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Sleep and Breathing

, Volume 23, Issue 1, pp 217–226 | Cite as

A French update on the Self-Efficacy Measure for Sleep Apnea (SEMSA) to assess continuous positive airway pressure (CPAP) use

  • Jean-Arthur Micoulaud-FranchiEmail author
  • Olivier Coste
  • Stéphanie Bioulac
  • Kelly Guichard
  • Pierre-Jean Monteyrol
  • Imad Ghorayeb
  • Terri E. Weaver
  • Sébastien Weibel
  • Pierre Philip
Sleep Breathing Physiology and Disorders • Original Article

Abstract

Purpose

The Self-Efficacy Measure for Sleep Apnea (SEMSA) is a 26-item self-questionnaire composed of three factors: risk perception of obstructive sleep apnea syndrome (OSAS), benefit of continuous positive airway pressure (CPAP), and self-efficacy (the confidence to engage in CPAP use). It is used to evaluate health beliefs about OSAS and CPAP in order to optimize CPAP use. The purpose of this study was to design and validate a French version of the SEMSA.

Methods

A forward-backward translation of the SEMSA was performed. Subjects with OSAS treated by CPAP and followed by our sleep clinic were invited to complete the questionnaire. The psychometric properties of the French SEMSA version were analyzed in terms of its construct validity (with confirmatory factor analysis, CFA), internal structural validity (Cronbach’s alpha coefficient), and external validity (Pearson’s correlation between SEMSA score and duration of CPAP use).

Results

Two hundred eighty-eight subjects filled in the questionnaire. The mean age was 63.16 ± 12.73 years. The number of years since the beginning of CPAP treatment was 6.58 ± 6.03 years. The mean CPAP use duration was 6.19 ± 2.03 h/night. CFA was unsatisfactory (RMSEA = 0.066 and CFI = 0.88). The exploratory factor analysis revealed a fourth factor named “cardiovascular risk” factor. Cronbach’s alpha coefficient was 0.886. The correlation between the “self-efficacy” factor and the duration of CPAP use was significant (r = 0.26, p ≤ 0.001).

Conclusions

The French version of the SEMSA is a psychometrically acceptable self-report questionnaire for measuring health beliefs and behavior in French patients with OSAS treated with CPAP. Such translation and validation should lead to the adoption of validated psychosocial methods for improving CPAP use.

Keywords

Sleep apnea Self-efficacy CPAP adherence CPAP treatment Validation 

Notes

Acknowledgments

Special thanks to VitalAire France, home healthcare provider, activity of Air Liquide HealthCare, and Muriel Bacarisse for collecting and monitoring data and for administrative, technical, and logistic support.

Many thanks to Ray Cooke for translation of the SEMSA items and copy-editing the paper.

Compliance with ethical standards

The study was conducted in accordance with the Declaration of Helsinki and French Good Clinical Practices.

Conflict of interest

Dr. Weaver is Principal Investigator for the University of Illinois at Chicago site for the Jazz Pharmaceuticals 110 pharmaceutical clinical trial. She also receives royalty fees from the following companies for use of the Functional Outcomes of Sleep Questionnaire: Philips Respironics, Nyxoah, ResMed, Jazz Pharmaceuticals, NightBalance, and Inspire, Inc. The other authors report no conflicts of interest.

Supplementary material

11325_2018_1686_MOESM1_ESM.docx (56 kb)
ESM 1 (DOCX 56 kb)

