Factors Influencing Adherence to Insomnia and Obstructive Sleep Apnea Treatments among Veterans with Mild Traumatic Brain Injury.

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY
Behavioral Sleep Medicine Pub Date : 2024-07-01 Epub Date: 2024-02-29 DOI:10.1080/15402002.2024.2322517
Adam R Kinney, Lisa A Brenner, Morgan Nance, Joseph Mignogna, Audrey D Cobb, Jeri E Forster, Christi S Ulmer, Risa Nakase-Richardson, Nazanin H Bahraini
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引用次数: 0

Abstract

Objective: To understand factors influencing adherence to recommended treatment for insomnia and obstructive sleep apnea (OSA) among Veterans with mild traumatic brain injury (mTBI).

Method: Semi-structured interviews (n = 49) with 29 clinical stakeholders and 20 Veterans were conducted. Clinical stakeholders included Veterans Health Administration providers and policymakers involved in the management of mTBI and/or sleep disorders. Veterans included those with a clinician-confirmed mTBI with a recent history of insomnia disorder and/or OSA treatment. Themes were identified using a Descriptive and Interpretive approach.

Results: Barriers to sleep disorder treatment adherence included factors associated with the patient (e.g., negative appraisal of treatment benefit), intervention (e.g., side effects), health conditions (e.g., cognitive challenges), health care system (e.g., limited availability of care), and socioeconomic status (e.g., economic instability). Similarly, facilitators of adherence included patient- (e.g., positive appraisal of treatment benefit), intervention- (e.g., flexible delivery format), condition- (e.g., accommodating cognitive impairments), health care system- (e.g., access to adherence support), and socioeconomic-related factors (e.g., social support).

Conclusions: Interviews revealed the multi-faceted nature of factors influencing adherence to sleep disorder treatment among Veterans with mTBI. Findings can inform the development of novel interventions and care delivery models that meet the complex needs of this population.

影响轻度脑外伤退伍军人坚持失眠和阻塞性睡眠呼吸暂停治疗的因素。
目的了解影响轻度脑外伤(mTBI)退伍军人坚持建议的失眠和阻塞性睡眠呼吸暂停(OSA)治疗的因素:对 29 名临床利益相关者和 20 名退伍军人进行了半结构式访谈(n = 49)。临床利益相关者包括退伍军人健康管理局的医疗服务提供者以及参与轻微创伤性脑损伤和/或睡眠障碍管理的政策制定者。退伍军人包括那些经临床医生确认患有 mTBI 且近期有失眠症和/或 OSA 治疗史的退伍军人。研究采用描述性和解释性方法确定主题:坚持睡眠障碍治疗的障碍包括与患者(如对治疗效果的负面评价)、干预(如副作用)、健康状况(如认知障碍)、医疗系统(如医疗服务有限)和社会经济地位(如经济不稳定)相关的因素。同样,促进坚持治疗的因素包括患者因素(如对治疗益处的积极评价)、干预因素(如灵活的治疗形式)、病情因素(如适应认知障碍)、医疗系统因素(如获得坚持治疗的支持)以及社会经济相关因素(如社会支持):访谈显示,影响患有 mTBI 的退伍军人坚持睡眠障碍治疗的因素是多方面的。研究结果可为开发新型干预措施和护理服务模式提供信息,以满足这一人群的复杂需求。
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来源期刊
Behavioral Sleep Medicine
Behavioral Sleep Medicine CLINICAL NEUROLOGY-PSYCHIATRY
CiteScore
7.20
自引率
3.20%
发文量
49
审稿时长
>12 weeks
期刊介绍: Behavioral Sleep Medicine addresses behavioral dimensions of normal and abnormal sleep mechanisms and the prevention, assessment, and treatment of sleep disorders and associated behavioral and emotional problems. Standards for interventions acceptable to this journal are guided by established principles of behavior change. Intending to serve as the intellectual home for the application of behavioral/cognitive science to the study of normal and disordered sleep, the journal paints a broad stroke across the behavioral sleep medicine landscape. Its content includes scholarly investigation of such areas as normal sleep experience, insomnia, the relation of daytime functioning to sleep, parasomnias, circadian rhythm disorders, treatment adherence, pediatrics, and geriatrics. Multidisciplinary approaches are particularly welcome. The journal’ domain encompasses human basic, applied, and clinical outcome research. Behavioral Sleep Medicine also embraces methodological diversity, spanning innovative case studies, quasi-experimentation, randomized trials, epidemiology, and critical reviews.
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