初级保健患者群体睡眠限制疗法的经验：一项与随机对照试验同时进行的定性研究

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-09-23 DOI:10.1016/j.sleep.2025.106822

Christina Bini , Josefin Bäckström , Kristofer Årestedt , Markus Jansson-Fröjmark , Christina Sandlund

{"title":"初级保健患者群体睡眠限制疗法的经验：一项与随机对照试验同时进行的定性研究","authors":"Christina Bini , Josefin Bäckström , Kristofer Årestedt , Markus Jansson-Fröjmark , Christina Sandlund","doi":"10.1016/j.sleep.2025.106822","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Sleep restriction therapy (SRT) is an effective and brief behavioral treatment for insomnia and could serve as a valuable complement to insomnia care. This study explores patients’ experiences of being offered and attending group-SRT at their primary care centers, including experiences of feasibility and mechanisms of impact.</div></div><div><h3>Methods</h3><div>This qualitative study was undertaken alongside a randomized controlled trial on nurse-led group-SRT in Swedish primary care, involving adults with insomnia disorder. Semi-structured interviews were conducted within three months post-intervention with fourteen patients. Verbatim transcripts were analyzed using qualitative content analysis before trial results were examined. The study was guided by the Medical Research Council framework for process evaluation of complex interventions.</div></div><div><h3>Results</h3><div>The result is presented in two themes: <em>Increased knowledge, motivation, and flexibility in enhancing adherence to group-SRT</em> and <em>Struggles, solutions, and group dynamics: A path to empowerment</em>. Patients found that understanding sleep reinforced their commitment to group-SRT by providing a rationale for participation. Adherence was influenced by treatment flexibility, personal motivation, and group dynamics. Patients experienced that while group-SRT was challenging, it also offered solutions for better sleep. However, life circumstances and depressive symptoms hindered compliance.</div></div><div><h3>Conclusions</h3><div>Patients' experience of group-SRT were influenced by the patient-provider relationship, motivation, and comorbid depression, all which impacted engagement. This study provides valuable insights into how patients perceive group-SRT, contributing to the refinement of future insomnia treatments. Further research should explore healthcare providers’ perspectives on both the challenges and opportunities for implementing group-SRT in primary care.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"136 ","pages":"Article 106822"},"PeriodicalIF":3.4000,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Patients’ experiences of group-delivered sleep restriction therapy in primary care: a qualitative study undertaken alongside a randomized controlled trial\",\"authors\":\"Christina Bini , Josefin Bäckström , Kristofer Årestedt , Markus Jansson-Fröjmark , Christina Sandlund\",\"doi\":\"10.1016/j.sleep.2025.106822\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Sleep restriction therapy (SRT) is an effective and brief behavioral treatment for insomnia and could serve as a valuable complement to insomnia care. This study explores patients’ experiences of being offered and attending group-SRT at their primary care centers, including experiences of feasibility and mechanisms of impact.</div></div><div><h3>Methods</h3><div>This qualitative study was undertaken alongside a randomized controlled trial on nurse-led group-SRT in Swedish primary care, involving adults with insomnia disorder. Semi-structured interviews were conducted within three months post-intervention with fourteen patients. Verbatim transcripts were analyzed using qualitative content analysis before trial results were examined. The study was guided by the Medical Research Council framework for process evaluation of complex interventions.</div></div><div><h3>Results</h3><div>The result is presented in two themes: <em>Increased knowledge, motivation, and flexibility in enhancing adherence to group-SRT</em> and <em>Struggles, solutions, and group dynamics: A path to empowerment</em>. Patients found that understanding sleep reinforced their commitment to group-SRT by providing a rationale for participation. Adherence was influenced by treatment flexibility, personal motivation, and group dynamics. Patients experienced that while group-SRT was challenging, it also offered solutions for better sleep. However, life circumstances and depressive symptoms hindered compliance.</div></div><div><h3>Conclusions</h3><div>Patients' experience of group-SRT were influenced by the patient-provider relationship, motivation, and comorbid depression, all which impacted engagement. This study provides valuable insights into how patients perceive group-SRT, contributing to the refinement of future insomnia treatments. Further research should explore healthcare providers’ perspectives on both the challenges and opportunities for implementing group-SRT in primary care.</div></div>\",\"PeriodicalId\":21874,\"journal\":{\"name\":\"Sleep medicine\",\"volume\":\"136 \",\"pages\":\"Article 106822\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sleep medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1389945725004976\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1389945725004976","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景睡眠限制疗法（SRT）是一种有效且简短的失眠行为治疗方法，可以作为失眠护理的宝贵补充。本研究探讨患者在基层医疗中心接受和参与小组srt的经验，包括可行性和影响机制的经验。方法：本定性研究与瑞典初级保健护士主导的srt随机对照试验同时进行，涉及患有失眠症的成年人。在干预后的三个月内对14名患者进行了半结构化访谈。在检验试验结果之前，使用定性内容分析对逐字记录进行分析。这项研究是在医学研究理事会复杂干预措施过程评价框架的指导下进行的。结果结果呈现在两个主题中：增加知识，动机和灵活性，以加强对群体srt的坚持，斗争，解决方案和群体动态：赋权之路。患者发现，通过提供参与的理由，对睡眠的理解加强了他们对群体srt的承诺。依从性受治疗灵活性、个人动机和群体动力的影响。患者体会到，虽然集体srt具有挑战性，但它也为改善睡眠提供了解决方案。然而，生活环境和抑郁症状阻碍了依从性。结论患者的群体srt体验受医患关系、动机和共病抑郁的影响，均影响参与。这项研究为患者如何看待群体srt提供了有价值的见解，有助于改进未来的失眠治疗。进一步的研究应探讨医疗保健提供者对在初级保健中实施群体srt的挑战和机遇的看法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Patients’ experiences of group-delivered sleep restriction therapy in primary care: a qualitative study undertaken alongside a randomized controlled trial

查看原文本刊更多论文

Patients’ experiences of group-delivered sleep restriction therapy in primary care: a qualitative study undertaken alongside a randomized controlled trial

Background

Sleep restriction therapy (SRT) is an effective and brief behavioral treatment for insomnia and could serve as a valuable complement to insomnia care. This study explores patients’ experiences of being offered and attending group-SRT at their primary care centers, including experiences of feasibility and mechanisms of impact.

Methods

This qualitative study was undertaken alongside a randomized controlled trial on nurse-led group-SRT in Swedish primary care, involving adults with insomnia disorder. Semi-structured interviews were conducted within three months post-intervention with fourteen patients. Verbatim transcripts were analyzed using qualitative content analysis before trial results were examined. The study was guided by the Medical Research Council framework for process evaluation of complex interventions.

Results

The result is presented in two themes: Increased knowledge, motivation, and flexibility in enhancing adherence to group-SRT and Struggles, solutions, and group dynamics: A path to empowerment. Patients found that understanding sleep reinforced their commitment to group-SRT by providing a rationale for participation. Adherence was influenced by treatment flexibility, personal motivation, and group dynamics. Patients experienced that while group-SRT was challenging, it also offered solutions for better sleep. However, life circumstances and depressive symptoms hindered compliance.

Conclusions

Patients' experience of group-SRT were influenced by the patient-provider relationship, motivation, and comorbid depression, all which impacted engagement. This study provides valuable insights into how patients perceive group-SRT, contributing to the refinement of future insomnia treatments. Further research should explore healthcare providers’ perspectives on both the challenges and opportunities for implementing group-SRT in primary care.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.