Knowledge, attitude, and practice of inpatients with cardiovascular disease regarding obstructive sleep apnea.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Sleep Apnea, Obstructive*/psychology ; Health Knowledge, Attitudes, Practice* ; Cardiovascular Diseases* ; Inpatients*; Humans ; Male ; Female ; Middle Aged ; Cross-Sectional Studies ; Surveys and Questionnaires ; Aged ; Risk Factors ; Adult

There is a significant interrelationship between cardiovascular disease and obstructive sleep apnea (OSA), as they share common risk factors and comorbidities. This study aimed to investigate the knowledge, attitude, and practice (KAP) of inpatients with cardiovascular disease towards OSA. This cross-sectional study was conducted between January, 2022 and January, 2023 at Zhongda Hospital Affiliated to Southeast University among inpatients with cardiovascular disease using a self-administered questionnaire. A self-designed questionnaire was used to assess KAP, and the STOP-Bang questionnaire was applied to evaluate participants' OSA risk. Spearman correlation and path analyses were conducted to explore relationships among KAP scores and high OSA risk. Subgroup analyses were conducted within the high-risk population identified by the STOP-Bang questionnaire. In a study analyzing 591 questionnaires, 66.33% were males. Mean scores were 6.81 ± 4.903 for knowledge, 26.84 ± 4.273 for attitude, and 14.46 ± 2.445 for practice. Path analysis revealed high risk of OSA positively impacting knowledge (β = 2.351, P < 0.001) and practice (β = 0.598, P < 0.001) towards OSA. Knowledge directly affected attitude (β = 0.544) and practice (β = 0.139), while attitude influenced practice (β = 0.266). Among high OSA risk individuals, knowledge directly impacted attitude (β = 0.645) and practice (β = 0.133). Knowledge indirectly influenced practice via attitude (β = 0.197). Additionally, attitude directly affected practice (β = 0.305). These findings provide insights into the interplay between OSA risk, knowledge, attitude, and practice. Inpatients with cardiovascular disease demonstrated inadequate knowledge, moderate attitude, and practice towards OSA. The findings highlighting the need for targeted educational interventions to improve awareness and management of OSA.
(© 2024. The Author(s).)

