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一项针对慢性失眠退伍军人的职业治疗师提供的认知行为疗法治疗失眠的等待对照试验的随访分析。

Follow-Up Analyses From a Wait-List Controlled Trial of Occupational Therapist-Delivered Cognitive-Behavioral Therapy for Insomnia Among Veterans With Chronic Insomnia.

机构信息

Aaron M. Eakman, PhD, OTR/L, FAOTA, is Associate Professor, Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University, Fort Collins;

Arlene A. Schmid, PhD, OTR/L, FAOTA, is Professor, Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University, Fort Collins.

出版信息

Am J Occup Ther. 2022 Mar 1;76(2). doi: 10.5014/ajot.2022.045682.

Abstract

IMPORTANCE

Veterans often experience chronic insomnia, and professionals capable of delivering effective interventions to address this problem are lacking.

OBJECTIVE

To evaluate the efficacy of the Restoring Effective Sleep Tranquility (REST) program, an occupational therapist-led cognitive-behavioral therapy for insomnia (CBT-I) intervention to treat sleep problems among post- 9/11 veterans.

DESIGN

Wait-list controlled trial with 3-mo follow-up.

SETTING

Community-based veteran support program in a Mountain West university.

PARTICIPANTS

Fifteen post-9/11 veterans with sleep disturbances who were assigned to either the REST intervention or a wait-list control group. Outcomes and Measures: Sleep-related, health-related, and participation-related patient-reported outcomes (PROs) and daily sleep diary variables.

RESULTS

Wait-list controlled trial benefits included improved sleep-related (e.g., sleep disturbance), health-related (e.g., depression), and participation-related (e.g., meaningful activity) PROs. Findings were confirmed after participants in both the intervention and the control groups (n = 13) received the REST intervention, including improved daily sleep diary outcomes (e.g., sleep efficiency). All gains were maintained at 3 mo.

CONCLUSIONS AND RELEVANCE

Occupational therapy practitioners with advanced training in CBT-I have the potential to safely deliver an effective CBT-I intervention to veterans with sleep disturbances in a community-based setting. What This Article Adds: Occupational therapy practitioners with sleep-related education and training can positively affect the well-being of their clients through improving sleep participation.

摘要

重要性

退伍军人经常经历慢性失眠,而缺乏能够提供有效干预措施来解决这个问题的专业人员。

目的

评估退伍军人睡眠恢复计划(REST)的疗效,这是一种职业治疗师主导的认知行为疗法失眠干预措施,用于治疗 9/11 后退伍军人的睡眠问题。

设计

为期 3 个月的随访的等待名单对照试验。

地点

在西部山区一所大学的社区退伍军人支持计划。

参与者

15 名患有睡眠障碍的 9/11 后退伍军人,他们被分配到 REST 干预组或等待名单对照组。

结局和测量

睡眠相关、健康相关和参与相关的患者报告结局(PROs)和每日睡眠日记变量。

结果

等待名单对照试验的益处包括改善睡眠相关(如睡眠障碍)、健康相关(如抑郁)和参与相关(如有意义的活动)的 PROs。在干预组和对照组(n=13)的参与者都接受了 REST 干预后,发现了这些结果,包括改善每日睡眠日记结果(如睡眠效率)。所有的收益都在 3 个月时得以维持。

结论和相关性

接受过认知行为疗法高级培训的职业治疗师有潜力在社区环境中为有睡眠障碍的退伍军人安全地提供有效的认知行为疗法干预。本文增加的内容:具有睡眠相关教育和培训的职业治疗师可以通过改善睡眠参与来积极影响他们的客户的健康状况。

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本文引用的文献

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Occupational Therapy Practice Framework: Domain and Process-Fourth Edition.《作业治疗实践框架:领域与过程》第四版。
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