References

  1. 1.
    Malhotra A, White DP (2002) Obstructive sleep apnoea. Lancet 360(9328):237–245Google Scholar
  2. 2.
    Levy P, Kohler M, McNicholas WT, Barbe F, McEvoy RD, Somers VK, Lavie L, Pepin JL (2015) Obstructive sleep apnoea syndrome. Nat Rev Dis Primers 1:15015Google Scholar
  3. 3.
    Gay P, Weaver T, Loube D, Iber C (2006) Evaluation of positive airway pressure treatment for sleep related breathing disorders in adults. Sleep 29(3):381–401Google Scholar
  4. 4.
    Reeves-Hoche MK, Meck R, Zwillich CW (1994) Nasal CPAP: an objective evaluation of patient compliance. Am J Respir Crit Care Med 149(1):149–154.  https://doi.org/10.1164/ajrccm.149.1.8111574 Google Scholar
  5. 5.
    Engleman HM, Martin SE, Douglas NJ (1994) Compliance with CPAP therapy in patients with the sleep apnoea/hypopnoea syndrome. Thorax 49(3):263–266Google Scholar
  6. 6.
    Kribbs NB, Pack AI, Kline LR, Smith PL, Schwartz AR, Schubert NM, Redline S, Henry JN, Getsy JE, Dinges DF (1993) Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis 147(4):887–895.  https://doi.org/10.1164/ajrccm/147.4.887 Google Scholar
  7. 7.
    Sawyer AM, Gooneratne NS, Marcus CL, Ofer D, Richards KC, Weaver TE (2011) A systematic review of CPAP adherence across age groups: clinical and empiric insights for developing CPAP adherence interventions. Sleep Med Rev 15(6):343–356Google Scholar
  8. 8.
    Engleman HM, Wild MR (2003) Improving CPAP use by patients with the sleep apnoea/hypopnoea syndrome (SAHS). Sleep Med Rev 7(1):81–99Google Scholar
  9. 9.
    Ward K, Hoare KJ, Gott M (2014) What is known about the experiences of using CPAP for OSA from the users’ perspective? A systematic integrative literature review. Sleep Med Rev 18(4):357–366Google Scholar
  10. 10.
    Olsen S, Smith S, Oei TP (2008) Adherence to continuous positive airway pressure therapy in obstructive sleep apnoea sufferers: a theoretical approach to treatment adherence and intervention. Clin Psychol Rev 28(8):1355–1371Google Scholar
  11. 11.
    Shapiro GK, Shapiro CM (2010) Factors that influence CPAP adherence: an overview. Sleep Breath 14(4):323–335.  https://doi.org/10.1007/s11325-010-0391-y Google Scholar
  12. 12.
    Crawford MR, Espie CA, Bartlett DJ, Grunstein RR (2014) Integrating psychology and medicine in CPAP adherence—new concepts? Sleep Med Rev 18(2):123–139Google Scholar
  13. 13.
    Weaver TE, Grunstein RR (2008) Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc 5(2):173–178.  https://doi.org/10.1513/pats.200708-119MG Google Scholar
  14. 14.
    Taylor S (2006) Health psychology. McGraw Hill, TorontoGoogle Scholar
  15. 15.
    Haynes R, Taylor D, Sackett D (1979) Compliance in health care. John Hopkins University Press, BaltimoreGoogle Scholar
  16. 16.
    Schwarzer R, Fuchs R (1996) Self-efficacy and health behaviours. In: Conner M, Norman P (eds) Predicting health behaviour. Open University Press, Philadephia,Google Scholar
  17. 17.
    Bandura A (1977) Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84(2):191–215Google Scholar
  18. 18.
    Sin DD, Mayers I, Man GC, Pawluk L (2002) Long-term compliance rates to continuous positive airway pressure in obstructive sleep apnea: a population-based study. Chest 121(2):430–435Google Scholar
  19. 19.
    Stepnowsky CJ Jr, Marler MR, Ancoli-Israel S (2002) Determinants of nasal CPAP compliance. Sleep Med 3(3):239–247Google Scholar
  20. 20.
    Micoulaud-Franchi JA, Monteyrol PJ, Guichard K, Bioulac B, Philip P (2017) Psychology factors and adherence to continuous positive airway pressure treatment: practical tools for an integrative sleep medicine. Médecine du Sommeil 14(2):99–111Google Scholar
  21. 21.
