OSA Knowledge and Attitudes

This study was approved by the institutional review board (IRB) of King Fahad Military Medical Complex – Dhahran, Saudi Arabia (IRB number AFHER-IRB-2020-014). The participants’ consents were obtained by electronic consent methods. This survey-based cross-sectional study utilized a previously validated questionnaire called the “OSAKA questionnaire.” The OSAKA questionnaire is composed of 18 items that are used to assess one’s knowledge and 5 items to assess one’s attitudes concerning dealing with OSA. An online questionnaire was sent between July and August 2020 via email and WhatsApp instant messaging to the Saudi board’s ORL trainee residents, including those in their second year of residency (R2) to their final year of residency (R5) (n = 185). First- year residency trainees were not included, as they were rotating in preparatory rotations and had no previous exposure to ORL clinical training. The survey was conducted anonymously. Along with the OSAKA questionnaire, sociodemographic data and data about previous exposure to sleep practices were also collected. The sociodemographic data included age, gender, level of training, years of ORL practice including residency, year of graduation from medical college, and residency program region (by province). Data reflecting previous exposure to sleep practices were also collected, such as the frequency of exposure to diagnosed OSA patients, patients susceptible to OSA, polysomnography data, obese patients, and surgery directed to treat OSA. We also collected data on trainees’ self-reported awareness and previous consideration of other sleep disorders during their clinical training (such as inadequate sleep hygiene, insomnia, narcolepsy, and periodic limb movement disorder) as well as awareness of other related disorders (such as overlap syndrome and obesity hypoventilation syndrome). We considered those who answered that they were “aware of other sleep disorders” and who gave examples of other sleep disorders as the aware group. The knowledge section of the OSAKA questionnaire was assessed by calculating the total true responses for the knowledge section. The total knowledge score was calculated out of 18. The attitude section of the OSAKA questionnaire consisted of five questions (two for importance and three for confidence). It was calculated out of 5 for each question (the responses “extremely important” and “strongly agree” were scored as scores of 5). The total attitude score was calculated using a maximum score of 25, reflecting the sum score of the five attitude elements. For the confidence questions, we considered those who answered “agree” and “strongly agree” as the confident group in identifying OSA-susceptible patients and managing OSA patients. Exposure to each of the aforementioned clinical exposure items was divided and classified as either no exposure or any number of exposure incidences.本研究已获得沙特阿拉伯达兰法赫德国王军事医疗综合机构审查委员会（Institutional Review Board）批准，审查委员会编号为AFHER-IRB-2020-014。本研究采用电子知情同意方式获取受试者的知情同意书。 本项基于调查的横断面研究采用了此前已通过验证的“OSAKA问卷”。该问卷包含18个条目，用于评估受试者对阻塞性睡眠呼吸暂停（Obstructive Sleep Apnea, OSA）的相关知识，另有5个条目用于评估受试者针对OSA的处理态度。 2020年7月至8月期间，研究团队通过电子邮件及WhatsApp即时通讯工具，向沙特耳鼻咽喉科（Otorhinolaryngology, ORL）住院医师培训学员发放线上问卷，招募对象涵盖住院医师第二学年（R2）至第五学年（R5）的受训人员，共计185人。住院医师第一年受训人员未纳入本研究，因其正处于预备轮转阶段，未接受过ORL临床培训。 本调查以匿名方式开展。除“OSAKA问卷”外，研究团队同时收集了受试者的社会人口学数据及既往睡眠医学相关临床接触经历数据。社会人口学数据包括年龄、性别、培训层级、ORL临床执业年限（含住院医师阶段）、医学院毕业年份及住院医师培训项目所在省份。既往睡眠医学相关临床接触经历数据包括：确诊OSA患者接触频次、OSA易感人群接触频次、多导睡眠图（Polysomnography）数据、肥胖患者接触情况及针对OSA的手术治疗相关接触情况。 研究团队还收集了受训人员自我报告的临床培训期间对其他睡眠障碍的认知及既往关注情况，包括睡眠卫生不良、失眠、发作性睡病及周期性肢体运动障碍等，同时收集了对其他相关疾病（如重叠综合征及肥胖低通气综合征）的认知数据。将回答“知晓其他睡眠障碍”且能举例说明的受训人员归类为认知组。 “OSAKA问卷”的知识维度得分通过统计知识模块的正确作答总数计算得出，总知识分满分为18分。态度维度包含5个问题（2个关于重要性认知，3个关于自信心评估），每个问题满分为5分（“极其重要”及“完全同意”的作答记为5分）。总态度分以5个态度条目得分之和计算，满分为25分。针对自信心问题，将作答“同意”及“完全同意”的受训人员归类为OSA易感人群识别及OSA患者管理的自信组。 上述各项临床接触经历均被划分为“无接触”及“有至少一次接触”两类。