Role and perception of healthcare professionals in referring cancer patients to online cognitive behavioral therapy for insomnia.

Abstract

Purpose: Insomnia represents a major issue in oncology, which can be successfully treated by online Cognitive-Behavioural Therapy for Insomnia, such as the Insomnet program. However, promoting its successful implementation in routine care requires healthcare providers' involvement. This study aimed to explore healthcare professionals' perceptions of this online program.

Methods: This qualitative study was a part of the French Sleep-4-All-2.0 multicentric study. It explored, through two focus groups including 19 healthcare professionals of three cancer centers, their perceptions regarding their role in patient referral, and the perceived barriers and facilitators in accessing this type of intervention. The content of the focus groups was subjected to a descriptive thematic analysis.

Results: Four major themes were identified: (1) ambivalent representations of online tools (including patients convinced by remote intervention, evolution of representations in relation to the health context, adapted to sleep disorders, professionals' preconceptions of online tools), (2) barriers to implementation (including few perceived barriers, forgetting patients' particularities, professionals' lack of knowledge, a possible threat to the patient-caregiver relationship, financial cost), (3) levers for implementation (including real benefits for patients, professionals who feel confident, preserved patient-caregiver relationship, institutional innovations to remedy dysfunctions), and (4) professional involvement in implementation (what they need, what to avoid, what they already do, what they see themselves doing).

Conclusion: Online (healthcare) services were reported to help increase access to healthcare, but that should not replace the relationship between patients and healthcare professionals. All professionals must be informed and trained to refer patients to these programs.