基于网络与远程医疗的认知行为疗法治疗失眠的随机对照试验。
Web- vs. telehealth-based delivery of cognitive behavioral therapy for insomnia: a randomized controlled trial.
机构信息
Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada.
Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada.
出版信息
Sleep Med. 2014 Feb;15(2):187-95. doi: 10.1016/j.sleep.2013.10.013. Epub 2013 Dec 31.
OBJECTIVES
The purpose of our study was to evaluate and compare two methods of service delivery (web-based and telehealth-based) for chronic insomnia with regard to patient preference, clinical effectiveness, and patient satisfaction.
METHODS
Our study was a randomized controlled trial with manualized telehealth- and web-based delivery conditions (nonblinded). The sample comprised 73 adults with chronic insomnia. Participants received web-based delivery from their homes or telehealth-based delivery from a nearby clinic. Both interventions consisted of identical psychoeducation, sleep hygiene and stimulus control instruction, sleep restriction treatment, relaxation training, cognitive therapy, mindfulness meditation, and medication-tapering assistance.
RESULTS
Using a linear mixed model analysis, results showed that both delivery methods produced equivalent changes in insomnia severity, with large effect sizes. Attendance patterns favored telehealth, whereas homework adherence and preference data favored web-based delivery.
CONCLUSIONS
Web- and telehealth-based delivery are both helpful in treating chronic insomnia in rural-dwelling adults.
目的
我们的研究旨在评估和比较两种慢性失眠服务提供方式（基于网络和基于远程医疗）在患者偏好、临床效果和患者满意度方面的差异。
方法
我们的研究是一项随机对照试验，采用了远程医疗和基于网络的两种标准化服务提供条件（非盲法）。样本包括 73 名患有慢性失眠的成年人。参与者在家中接受基于网络的服务，或在附近的诊所接受基于远程医疗的服务。两种干预措施均包括相同的心理教育、睡眠卫生和刺激控制指导、睡眠限制治疗、放松训练、认知疗法、正念冥想和药物减量辅助。
结果
使用线性混合模型分析，结果表明两种服务提供方式在治疗慢性失眠的严重程度方面均产生了等效的变化，且效果显著。就诊模式更倾向于远程医疗，而家庭作业的依从性和偏好数据则更倾向于基于网络的服务。
结论
基于网络和基于远程医疗的服务均有助于治疗农村地区成年人的慢性失眠。
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