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Title: A lifestyle modification programme for people with Obstructive Sleep Apnoea (OSA) at high risk of Cardiovascular Disease (CVD) and Dysglycaemia
Authors: Thomasouli, Maria-Anna
Supervisors: Khunti, Kamlesh
Davies, Melanie
Award date: 1-Apr-2014
Presented at: University of Leicester
Abstract: The aim of the work reported in this thesis was centred on the development of a fit for purpose structured education lifestyle modification programme for the self-management of Obstructive Sleep Apnoea (OSA). The programme aimed to promote compliance to Continuous Positive Airway Pressure (CPAP) therapy and increase physical activity levels. A mixed method study, the Predicting the Use of Continuous Positive Airway Pressure Therapy in Obstructive Sleep Apnoea in a UK population: The PUCOSA-UK study was carried out to explore the interplay of potential psycho-social predictors of CPAP adherence using a strong framework of psychology models in newly diagnosed and established OSA patients. The study showed that adherence to CPAP therapy was heavily dependent on the early formation of strong beliefs and preconceptions of the condition and CPAP therapy prior to trialling the therapy. The qualitative element of the study identified a number of common barriers associated with CPAP compliance including inability to recognise symptoms and link to with being diagnosed with OSA, initial negative reactions to the idea of using CPAP therapy, discomfort and inconvenience caused when wearing a CPAP mask and operating a CPAP device, lack of spousal or peer support and self-image issues. A systematic review and meta-analysis was conducted to evaluate the impact of diet, exercise and lifestyle modification interventions with or without CPAP therapy on obesity indices, OSA parameters and quality of life in adults with OSA. Intensive lifestyle intervention programmes were found to be more effective in reducing indices of obesity and in improving OSA parameters than less intensive lifestyle interventions or routine care. A structured education curriculum was written and piloted in small groups. The results of the pilot work combined with the results of the aforementioned studies informed the content of the curriculum. Overall, the patients benefited from attending the education programme and learnt useful self-management skills. Concluding, the findings from the work reported here warrant formal testing of the educational programme in a definitive randomised controlled trial.
Type: Thesis
Level: Doctoral
Qualification: PhD
Rights: Copyright © the author. All rights reserved.
Appears in Collections:Theses, Dept. of Health Sciences
Leicester Theses

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