Affecting factors of the selection for electronically-delivered cognitive behavioral therapy among patients with insomnia
10.3760/cma.j.cn113661-20231030-00167
- VernacularTitle:失眠患者数字化失眠认知行为治疗选择倾向的影响因素分析
- Author:
Yujing ZHOU
1
;
Binbin LEI
;
Ting WEI
;
Xiaoyin LU
;
Yong WEI
;
Qiuqiang CHEN
;
Mingqing ZHOU
;
Jihui ZHANG
Author Information
1. 广州医科大学附属脑科医院睡眠与节律医学中心，广州 510370
- Publication Type:Journal Article
- Keywords:
Sleep disorders;
Cognitive behavioral therapy for insomnia;
Digitalization;
Diurnal dysfunction;
Circadian rhythm;
Suicidality
- From:
Chinese Journal of Psychiatry
2024;57(9):579-585
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the factors influencing electronically-delivered cognitive behavioral therapy for insomnia (e-CBTI) selection among patients with insomnia, and to provide empirical evidence for the clinical promotion of e-CBTI.Methods:Between November 2022 and July 2023, a convenience sampling method was employed to collect samples from 38 public hospitals and their surrounding communities. A total of 756 insomnia patients aged 18-65 years were included in the study. Based on their choice to participate in e-CBTI treatment, patients were divided into two groups: 605 patients (605/756,80.0%) chose to participate in e-CBTI treatment, while 151 patients (151/756,20.0%) did not. Rater-rated structured clinical interviews were applied in the current study, assessing individual′s insomnia symptoms, mental disorders, other sleep disorders, and suicidality and self-injury. The chi-square test and logistic regression were applied in data analyses.Results:Compared to the control group, the e-CBTI group had a higher proportion of females (χ 2=4.29) and a higher educational level (χ 2=5.76), while the proportion of living in rural areas was lower (χ 2=6.87), all with P<0.05. Additionally, the e-CBTI group exhibited a higher proportion of daytime symptoms compared to the control group, including decreased attention or memory (χ 2=16.42), impaired function or performance (χ 2=6.75), mood changes (χ 2=4.71), and reduced enthusiasm, energy, or motivation (χ 2=4.77), all with P<0.05. The e-CBTI group also showed a higher tendency for delayed sleep phase (χ 2=6.61), generalized anxiety disorder (χ 2=6.22), suicidal ideation (χ 2=10.45), and non-suicidal self-injury (χ 2=5.19), all with statistically significant differences ( P<0.05). Multivariate logistic regression analysis revealed that the type of residence ( OR=0.53, 95 %CI=0.29-0.95), educational level ( OR=2.42, 95 %CI=1.34-4.37), decreased attention or memory ( OR=1.95, 95 %CI=1.11-3.42), impaired function or performance ( OR=1.80, 95 %CI=1.15-2.82), and suicidal ideation ( OR=3.12, 95 %CI=1.29-7.58) remained significant influential factors in the selection of e-CBTI. Insomnia′s nighttime symptoms, including difficulty falling asleep, difficulty maintaining sleep, and early morning awakenings, were not associated with the inclination to choose e-CBTI. Conclusions:Daytime symptoms of insomnia and suicidal ideation are significant factors that prompt insomnia patients to choose e-CBTI.