    Wallace DM, Shafazand S, Aloia MS, Wohlgemuth WK (2013) The association of age, insomnia, and self-efficacy with continuous positive airway pressure adherence in black, white, and Hispanic U.S. Veterans. J Clin Sleep Med 9(9):885–895.  https://doi.org/10.5664/jcsm.2988 Google Scholar
  22. 22.
    Dzierzewski JM, Wallace DM, Wohlgemuth WK (2016) Adherence to continuous positive airway pressure in existing users: self-efficacy enhances the association between continuous positive airway pressure and adherence. J Clin Sleep Med 12(2):169–176Google Scholar
  23. 23.
    Wohlgemuth WK, Chirinos DA, Domingo S, Wallace DM (2015) Attempters, adherers, and non-adherers: latent profile analysis of CPAP use with correlates. Sleep Med 16(3):336–342Google Scholar
  24. 24.
    Olsen S, Smith S, Oei T, Douglas J (2008) Health belief model predicts adherence to CPAP before experience with CPAP. Eur Respir J 32(3):710–717Google Scholar
  25. 25.
    Sawyer AM, Canamucio A, Moriarty H, Weaver TE, Richards KC, Kuna ST (2011) Do cognitive perceptions influence CPAP use? Patient Educ Couns 85(1):85–91Google Scholar
  26. 26.
    Lai AY, Fong DY, Lam JC, Weaver TE, Ip MS (2013) Linguistic and psychometric validation of the Chinese version of the self-efficacy measures for sleep apnea questionnaire. Sleep Med 14(11):1192–1198Google Scholar
  27. 27.
    Wallace DM, Vargas SS, Schwartz SJ, Aloia MS, Shafazand S (2013) Determinants of continuous positive airway pressure adherence in a sleep clinic cohort of South Florida Hispanic veterans. Sleep Breath 17(1):351–363.  https://doi.org/10.1007/s11325-012-0702-6 Google Scholar
  28. 28.
    Ye L, Pack AI, Maislin G, Dinges D, Hurley S, McCloskey S, Weaver TE (2012) Predictors of continuous positive airway pressure use during the first week of treatment. J Sleep Res 21(4):419–426.  https://doi.org/10.1111/j.1365-2869.2011.00969.x Google Scholar
  29. 29.
    Bakker JP, O’Keeffe KM, Neill AM, Campbell AJ (2011) Ethnic disparities in CPAP adherence in New Zealand: effects of socioeconomic status, health literacy and self-efficacy. Sleep 34(11):1595–1603.  https://doi.org/10.5665/sleep.1404 Google Scholar
  30. 30.
    Weaver TE, Maislin G, Dinges DF, Younger J, Cantor C, McCloskey S, Pack AI (2003) Self-efficacy in sleep apnea: instrument development and patient perceptions of obstructive sleep apnea risk, treatment benefit, and volition to use continuous positive airway pressure. Sleep 26(6):727–732Google Scholar
  31. 31.
    Sawyer AM, King TS, Hanlon A, Richards KC, Sweer L, Rizzo A, Weaver TE (2014) Risk assessment for CPAP nonadherence in adults with newly diagnosed obstructive sleep apnea: preliminary testing of the Index for Nonadherence to PAP (I-NAP). Sleep Breath 18(4):875–883.  https://doi.org/10.1007/s11325-014-0959-z Google Scholar
  32. 32.
    Saito A, Kojima S, Sasaki F, Hayashi M, Mieno Y, Sakakibara H, Hashimoto S (2015) Development and evaluation of a self-efficacy instrument for Japanese sleep apnea patients receiving continuous positive airway pressure treatment. Nat Sci Sleep 7:25–31.  https://doi.org/10.2147/NSS.S74268 Google Scholar
  33. 33.
    Organisation International de la francophonie (2009) Le français, enjeux du XXIe siécleGoogle Scholar
  34. 34.
    Brislin R (1970) Back-translation for cross-cultural research. J Cross-Cult Psychol 1(3):185–216Google Scholar
  35. 35.
    Truxillo C (2005) Maximum likelihood parameter estimation with incomplete data. Proceedings Thirtieth Annual SAS(r) Users Group Int Conference Sugi 30:111–130Google Scholar
  36. 36.
    Kaiser H (1958) The varimax criterion for analytic rotation in factor analysis. Psychometrika 23(3):187–200Google Scholar
  37. 37.
    Weaver B, Maxwell H (2014) Exploratory factor analysis and reliability analysis with missing data: a simple method for SPSS users. Quantitative Methods Psychology 10(2):143–152Google Scholar