Heda, P. et al. Long-term periodontal changes associated with oral appliance treatment of obstructive sleep apnea. J. Clin. Sleep. Med. 17, 2067–2074 (2021). (PMID: 33985648849409010.5664/jcsm.9358)
Sillanmäki, S. et al. QTc prolongation is associated with severe desaturations in stroke patients with sleep apnea. BMC Pulm Med. 22, 204 (2022). (PMID: 35610617912827510.1186/s12890-022-01996-y)
Zhou, J., Bai, W., Liu, Q., Cui, J. & Zhang, W. Intermittent Hypoxia Enhances THP-1 Monocyte Adhesion and Chemotaxis and Promotes M1 Macrophage Polarization via RAGE. Biomed Res Int. ; 2018:1650456. (2018).
Wasey, W., Wasey, N., Manahil, N., Saleh, S. & Mohammed, A. Hidden dangers of severe obstructive sleep apnea. Cureus. 14, e21513 (2022). (PMID: 352232898862691)
Zhang, Y. et al. The impact of left ventricular geometry on left atrium phasic function in obstructive sleep apnea syndrome: a multimodal echocardiography investigation. BMC Cardiovasc. Disord. 21, 209 (2021). (PMID: 33894755807027610.1186/s12872-021-02018-1)
Gottlieb, D. J. & Punjabi, N. M. Diagnosis and management of obstructive sleep apnea: a review. Jama. 323, 1389–1400 (2020). (PMID: 3228664810.1001/jama.2020.3514)
Kajiyama, T., Komori, M., Hiyama, M., Kobayashi, T. & Hyodo, M. Changes during medical treatments before adenotonsillectomy in children with obstructive sleep apnea. Auris Nasus Larynx. 49, 625–633 (2022). (PMID: 3484003510.1016/j.anl.2021.11.001)
Wojeck, B. S. et al. Ertugliflozin and incident obstructive sleep apnea: an analysis from the VERTIS CV trial. Sleep. Breath. 27, 669–672 (2023). (PMID: 3559603010.1007/s11325-022-02594-2)
Bommineni, V. L. et al. Automatic segmentation and quantification of Upper Airway Anatomic Risk factors for obstructive sleep apnea on unprocessed magnetic resonance images. Acad. Radiol. 30, 421–430 (2023). (PMID: 3560625710.1016/j.acra.2022.04.023)
Xu, J. et al. Obstructive sleep apnea aggravates neuroinflammation and pyroptosis in early brain injury following subarachnoid hemorrhage via ASC/HIF-1α pathway. Neural Regen Res. 17, 2537–2543 (2022). (PMID: 35535908912066910.4103/1673-5374.339000)
Cepeda-Valery, B., Acharjee, S., Romero-Corral, A., Pressman, G. S. & Gami, A. S. Obstructive sleep apnea and acute coronary syndromes: etiology, risk, and management. Curr. Cardiol. Rep. 16, 535 (2014). (PMID: 2513534710.1007/s11886-014-0535-y)
Liu, Y., Wang, M. & Shi, J. Influence of obstructive sleep apnoea on coronary artery disease in a Chinese population. J. Int. Med. Res. 50, 3000605221115389 (2022). (PMID: 3603637210.1177/03000605221115389)
Peker, Y., Hedner, J., Kraiczi, H. & Löth, S. Respiratory disturbance index: an independent predictor of mortality in coronary artery disease. Am. J. Respir Crit. Care Med. 162, 81–86 (2000). (PMID: 1090322410.1164/ajrccm.162.1.9905035)
Khalid, A. et al. Promoting health literacy about Cancer Screening among Muslim immigrants in Canada: perspectives of imams on the Role they can play in Community. J. Prim. Care Community Health. 13, 21501319211063051 (2022). (PMID: 35118911881981810.1177/21501319211063051)
Koni, A. et al. A cross-sectional evaluation of knowledge, attitudes, practices, and perceived challenges among Palestinian pharmacists regarding COVID-19. SAGE Open. Med. 10, 20503121211069278 (2022). (PMID: 35070309877173010.1177/20503121211069278)
Shubayr, M. A., Kruger, E. & Tennant, M. Oral health providers’ views of oral health promotion in Jazan, Saudi Arabia: a qualitative study. BMC Health Serv. Res. 23, 214 (2023). (PMID: 36879255999029410.1186/s12913-023-09170-8)
Devaraj, N. K. Knowledge, attitude, and practice regarding obstructive sleep apnea among primary care physicians. Sleep. Breath. 24, 1581–1590 (2020). (PMID: 3209601210.1007/s11325-020-02040-1)
Nguyen, V. T. Knowledge, attitude, and clinical practice of dentists toward obstructive sleep apnea: a literature review. Cranio. 41, 238–244 (2023). (PMID: 3287076110.1080/08869634.2020.1816408)
Nwosu, N. et al. Knowledge attitude and practice regarding obstructive sleep apnea among medical doctors in Southern Nigeria. West. Afr. J. Med. 37, 783–789 (2020). (PMID: 33296488)
Chung, F., Abdullah, H. R., Liao, P. & STOP-Bang Questionnaire A practical Approach to screen for obstructive sleep apnea. Chest. 149, 631–638 (2016). (PMID: 2637888010.1378/chest.15-0903)
Teng, Y., Wang, S., Wang, N. & Muhuyati STOP-Bang questionnaire screening for obstructive sleep apnea among Chinese patients with type 2 diabetes mellitus. Arch. Med. Sci. 14, 971–978 (2018). (PMID: 30154877611135010.5114/aoms.2018.73984)
Zheng, Z. et al. Application value of joint STOP-Bang questionnaire and Epworth Sleepiness Scale in screening for obstructive sleep apnea. Front. Public. Health. 10, 950585 (2022). (PMID: 36267990957800910.3389/fpubh.2022.950585)
Sia, C. H. et al. Awareness and knowledge of obstructive sleep apnea among the general population. Sleep. Med. 36, 10–17 (2017). (PMID: 2873590510.1016/j.sleep.2017.03.030)
Thirunavukkarasu, B. F. A. L. et al. Knowledge, attitude, and practice towards evidence-based Medicine among Northern Saudi Primary Care Physicians: a cross-sectional study. Healthc. (Basel) 10(11), 2285 (2022).
