阻塞性睡眠呼吸中止症婦女之生活經驗關鍵詞 : 2010 OSA. obstructive sleep apnea, OSA OSA. OSA in Women

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1 48 阻塞性睡眠呼吸中止症婦女之生活經驗 * 摘要背景目的方法結果結論 obstructive sleep apnea, OSA 10 OSA OSA OSA OSA 關鍵詞 : 前言 obstructive sleep apnea, Eckert, Malhotra, & Jordan, OSA OSA OSA doi: /jn * leeing@ntunhs.edu.tw 引用格式 [Lee, C. H., Lin, M. H., Chen, N. H., Ho, L. H., Lee, H. F., & Tsao, L. I. (2015). The experiences of obstructive sleep apnea in women. The Journal of Nursing, 62(6), ] doi: /jn

2 OSA 49 文獻探討 OSA 之相關概念與對個案的影響 American Academy of Sleep Medicine [AASM], 2014 polysomnography, PSG 10 4% 50% 2% 5 daytime sleepiness apnea hypopnea index, AHI Tsioufis, Kasiakogias, Thomopoulos, Manolis, & Stefanadis, OSA 2% 24% OSA OSA 2011 Lavie, Lavie, & Herer, 2005; Patil, Schneider, Schwartz, & Smith, 2007 van der Kooy et al., 2006 continuous positive airway pressure, CPAP 95% 25 50% CPAP Avlonitou, Kapsimalis, Varouchakis, Vardavas, & Behrakis, 2012 OSA 與女性相關之研究 Wahner-Roedler 2007 body mass index, BMI OSA Anttalainen et al., 2007 Lowenstein OSA OSA OSA Ma et al., 2010 婦女角色功能與生活經驗 Denzin, 1989/ Herth, OSA OSA 方法 grounded theory CPAP OSA 護理雜誌 62 卷 6 期中華民國 104 年 12 月

3 50 purposive sampling OSA saturation A B C Denzin 1989/2000 ㈠㈡㈢㈣㈤㈥ trustworthiness Lincoln Guba 1985 credibility peer review member checks transferability OSA dependability confirmability 結果 OSA % AASM OSA 90% > % 一睡眠差而提不起勁的日子㈠ A G H I

4 OSA 51 中 B ㈡年 C A J 中 E ㈢ E H I 二一波三折的尋醫歷程㈠ OSA 年 D H C ㈡ B H ㈢ E B A G 三接受使用持續陽壓呼吸器的不一樣生活㈠ A D E 1 2 年 C ㈡ I E D F A G MC menstrual cycle 期 E 年 J 護理雜誌 62 卷 6 期中華民國 104 年 12 月

5 52 ㈢ E H B I H J 討論 OSA 一睡眠差而提不起勁的日子 2011 Lavie et al., 2005; Patil et al., OSA van der Kooy et al., 二一波三折的尋醫歷程 OSA Wahner-Roedler 2007 OSA 2011 OSA OSA 三接受使用持續陽壓呼吸器的不一樣生活 95% Brin, Reuveni, Greenberg, Tal, & Tarasiuk, 2005 OSA CPAP Huang, Chu, Liu, & Yu, 2015; Sharma et al., 2011 Hu, Yu, Lee, & Tsao, 2013; Kreivi, Virkkula, Lehto, & Brander, 2010

6 OSA 53 結論與建議 OSA OSA 研究限制 OSA 參考文獻 [Wang, H. H. (2011). Gender mainstreaming and nursing. The Journal of Nursing, 58(6), 5 10.] doi: /jn [Wang, L. C., Wu, S. S., & Chen, M. L. (2012). Nursing experience using cognitive behavior therapy to treat a patient with obstructive sleep apnea. New Taipei Journal of Nursing, 14(1), ] [Wang, Y. F., & Chen, H. Y. (2009). The lived experience of women with overactive bladder. Journal of Nursing and Healthcare Research, 5(4), ] doi: /jnhr [Wu, C. S., Tsai, Y. J., Chen, N. H., & Yang, C. M. (2011). The association between severity of obstructive sleep apnea syndrome and mood status: An exploration of possible mediating effects by autonomic nerve system and excessive sleepiness. Research in Applied Psychology, 50, ] [Lee, B. O. (2014). Gender and women s health. In Y. M. Yu Chao (Ed.), Women s health. Taipei City, Taiwan, ROC: Farseeing.] [Chou, K. T., Wu, S. H., & Hsiao, G. M. (2012). A brief introduction to obstructive sleep apnea. Journal of the Taipei Medical Association, 56(10), ] [Hu, W. T. (2013). Patients with a history of chronic psychological adjustment and their adjustment factors. Counseling & Guidance, 331, ] [Shu, B. C. (2012). Perspective on gender of care and caring. In H. C. Yang (Ed.), Gender and nursing (pp ). Taipei City, Taiwan, ROC: Farseeing.] [Maa, S. H. (2011). A brief introduction to the obstructive sleep apnea syndrome. National Taitung University College of Humanities, 1(2), ] [Chang, J. C., & 護理雜誌 62 卷 6 期中華民國 104 年 12 月