  38. 38.
    Carey RG, Seibert JH (1993) A patient survey system to measure quality improvement: questionnaire reliability and validity. Med Care 31(9):834–845Google Scholar
  39. 39.
    Campbell DT, Fiske DW (1959) Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull 56(2):81–105Google Scholar
  40. 40.
    Cronbach LJ (1951) Coefficient alpha and the internal consistency of tests. Psychometrika 16:297–334Google Scholar
  41. 41.
    Wright B, Stone M (1979) Best test design: Rasch measurement MESA Press, ChicagoGoogle Scholar
  42. 42.
    Quera-Salva MA, Hartley S, Sauvagnac-Quera R, Sagaspe P, Taillard J, Contrand B, Micoulaud JA, Lagarde E, Barbot F, Philip P (2016) Association between reported sleep need and sleepiness at the wheel: comparative study on French highways between 1996 and 2011. BMJ Open 6(12):e012382Google Scholar
  43. 43.
    Peppard PE, Young T, Palta M, Skatrud J (2000) Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 342(19):1378–1384.  https://doi.org/10.1056/NEJM200005113421901 Google Scholar
  44. 44.
    Guilleminault C, Stoohs R, Kim YD, Chervin R, Black J, Clerk A (1995) Upper airway sleep-disordered breathing in women. Ann Intern Med 122(7):493–501Google Scholar
  45. 45.
    Fanfulla F, Malaguti S, Montagna T, Salvini S, Bruschi C, Crotti P, Casale R, Rampulla C (2000) Erectile dysfunction in men with obstructive sleep apnea: an early sign of nerve involvement. Sleep 23(6):775–781Google Scholar
  46. 46.
    Adult Obstructive Sleep Apnea Task Force of Société de pneumologie de langue française., Société française de recherche et de médecine du sommeil, Société française d’ORL, Société française de médecine du travail, Société de physiologie, Société francaise de cardiologie, Association de langue française pour l’étude du diabète et des maladies métaboliques, Société française d’anesthésie et de réanimation (2010) Synthèse des recommandations de bonne pratique clinique : prise en charge du syndrome d’apnées-hypopnées de l’adulte obstructives du sommeil (SAHOS). Médecine Sommeil 7(4):161–167Google Scholar
  47. 47.
    Steffen M (2016) Universalism, responsiveness, sustainability—regulating the French health care system. N Engl J Med 374(5):401–405.  https://doi.org/10.1056/NEJMp1504547 Google Scholar
  48. 48.
    Frijling BD, Lobo CM, Keus IM, Jenks KM, Akkermans RP, Hulscher ME, Prins A, van der Wouden JC, Grol RP (2004) Perceptions of cardiovascular risk among patients with hypertension or diabetes. Patient Educ Couns 52(1):47–53Google Scholar
  49. 49.
    Destors M, Tamisier R, Galerneau LM, Levy P, Pepin JL (2017) Pathophysiology of obstructive sleep apnea syndrome and its cardiometabolic consequences. Presse Med 46(4):395–403Google Scholar
  50. 50.
    Mendelson M, Vivodtzev I, Tamisier R, Laplaud D, Dias-Domingos S, Baguet JP, Moreau L, Koltes C, Chavez L, De Lamberterie G, Herengt F, Levy P, Flore P, Pepin JL (2014) CPAP treatment supported by telemedicine does not improve blood pressure in high cardiovascular risk OSA patients: a randomized, controlled trial. Sleep 37(11):1863–1870.  https://doi.org/10.5665/sleep.4186 Google Scholar
  51. 51.
    Goldman RE, Parker DR, Eaton CB, Borkan JM, Gramling R, Cover RT, Ahern DK (2006) Patients’ perceptions of cholesterol, cardiovascular disease risk, and risk communication strategies. Ann Fam Med 4(3):205–212Google Scholar
  52. 52.
    van der Weijden T, van Steenkiste B, Stoffers HE, Timmermans DR, Grol R (2007) Primary prevention of cardiovascular diseases in general practice: mismatch between cardiovascular risk and patients’ risk perceptions. Med Decis Mak 27(6):754–761Google Scholar
  53. 53.
