School of Psychology, Deakin University, Burwood, Australia.
Reconnexion counsellor - Benzodiazepine Dependency Treatment Program, Reconnexion, a service of EACH; research fellow, School of Psychology, Deakin University, Burwood, Australia.
Br J Gen Pract. 2024 Jul 25;74(745):e560-e569. doi: 10.3399/BJGP.2023.0310. Print 2024 Aug.
Cognitive behavioural therapy for insomnia (CBT-I) is recommended as the first-line treatment for insomnia yet remains underutilised in general practice. Understanding patient motivations and barriers to engaging in psychological interventions for insomnia is critical. Theoretical frameworks, such as the theory of planned behaviour, are needed to identify variables related to intentions and behaviour change.
To explore key influences that motivate individuals' intention to engage with psychological interventions for insomnia.
Qualitative study consisting of an online survey and interviews with 20 community-dwelling participants with insomnia aged 26-75 years residing in Victoria, Australia.
Guided by the theory of planned behaviour, reflexive thematic analysis was used to identify factors influencing participants' intention to engage with psychological interventions for insomnia.
Participants reported positive attitudes towards psychological interventions for insomnia, stemming from negative beliefs about pharmacological sleep aids and the perceived benefits of a structured and evidence-based intervention. Important others positively influenced participants' intention to engage; however, the GP influence was less consistent and often indirect. Participants believed in the efficacy of psychological interventions, but several barriers hampered their ability to benefit from them. Accessibility was identified as a key facilitator, whereas lack of knowledge and clear referral pathways were the main barriers having an impact on uptake.
This study highlights key factors influencing patients' intention to engage in psychological interventions for insomnia as well as opportunities for GPs to support uptake and engagement. Routine conversations about sleep health are essential to reduce the burden of untreated insomnia in the community, and the active promotion of evidence-based psychological interventions is needed.
认知行为疗法（CBT-I）被推荐为失眠的一线治疗方法，但在全科医学实践中仍未得到充分应用。了解患者对参与失眠心理干预的动机和障碍至关重要。理论框架，如计划行为理论，需要确定与意图和行为改变相关的变量。
探索促使个体有意愿参与失眠心理干预的关键影响因素。
这是一项定性研究，包括一项在线调查和对 20 名居住在澳大利亚维多利亚州的 26-75 岁社区居民的失眠患者进行的访谈。
在计划行为理论的指导下，采用反思性主题分析来确定影响参与者参与失眠心理干预意愿的因素。
参与者对失眠的心理干预持积极态度，这源于对药物助眠剂的负面看法以及对结构化和基于证据的干预措施的益处的认知。重要他人对参与者参与的意愿有积极影响；然而，全科医生的影响并不一致，而且往往是间接的。参与者相信心理干预的疗效，但有几个障碍妨碍了他们从中受益的能力。可及性被确定为一个关键的促进因素，而缺乏知识和明确的转介途径则是影响参与的主要障碍。
本研究强调了影响患者参与失眠心理干预意愿的关键因素，以及全科医生支持参与和参与的机会。关于睡眠健康的常规对话对于减轻社区中未治疗的失眠负担至关重要，需要积极推广基于证据的心理干预措施。