7 54 Lin, H. I. (2014). An exploration of Taiwanese women entrepreneurs with the social skills. Journal of Innovation and Management, 11(1), ] [Chen, N. C., & Hung, T. C. (2010). Obstructive sleep apnea and cardiovascular diseases. Family Medicine & Primary Medical Care, 25(6), ] [Yang, J. X., & Chen, C. C. (2006). Diagnosis and treatment of obstructive sleep apnea syndrome. Primary Medical Care & Family Medicine, 21(11), ] [Liu, C. L. (2005). The gender role characteristics of young Taiwanese women -The case of non-college educated women. Soochow Journal of Social Work, 13, ] [Liu, C. M. (2011). Snoring and obstruction sleep apnea syndrome. Journal of Taipei Medical Association, 55(3), ] [Cheng, C. Y., & Lin, C. M. (2014). Medical treatment for sleep apnea. Formosan Journal of Medicine, 18(2), ] doi: / FJM (2).10 Denzin, N. K [Denzin, N. K. (2000). Interpretive Interactionism (C. M. Chuang, Trans.). Taipei City, Taiwan, ROC: Yang Chih Book. (Original work published 1989)] American Academy of Sleep Medicine. (2014). The international classification of sleep disorder (3rd ed.). Westchester, IL: Author. Anttalainen, U., Saaresranta, T., Kalleinen, N., Aittokallio, J., Vahlberg, T., & Polo, O. (2007). Gender differences in age and BMI distributions in partial upper airway obstruction during sleep. Respiratory Physiology & Neurobiology, 159(2), doi: /j.resp Avlonitou, E., Kapsimalis, F., Varouchakis, G., Vardavas, C. I., & Behrakis, P. (2012). Adherence to CPAP therapy improves quality of life and reduces symptoms among obstructive sleep apnea syndrome patients. Sleep and Breath, 16(2), doi: /s Brin, Y. S., Reuveni, H., Greenberg, S., Tal, A., & Tarasiuk, A. (2005). Determinants affecting initiation of continuous positive airway pressure treatment. The Israel Medical Association Journal, 7(1), Eckert, D. J., Malhotra, A., & Jordan, A. S. (2009). Mechanisms of apnea. Progress in Cardiovascular Diseases, 51(4), doi: /j.pcad Herth, K. (1998). Integrating hearing loss into one slife. Qualitative Health Research, 8(2), doi: / Hu, S. T., Yu, C. C., Lee, P. S., & Tsao, L. I. (2013). Life experiences among obstructive sleep apnoea patients receiving continuous positive airway pressure therapy. Journal of Clinical Nursing, 23(1-2), doi: / jocn Huang, S. C., Chu, C. M., Liu, Y. C., & Yu, C. C. (2015). Differences in morning and evening blood pressure in patients with obstructive sleep apnea. Thoracic Medicine, 30(2), Kreivi, H.-R., Virkkula, P., Lehto, J., & Brander, P. (2010). Frequency of upper airway symptoms before and during continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome. Respiration, 80(6), doi: / Lavie, P., Lavie, L., & Herer, P. (2005). All-cause mortality in males with sleep apnoea syndrome: Declining mortality rates with age. European Respiratory Journal, 25(3), doi: / Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry (pp ). Newbury Park, CA: Sage. Lowenstein, L., Kenton, K., Brubaker, L., Pillar, G., Undevia, N., Mueller, E. R., & FitzGerald, M. P. (2008). The relationship between obstructive sleep apnea, nocturia, and daytime overactive bladder syndrome in women. American Journal of Obstetrics & Gynecology, 198(5), 598.e e5. doi: /j.ajog Ma, G. H., Li, M., Chen, L., Ye, L., Yang, K., & Wan, H. Y. (2010). Study of obstructive sleep apnea-hypopnea syndrome and metabolic syndrome in females. Journal of Shanghai Jiaotong University (Medical Science), 30(2),