    Bailly S, Destors M, Grillet Y, Richard P, Stach B, Vivodtzev I, Timsit JF, Levy P, Tamisier R, Pepin JL (2016) Obstructive sleep apnea: a cluster analysis at time of diagnosis. PLoS One 11(6):e0157318.  https://doi.org/10.1371/journal.pone.0157318 Google Scholar
  54. 54.
    Gagnadoux F, Le Vaillant M, Paris A, Pigeanne T, Leclair-Visonneau L, Bizieux-Thaminy A, Alizon C, Humeau MP, Nguyen XL, Rouault B, Trzepizur W, Meslier N (2016) Relationship between OSA clinical phenotypes and CPAP treatment outcomes. Chest 149(1):288–290Google Scholar
  55. 55.
    Smith S, Lang C, Sullivan K, Warren J (2004) Two new tools for assessing patients’ knowledge and beliefs about obstructive sleep apnea and continuous positive airway pressure therapy. Sleep Med 5(4):359–367.  https://doi.org/10.1016/j.sleep.2003.12.007 Google Scholar
  56. 56.
    Sage C, Southcott A, Brown S (2011) The health belief model and compliance with CPAP treatment for obstructive sleep apnoea. Behav Change 18(3):177–185Google Scholar
  57. 57.
    Poulet C, Veale D, Arnol N, Levy P, Pepin JL, Tyrrell J (2009) Psychological variables as predictors of adherence to treatment by continuous positive airway pressure. Sleep Med 10(9):993–999.  https://doi.org/10.1016/j.sleep.2009.01.007 Google Scholar
  58. 58.
    Olsen S, Smith S, Oei TP, Douglas J (2010) Cues to starting CPAP in obstructive sleep apnea: development and validation of the cues to CPAP use questionnaire. J Clin Sleep Med 6(3):229–237Google Scholar
  59. 59.
    Aloia MS, Arnedt JT, Stepnowsky C, Hecht J, Borrelli B (2005) Predicting treatment adherence in obstructive sleep apnea using principles of behavior change. J Clin Sleep Med 1(4):346–353Google Scholar
  60. 60.
    Baron KG, Smith TW, Berg CA, Czajkowski LA, Gunn H, Jones CR (2011) Spousal involvement in CPAP adherence among patients with obstructive sleep apnea. Sleep Breath 15(3):525–534.  https://doi.org/10.1007/s11325-010-0374-z Google Scholar
  61. 61.
    Sampaio R, Pereira MG, Winck JC (2013) A new characterization of adherence patterns to auto-adjusting positive airway pressure in severe obstructive sleep apnea syndrome: clinical and psychological determinants. Sleep Breath 17(4):1145–1158.  https://doi.org/10.1007/s11325-013-0814-7 Google Scholar
  62. 62.
    Stepnowsky CJ, Marler MR, Palau J, Annette Brooks J (2006) Social-cognitive correlates of CPAP adherence in experienced users. Sleep Med 7(4):350–356Google Scholar
  63. 63.
    Stepnowsky CJ Jr, Bardwell WA, Moore PJ, Ancoli-Israel S, Dimsdale JE (2002) Psychologic correlates of compliance with continuous positive airway pressure. Sleep 25(7):758–762Google Scholar
  64. 64.
    Wild MR, Engleman HM, Douglas NJ, Espie CA (2004) Can psychological factors help us to determine adherence to CPAP? A Prospective Study Eur Respir J 24(3):461–465.  https://doi.org/10.1183/09031936.04.00114603 Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Jean-Arthur Micoulaud-Franchi
    • 1
    • 2
    Email author
  • Olivier Coste
    • 1
  • Stéphanie Bioulac
    • 1
    • 2
  • Kelly Guichard
    • 1
    • 2
  • Pierre-Jean Monteyrol
    • 1
  • Imad Ghorayeb
    • 1
    • 3
  • Terri E. Weaver
    • 4
  • Sébastien Weibel
    • 5
  • Pierre Philip
    • 1
    • 2
  1. 1.Clinique du Sommei, Service d’Explorations Fonctionnelles du Système NerveuxCHU de BordeauxBordeauxFrance
  2. 2.USR CNRS 3413 SANPSYUniversité de BordeauxBordeauxFrance
  3. 3.CNRS, Institut de Neurosciences Cognitives et Intégratives d’Aquitaine, UMR 5287BordeauxFrance
  4. 4.Department of Biobehavioral Health Science, Center for Narcolepsy, Sleep and Health, College of NursingUniversity of Illinois at ChicagoChicagoUSA
  5. 5.Department of PsychiatryUniversity Hospital of StrasbourgStrasbourgFrance

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