Pan, Z. et al. People’s knowledge, attitudes, practice, and healthcare education demand regarding OSA: a cross-sectional study among Chinese general populations. Front. Public. Health. 11, 1128334 (2023). (PMID: 375219671037242510.3389/fpubh.2023.1128334)
Fukuoka, Y. et al. Baseline feature of a randomized trial assessing the effects of disease management programs for the prevention of recurrent ischemic stroke. J. Stroke Cerebrovasc. Dis. 24, 610–617 (2015). (PMID: 2557635110.1016/j.jstrokecerebrovasdis.2014.10.007)
Biglino, G. et al. 3D-manufactured patient-specific models of congenital heart defects for communication in clinical practice: feasibility and acceptability. BMJ Open. 5, e007165 (2015). (PMID: 25933810442097010.1136/bmjopen-2014-007165)
Huang, S. et al. Oral health knowledge, attitudes, and practices and oral health-related quality of life among stroke inpatients: a cross-sectional study. BMC Oral Health. 22, 410 (2022). (PMID: 36123656948416610.1186/s12903-022-02446-1)
Kumar, S. et al. Assessment of Patient Journey Metrics for users of a Digital Obstructive Sleep Apnea Program: single-arm feasibility pilot study. JMIR Form. Res. 6, e31698 (2022). (PMID: 34792470879277610.2196/31698)
Seixas, A. A. et al. Culturally tailored, peer-based sleep health education and social support to increase obstructive sleep apnea assessment and treatment adherence among a community sample of blacks: study protocol for a randomized controlled trial. Trials. 19, 519 (2018). (PMID: 30249293615489310.1186/s13063-018-2835-9)
Sutherland, K., Kairaitis, K., Yee, B. J. & Cistulli, P. A. From CPAP to tailored therapy for obstructive sleep Apnoea. Multidiscip Respir Med. 13, 44 (2018). (PMID: 30524729627620810.1186/s40248-018-0157-0)
Kim, Y. R. Mediating effect of self-cognitive oral health status on the effect of obstructive sleep apnea risk factors on quality of life (HINT-8) in Middle-aged Korean women: The Korea National Health and Nutrition Examination Survey. Life (Basel). 12(10), 1569 (2022).
Mahdi, A., Svantesson, M., Wretenberg, P. & Hälleberg-Nyman, M. Patients’ experiences of discontentment one year after total knee arthroplasty- a qualitative study. BMC Musculoskelet. Disord. 21, 29 (2020). (PMID: 31937282696128810.1186/s12891-020-3041-y)
Makhinova, T. et al. Improving asthma management: patient-pharmacist partnership program in enhancing therapy adherence. Pharm. (Basel) 10(1), 34 (2022).
Cho, J. et al. Snoring during bronchoscopy with moderate sedation is a predictor of obstructive sleep apnea. Tuberc Respir Dis. (Seoul). 82, 335–340 (2019). (PMID: 3117270710.4046/trd.2019.0007)
Mohammadi, I. et al. Evaluation of blood levels of Omentin-1 and Orexin-A in adults with obstructive sleep apnea: a systematic review and Meta-analysis. Life (Basel) 13(1), 245 (2023).
Bassetti, C. L. Sleep and stroke. Semin Neurol. 25, 19–32 (2005). (PMID: 1579893410.1055/s-2005-867073)
Vazir, A. & Kapelios, C. J. Sleep-disordered breathing and cardiovascular disease: who and why to test and how to intervene? Heart. (2023).
Mosli, H. H., Kutbi, H. A., Alhasan, A. H. & Mosli, R. H. Understanding the interrelationship between Education, Income, and obesity among adults in Saudi Arabia. Obes. Facts. 13, 77–85 (2020). (PMID: 31955158709829310.1159/000505246)
Zheng, X. et al. The association between health-promoting-lifestyles, and socioeconomic, family relationships, social support, health-related quality of life among older adults in China: a cross sectional study. Health Qual. Life Outcomes. 20, 64 (2022). (PMID: 35443689902225510.1186/s12955-022-01968-0)
Zhang, Q. N. & Lu, H. X. Knowledge, attitude, practice and factors that influence the awareness of college students with regards to breast cancer. World J. Clin. Cases. 10, 538–546 (2022). (PMID: 35097079877138610.12998/wjcc.v10.i2.538)
Chatterjee, S. et al. Diabetes structured self-management education programmes: a narrative review and current innovations. Lancet Diabetes Endocrinol. 6, 130–142 (2018). (PMID: 2897003410.1016/S2213-8587(17)30239-5)
Kuwabara, A., Su, S. & Krauss, J. Utilizing Digital Health Technologies for Patient Education in Lifestyle Medicine. Am. J. Lifestyle Med. 14, 137–142 (2020). (PMID: 3223147810.1177/1559827619892547)
Seymour, J. The Impact of Public Health Awareness Campaigns on the awareness and quality of Palliative Care. J. Palliat. Med. 21, S30–s6 (2018). (PMID: 2928386710.1089/jpm.2017.0391)
Kim, J. M. et al. Evaluation of patient and Family Engagement Strategies to improve Medication Safety. Patient. 11, 193–206 (2018). (PMID: 2879533810.1007/s40271-017-0270-8)
AlRuthia, Y. et al. The relationship between Health-Related Quality of Life and Trust in Primary Care Physicians among patients with diabetes. Clin. Epidemiol. 12, 143–151 (2020). (PMID: 32104098700819410.2147/CLEP.S236952)
Baghri Lankaran, K. & Ghahramani, S. Social studies in health: a must for today. Med. J. Islam Repub. Iran. 32, 106 (2018). (PMID: 308154016387824)
Kline, R. B. Principles and Practice of Structural Equation Modeling (Guilford, 2023).

82200548 National Natural Science Foundation Youth Fund Project

Keywords: Attitude; Cardiovascular Disease; Cross-sectional study; Knowledge; Obstructive sleep apnea; Practice

Date Created: 20241030 Date Completed: 20241030 Latest Revision: 20241102

20241102

PMC11522412

10.1038/s41598-024-77546-9

39472645