8 OSA 55 Patil, S. P., Schneider, H., Schwartz, A. R., & Smith, P. L. (2007). Adult obstructive sleep apnea: Pathophysiology and diagnosis. Chest, 132(1), doi: / chest Sharma, S. K., Agrawal, S., Damodaran, D., Streenivas, V., Kadhiravan, T., Lakshmy, R., Kumar, A. (2011). CPAP for the metabolic syndrome in patients with obstructive sleep apnea. The New England Journal of Medicine, 365(24), doi: /nejmoa Tsioufis, C., Kasiakogias, A., Thomopoulos, C., Manolis, A., & Stefanadis, C. (2010). Managing hypertension in obstructive sleep apnea: The interplay of continuous positive airway pressure, medication and chronotherapy. Journal of Hypertension, 28(5), doi: / HJH.0b013e328336ed85 van der Kooy, K. G., van Hout, H. P. J., van Marwijk, H. W. J., de Haan, M., Stehouwer, C. D. A., & Beekman, A. T. F. (2006). Differences in heart rate variability between depressed and non-depressed elderly. International Journal of Geriatric Psychiatry, 21(2), doi: / gps.1439 Wahner-Roedler, D. L., Olson, E. J., Narayanan, S., Sood, R., Hanson, A. C., Loehrer, L. L., & Sood, A. (2007). Genderspecific differences in a patient population with obstructive sleep apnea-hypopnea syndrome. Gender Medicine, 4(4), doi: /s (07) 護理雜誌 62 卷 6 期中華民國 104 年 12 月

9 56 The Experiences of Obstructive Sleep Apnea in Women Chao-Hui Lee 1 Mei-Hsiang Lin 2 Ning-Hung Chen 3 Lun-Hui Ho 4 Hsiu-Fang Lee 5 Lee-Ing Tsao 6 * 1 MS, RN, Certified Quality Manager, Department of Administration, Chang Gung Memorial Hospital, Linkou; 2 EdD, RN, Associate Professor, Graduate Institute of Health Allied Education, and School of Nursing, National Taipei University of Nursing and Health Sciences; 3 MD, Director, Sleep Center, Chang Gung Memorial Hospital, Taoyuan, and Department of Pulmonary and Critical Care Medicine, Chang Gung Medical Hospital, Linkou; 4 MHA, RN, Deputy Director, Department of Nursing, Chang Gung Memorial Hospital, Linkou; 5 MS, RN, Supervisor, Department of Nursing, Chang Gung Memorial Hospital, Linkou; 6 DNSc, RN, Professor and Dean, College of Nursing, and Vice President, National Taipei University of Nursing and Health Sciences. Abstract Background: Obstructive sleep apnea (OSA) is a potentially lethal respiratory sleep disorder. However, few studies have studied OSA women. Purpose: The purpose of the current study was to explore the life experiences of women with OSA. Method: A qualitative study using the grounded theory method was used to establish a descriptive theory. Results: The results were expressed in terms of three stages with related categories. Stage 1: No interest days due to poor sleep, including uncontrollable sleep, perceived health deteriorates, and poor female image harmed by snoring ; Stage 2: Indecision and disappointments during treatment seeking, including doctor shopping, being urged by others to seek medical help, and being shocked by the severity of disease ; and Stage 3: Accepting a new lifestyle with a continuous positive pressure respirator, including adaptation of the new sleep, adequate sleep, and secret worry of being an OSA woman. Conclusions: Based on the findings of the present study, medical knowledge and treatments related to OSA should be widely promoted with appropriate professional education and counseling services in order to enhance the awareness of patients and to facilitate their acceptance of the healing process using a continuous positive airway pressure respirator. Key Words: obstructive sleep apnea (OSA), continuous positive airway pressure (CPAP), women s health, qualitative research. Accepted for publication: August 17, 2015 *Address correspondence to: Lee-Ing Tsao, No. 365, Ming-Te Rd., Peitou District, Taipei City 11219, Taiwan, ROC. Tel: +886 (2) ext. 3184; leeing@ntunhs.edu.tw

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阻塞性睡眠呼吸中止症婦女之生活經驗 關鍵詞 : 2010 OSA. obstructive sleep apnea, OSA OSA. OSA in Women

阻塞性睡眠呼吸中止症婦女之生活經驗關鍵詞 : 2010 OSA. obstructive sleep apnea, OSA OSA. OSA in Women