School of Health and Life Sciences, Federation University Australia, Ballarat, Victoria, Australia.
Deputy Vice Chancellor-Research and Innovation Portfolio, Federation University Australia, Ballarat, Victoria, Australia.
Aging Ment Health. 2020 Jun;24(6):932-938. doi: 10.1080/13607863.2019.1571013. Epub 2019 Feb 12.
To explore the experiences of older adults who participated in a randomised controlled trial (RCT) that tested cognitive behaviour therapy for insomnia and depression. Focus groups were conducted post treatment for older adults ( age = 75 years; 61% female) who participated in a RCT that tested two experiential interventions targeting comorbid insomnia and depression (cognitive behaviour therapy for insomnia, CBT-I; cognitive behaviour therapy for insomnia plus positive mood strategies, CBT-I+). Six semi-structured focus group interviews ( = 31) were analysed using a qualitative thematic analysis. Interview data were transcribed into 424 sentences and 60 codes were extracted. Thirty-four initial themes emerged, which were transformed into 3 themes and 10 subthemes. The three primary themes were (1) positive experiences, (2) negative experiences, and (3) suggested modifications. The positive subthemes were (1a) therapists, (1b) togetherness, (1c) use of strategies reduced symptoms, and (1d) acceptance. The negative subthemes were (2a) persistent symptoms, (2b) program too condensed, and (2c) attendance obstacles. The suggested modifications were (3a) lengthen program, (3b) multi-dimensional learning, and (3c) multi-modal delivery options. The experiences and suggestions identified in this study strengthen the foundation to advance therapeutic program development for older adults with comorbid insomnia and depression. Future CBT-I programs for older adults may be improved by increasing the length of therapy (e.g. 8 sessions to 12 sessions), adding multi-dimensional learning opportunities (e.g. visual/audio/mentorship), and offering various modes of treatment delivery (e.g. group, individual, internet, telephone).
探讨参与一项随机对照试验（RCT）的老年人的体验，该试验测试了针对失眠和抑郁共病的认知行为疗法。在对参加一项 RCT 的老年人（年龄=75 岁；61%为女性）进行治疗后进行焦点小组访谈，该 RCT 测试了两种针对共病失眠和抑郁的体验性干预措施（失眠认知行为疗法，CBT-I；失眠认知行为疗法加积极情绪策略，CBT-I+）。使用定性主题分析对 6 个半结构化焦点小组访谈（=31）进行分析。访谈数据被转录为 424 个句子，提取了 60 个代码。出现了 34 个初始主题，这些主题转化为 3 个主题和 10 个子主题。三个主要主题是（1）积极体验，（2）消极体验，和（3）建议修改。积极的子主题是（1a）治疗师，（1b）团结，（1c）使用策略减轻症状，和（1d）接受。消极的子主题是（2a）持续的症状，（2b）方案过于紧凑，和（2c）出席障碍。建议的修改是（3a）延长方案，（3b）多维学习，和（3c）多模式治疗方案。本研究中确定的经验和建议为推进针对失眠和抑郁共病的老年人的治疗方案的发展奠定了基础。未来针对老年人的 CBT-I 方案可以通过增加治疗时间（例如，从 8 次增加到 12 次）、增加多维学习机会（例如，视觉/音频/导师）和提供各种治疗方案来改善（例如，小组、个体、互联网、电话）。
