STROBE. The study population consisted of patients diagnosed with obstructive sleep apnoea syndrome (OSAS) and using continuous positive airway pressure (CPAP) device. The sample consisted of 113 patients who were 18 years of age or older, had been using CPAP for at least one month, had no additional sleep disorder or severe mental disorder, had no physical or mental disability, and volunteered. During the data collection process, the tools were sent online to the participants. According to the findings of the study, the mean score of the participants was found to be at the middle-upper level (3.876±0.595) and the mean score of the SEMSA was found to be at the middle level (2.686±0.495). The participants had the highest mean score of 'Self-perception' among the sub-dimensions of HPBS (3,979±0,665). The mean scores of the HPDS and some of its sub-dimensions differed statistically significantly according to age groups, gender, educational status, income level, marital status, having chronic diseases and sleep problems (p<0.005). However, no significant difference was found in the cases of having children, going for control after starting to use the device, having problems while using the device, smoking and alcohol use (p>0.005). The scores of 'Outcome Expectancy' (2,995±0,663), 'Treatment Self-Efficacy' (2,921±0,732) and 'Risk Perception' (2,073±0,755) were obtained from the sub-dimensions of the SEMSA scale. A significant difference was found in the SEMSA general score and sub-dimensions according to marital status, number of children, having problems while using the device, frequency of visits for follow-up and having sleep problems (p<0.005). However, no significant difference was found according to gender, educational status, employment status and duration of daily use of CPAP device (p>0.005). No significant correlation was found between HPDS and SEMSA general scores (r=0.148, p=0.118). However, positive and significant correlations were found between the general score of the HPAS and the SEMSA 'Outcome Expectancy' sub-dimension (r=0.193, p=0.041) and between the HPAS 'Social Competence' and SEMSA 'Outcome Expectancy' (r=0.193, p=0.040). In line with these results, awareness of OSAS and CPAP treatment should be increased. Individualised training programmes can be organised to support patients' self-efficacy in the treatment process. Social support mechanisms should be strengthened and the participation of family and close environment in the treatment should be encouraged. Group studies supporting psychological resilience can be carried out with a particular focus on strengthening patients' beliefs and motivation to achieve positive results related to treatment and social skills that will enable them to reach their social support. Practical information and technical support regarding the use of the CPAP device should be provided to increase adherence to treatment. Additional interventions can be applied for sleep problems. In addition, regular follow-up and feedback mechanisms should be established, the needs of patients should be taken into consideration, and solutions appropriate to individual differences should be offered. Keywords: Psychologıcal Resilience, Self Efficacy, Continuous Positive Airway Pressure, Obstructive Sleep Apnea