Identifying predictors of the amount of veteran participation in cognitive behavioral therapy for insomnia in the Veterans Affairs health care system.
Identifying predictors of the amount of veteran participation in cognitive behavioral therapy for insomnia in the Veterans Affairs health care system.
复制标题
确定退伍军人事务部医疗保健系统中退伍军人参与失眠认知行为治疗的预测因素。
DOI：
10.1037/ser0000818
复制
发表时间：
2023
影响因子：
2.3
通讯作者：
Bramoweth,AdamD
中科院分区：
文献类型：
--
作者：
Tighe,CaitlanA;Berlin,GregoryS;Boland,ElaineM;Miller,KatherineE;Bramoweth,AdamD
失眠是退伍军人中普遍存在的一种负面影响的疾病。退伍军人事务部（VA）已经投入了大量资源来开发和传播与失眠认知行为疗法（CBT-I）相关的培训，CBT-I是慢性失眠障碍的推荐一线干预措施。已经确定，VA临床医生可以有效地接受培训，以提供高保真的CBT-I，并且治疗结果显着改善了失眠。然而，在常规VA临床护理中，退伍军人参与CBT-I的比率和预测因素的研究缺乏。在这项研究中，我们对VA电子健康记录（EHR）的数据进行了二次分析，以确定与参与CBT-I相关的个体易感因素、启用因素和需求因素。样本包括在2015年至2019年期间至少有一份来自美国VA中大西洋地区（VISN4）的CBT-I模板笔记的退伍军人（N= 2,801）。参与CBT-I是通过在初始音符后6个月内出现的CBT-I模板音符数量来定义的。研究结果表明，退伍军人通常只完成了一次CBT-I，平均完成了大约三次。多项logistic回归的结果发现，种族、共病精神健康障碍的存在、乡村性、失眠诊断的存在和失眠药物与参与CBT-I有显著关联；关联因参与CBT-I的定义而异。需要更多的工作来更好地了解参与的因素以及完成和未完成CBT-I的原因。（PsycInfo数据库记录(c) 2024 APA，版权所有）
Insomnia is a prevalent and negatively impactful disorder among veterans. The Department of Veterans Affairs (VA) has committed significant resources to the development and dissemination of training related to cognitive behavioral therapy for insomnia (CBT-I), the recommended first-line intervention for chronic insomnia disorder. It has been established that VA clinicians can be effectively trained to deliver high fidelity CBT-I and that treatment results in significant improvements in insomnia. However, there is a paucity of research examining rates and predictors of veterans’ participation in CBT-I in routine VA clinical care. In this study, we conducted a secondary analysis of data from VA electronic health records (EHR) to determine individual predisposing, enabling, and need factors associated with CBT-I participation. The sample included veterans who had at least one CBT-I templated note from the VA mid-Atlantic region of the United States (VISN4) between 2015 and 2019 in their chart (N= 2,801). CBT-I participation was defined by number of CBT-I templated notes occurring within a 6-month period from the initial note. Findings indicated that veterans most often completed only one session of CBT-I and, on average, completed approximately three sessions. Results from multinomial logistic regression identified significant associations of race, the presence of comorbid mental health disorders, rurality, presence of insomnia diagnosis, and insomnia medication with CBT-I participation; associations varied depending on how CBT-I participation was defined. More work is needed to better understand factors contributing to participation and reasons for completion and noncompletion of CBT-I.(PsycInfo Database Record (c) 2024 APA, all rights reserved)