Optimizing a Transdiagnostic Sleep and Circadian Intervention for Autistic Young Adults: A Qualitative Study Using an Implementation Science Framework.

IF 1.6 3区 医学 Q3 CLINICAL NEUROLOGY
Kristina P Lenker, Allison G Harvey, Amanda L Richdale, William A Calo, Julio Fernandez-Mendoza
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引用次数: 0

Abstract

Objectives: Autistic adults frequently report a multitude of pervasive sleep and related circadian problems. Although these sleep and circadian problems have been identified as a critical and unmet public health concern, few sleep interventions have been tailored for and tested in this population. This qualitative study assessed autistic adult, caregiver, and clinician perspectives to inform the adaptation and implementation of an evidence-based transdiagnostic intervention.

Method: Semi-structured interviews were conducted with 20 autistic young adults, 20 caregivers, and 20 clinicians to guide adaptations of Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) for autistic people.

Results: Qualitative reports first supported the need to treat sleep and circadian problems in a transdiagnostic manner, given the multidimensional nature of their reported sleep problems. Patterns of convergence and divergence in stakeholder perspectives emerged across themes, with several barriers and facilitators to intervention delivery and adherence. These barriers and facilitators directly informed the development of potential adaptations to TranS-C: (1) adapting content (memory-enhancement strategies, routines, involving others' support, treatment "spreading," and simplifying handouts), and (2) enhancing delivery (check-ins between sessions, telehealth, enhanced provider training in autism, and electronic sleep diaries).

Conclusions: Sleep and circadian problems experienced by autistic adults are multidimensional and require transdiagnostic approaches to address the broader range of issues, including regularity, satisfaction, irregularity, dissatisfaction, alertness, continuity, efficiency, and timing. Adaptations to TranS-C format and delivery may serve to promote intervention adherence and adequately respond to unique features of autism across the lifespan.

优化自闭症青年的跨诊断睡眠和昼夜干预:一项使用实施科学框架的定性研究。
目的:自闭症成年人经常报告大量的普遍睡眠和相关的昼夜节律问题。尽管这些睡眠和昼夜节律问题已被确定为一个关键的、未得到解决的公共卫生问题,但针对这一人群量身定制的睡眠干预措施和在这一人群中进行的测试却很少。本定性研究评估了自闭症成人、护理者和临床医生的观点,为适应和实施循证跨诊断干预提供信息。方法:对20名自闭症青年、20名护理人员和20名临床医生进行半结构化访谈,以指导自闭症患者适应睡眠和昼夜功能障碍的跨诊断干预(TranS-C)。结果:定性报告首先支持以跨诊断方式治疗睡眠和昼夜节律问题的必要性,因为他们报告的睡眠问题具有多维性。各主题的利益攸关方观点出现了趋同和分歧的模式,在实施和遵守干预措施方面存在一些障碍和促进因素。这些障碍和促进因素直接影响了对TranS-C的潜在适应的发展:(1)调整内容(记忆增强策略、常规、涉及他人支持、治疗“传播”和简化讲义);(2)加强交付(会议之间的检查、远程医疗、加强自闭症提供者培训和电子睡眠日记)。结论:自闭症成人的睡眠和昼夜节律问题是多维的,需要跨诊断方法来解决更广泛的问题,包括规律性、满意度、不规则性、不满意度、警觉性、连续性、效率和时间。适应TranS-C格式和交付可能有助于促进干预依从性,并充分应对自闭症在整个生命周期中的独特特征。
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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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