Nurse-delivered sleep restriction therapy in primary care for adults with insomnia disorder: a mixed-methods process evaluation

被引：0

作者：

Armstrong, Stephanie ^{[1
]}

Pattinson, Julie ^{[1
]}

Siriwardena, Aloysius Niroshan ^{[1
,7
]}

Kyle, Simon ^{[1
]}

Bower, Peter ^{[2
,3
]}

Yu, Ly-Mee ^{[4
]}

Yang, Yaling

Ogburn, Emma ^{[4
]}

Begum, Nargis ^{[4
]}

Maurer, Leonie ^{[5
]}

Robinson, Barbara ^{[4
]}

Gardner, Caroline ^{[5
,6
]}

Lee, Victoria ^{[5
]}

Gavriloff, Dimitri

Espie, Colin A. ^{[1
]}

Aveyard, Paul ^{[1
,4
]}

机构：

[1] Univ Oxford, Sleep & Circadian Neurosci Inst, Nuffield Dept Clin Neurosci, Oxford, England

[2] Univ Manchester, NIH, Ctr Primary Care, Manchester, England

[3] Univ Manchester, Care Res Sch Primary Care Res, Manchester, England

[4] Univ Oxford, Nuffield Dept Primary Care Hlth Sci, Behav Med, Oxford, England

[5] Univ Manchester, Ctr Primary Care & Hlth Serv Res, Manchester, England

[6] GmbH, Leipzig, Germany

[7] Univ Lincoln, Sch Hlth & Social Care, Community & Hlth Res Unit, Ross Lucas Med Sci Bldg, Lincoln LN6 7TS, England

来源：

BRITISH JOURNAL OF GENERAL PRACTICE | 2024年 / 74卷 / 738期

关键词：

cognitive behavior therapy; general practice; insomnia disorder; nursing primary care; programme evaluation;

D O I：

暂无

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background Sleep restriction therapy (SRT) is a behavioural therapy for insomnia. Aim To conduct a process evaluation of a randomised controlled trial comparing SRT delivered by primary care nurses plus a sleep hygiene booklet with the sleep hygiene booklet only for adults with insomnia disorder. Design and setting A mixed -methods process evaluation in a general practice setting. Method Semi -structured interviews were conducted in a purposive sample of patients receiving SRT, the practice nurses who delivered the therapy, and also GPs or practice managers at the participating practices. Qualitative data were explored using framework analysis, and integrated with nurse comments and quantitative data, including baseline Insomnia Severity Index score and serial sleep efficiency outcomes to investigate the relationships between these. Results In total, 16 patients, 13 nurses, six practice managers, and one GP were interviewed. Patients had no previous experience of behavioural therapy, needed flexible appointment times, and preferred face-to-face consultations; nurses felt prepared to deliver SRT, accommodating patient concerns, tailoring therapy, and negotiating sleep timings despite treatment complexity and delays between training and intervention delivery. How the intervention produced change was explored, including patient and nurse interactions and patient responses to SRT. Difficulties maintaining SRT, negative attitudes towards treatment, and low self -efficacy were highlighted. Contextual factors, including freeing GP time, time constraints, and conflicting priorities for nurses, with suggestions for alternative delivery options, were raised. Participants who found SRT a positive process showed improvements in sleep efficiency, whereas those who struggled did not. Conclusion SRT was successfully delivered by practice nurses and was generally well received by patients, despite some difficulties delivering and applying the intervention in practice

引用

页码：E34 / E40

页数：7