Randomized trial of a cognitive-behavioral intervention for insomnia in breast cancer survivors.
Randomized trial of a cognitive-behavioral intervention for insomnia in breast cancer survivors.
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DOI：
10.1188/07.onf.e51-e59
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发表时间：
2007-09-01
影响因子：
1.9
通讯作者：
Dirksen, Shannon R
中科院分区：
文献类型：
--
作者：
Epstein, Dana R;Dirksen, Shannon R
目的/目标：确定认知行为干预治疗乳腺癌幸存者失眠的有效性。设计：随机对照试验。地点：大学和医疗中心设置。样本：72 名女性在乳腺癌初次治疗后至少三个月内，每周至少三晚入睡或睡眠维持性失眠，持续至少三个月，通过每日睡眠日记确定。方法：随机分配至多成分干预（刺激控制）主要研究变量：入睡潜伏期、入睡后觉醒、总睡眠时间、卧床时间、睡眠效率和睡眠质量。结果：干预后，两组基于每日睡眠日记的入睡潜伏期、入睡后觉醒、总睡眠时间、卧床时间、睡眠效率和睡眠质量均有所改善。组间在床上的时间存在差异。腕部活动记录仪数据显示干预前后入睡潜伏期、入睡后觉醒、总睡眠时间和床上时间的显着变化。与对照组相比，多成分干预组的整体睡眠状况得到改善。结论：非药物干预对于治疗乳腺癌幸存者的失眠是有效的。对护理的影响：乳腺癌幸存者可以从针对慢性失眠的认知行为干预中受益。睡眠教育和卫生是一种比多成分干预措施简单的治疗方法，也能有效治疗失眠。
PURPOSE/OBJECTIVES: To determine the efficacy of a cognitive-behavioral intervention for treating insomnia in breast cancer survivors.DESIGN: Randomized controlled trial.SETTING: University and medical center settings.SAMPLE: 72 women at least three months after primary treatment for breast cancer with sleep-onset or sleep maintenance insomnia at least three nights per week for at least three months as determined through daily sleep diaries.METHODS: Random assignment to a multicomponent intervention (stimulus control instructions, sleep restriction, and sleep education and hygiene) or a single-component control group (sleep education and hygiene).MAIN RESEARCH VARIABLES: Sleep-onset latency, wake after sleep onset, total sleep time, time in bed, sleep efficiency, and sleep quality.FINDINGS: After the intervention, both groups improved on sleep-onset latency, wake after sleep onset, total sleep time, time in bed, sleep efficiency, and sleep quality based on daily sleep diaries. A between-group difference existed for time in bed. Wrist actigraph data showed significant pre- to postintervention changes for sleep-onset latency, wake after sleep onset, total sleep time, and time in bed. When compared to the control group, the multicomponent intervention group rated overall sleep as more improved.CONCLUSIONS: A nonpharmacologic intervention is effective in the treatment of insomnia in breast cancer survivors.IMPLICATIONS FOR NURSING: Breast cancer survivors can benefit from a cognitive-behavioral intervention for chronic insomnia. Sleep education and hygiene, a less complex treatment than a multicomponent intervention, also is effective in treating insomnia.