Mastering Treatment for Sleep Apnoea: The Grounded Theory of Bargaining and Balancing Life With Continuous Positive Airway Pressure (CPAP), in the Context of Decisional Conflict and Change Theories




chronic illness, continuous positive airway pressure, grounded theory methodology, patient perspectives, sleep apnoea, storyline


Continuous positive airway pressure (CPAP) treatment for sleep apnoea can be challenging for patients to master. Given limited evidence on this topic, we used constructionist grounded theory methodology to explore experiences of living with CPAP from participants' perspectives. Adults (n=16) were recruited through a main-center respiratory service in New Zealand and participated in semi-structured interviews. Data were analyzed until theoretical saturation was achieved.

In this article, we present the newly constructed grounded theory of bargaining and balancing life with CPAP, which explains how participants made a series of personal decisions about whether to use and how to master CPAP. To situate, support and provide explanatory power the new theory is discussed in the context of change and decision theories to illustrate the varying phases of readiness experienced by persons preparing to engage with CPAP and the decision-making process required for effective management of CPAP at home.

This study provides valuable CPAP-user centered information for the development of interventions to optimize CPAP use. Acknowledging individuals' abilities to make reasoned healthcare decisions and providing clinical environments that support the active process of bargaining and balancing may increase uptake of CPAP, and potentially other long-term therapies.


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Author Biographies

Kim Ward, The University of Auckland

Kim WARD is a registered nurse and lecturer at the University of Auckland's School of Nursing specializing in patients' experiences of long-term conditions to inform practice and interventions, primarily in sleep medicine. She has a background in intensive care and respiratory nursing and completed her doctorate exploring experiences of using therapies for sleep apnoea. She is a qualitative researcher, currently exploring patient experience and the function of partners in improving patient outcomes in the areas of sleep medicine and long-term therapies. Research interests include patients' experiences of healthcare and qualitative methodologies, particularly grounded theory and mixed methodology.

Merryn Gott, The University of Auckland

Merryn GOTT is a professor at the University of Auckland's School of Nursing and a palliative care and gerontology research specialist who has been conducting research with older people for over 20 years. She has a particular interest in developing models of palliative and end of life care to meet the needs of ageing populations. Merryn directs the Te Arai Palliative Care and End of Life Research Group. The group conducts multi-disciplinary bicultural research using creative social research methods to inform practice, policy, and teaching in palliative and end of life care both nationally and internationally.

Karen Hoare, Massey University

Karen HOARE is an associate professor at Massey University and works as a nurse practitioner for children and young people in general practice in South Auckland. She is director of the postgraduate program in the School of Nursing. Her research interests include child and youth health, new graduate nurses in primary care and children's perceptions of issues in the developing world. She has published several articles relating to constructivist grounded theory methodology.




How to Cite

Ward, K., Gott, M., & Hoare, K. (2019). Mastering Treatment for Sleep Apnoea: The Grounded Theory of Bargaining and Balancing Life With Continuous Positive Airway Pressure (CPAP), in the Context of Decisional Conflict and Change Theories. Forum Qualitative Sozialforschung Forum: Qualitative Social Research, 20(3).