Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-25T21:34:43.625Z Has data issue: false hasContentIssue false

A feasibility study of a two-session home-based cognitive behavioral therapy–insomnia intervention for bereaved family caregivers

Published online by Cambridge University Press:  18 June 2009

Patricia A. Carter*
Affiliation:
School of Nursing, The University of Texas at Austin, Austin, Texas
Sabrina Q. Mikan
Affiliation:
School of Nursing, The University of Texas at Austin, Austin, Texas
Cherie Simpson
Affiliation:
School of Nursing, The University of Texas at Austin, Austin, Texas
*
Address correspondence and reprint requests to: Patricia A. Carter, School of Nursing, The University of Texas at Austin, 1700 Red River, Austin, TX 78701. E-mail: [email protected]

Abstract

Objective:

In 2008 over two million family caregivers will become bereaved. The vast majority of these caregivers have provided ‘round-the-clock care for a period ranging from months to years. Bereaved family caregivers report insomnia symptoms that persist beyond 1 year, longer than what is seen in bereaved noncaregivers, placing them at increased risk of depression and complicated grief. Despite some rewarding elements, caregiving is a stressful and exhausting role that often requires the caregiver to restructure his or her life around the needs of the patient. Once the patient dies, the structure is lost. Cognitive behavioral therapy interventions are effective in providing structure. This pilot study explored the feasibility of a two-session home-based cognitive behavioral therapy–insomnia (CBT-I) intervention for bereaved family caregivers.

Method:

A 5-week longitudinal descriptive study design was used with 11 adult primary family caregivers of patients who died from cancer. A master's prepared nurse delivered two CBT-I intervention sessions in participant homes. Data collection sessions occurred at baseline, 3, and 5 weeks. A debriefing session was held at Week 6.

Results:

Participant evaluations of the intervention indicated that it was feasible and acceptable (e.g., 100% would recommend it to others); objective data further supported its feasibility (e.g., 100% completed the trial). In addition, when comparing baseline with Weeks 3 and 5, participants demonstrated improvement in insomnia and depressive symptoms.

Significance of results:

The results of this pilot study suggest that the intervention is feasible and acceptable and produces promising effects on insomnia and depressive symptoms in bereaved family caregivers.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bellg, A.J., Borrelli, B., Resnick, B., et al. (2004). Enhancing treatment fidelity in health behavior change studies: Best practices and recommendations from the NIH Behavior Change Consortium. Health Psychology, 23, 443451.CrossRefGoogle ScholarPubMed
Brown, L.F., Reynolds, C.F. 3rd, Monk, T.H., et al. (1996). Social rhythm stability following late-life spousal bereavement: Association with depression and sleep impairment. Psychiatry Research, 62, 161169.CrossRefGoogle ScholarPubMed
Buysse, D., Reynolds, C., Monk, T., et al. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28, 193213.CrossRefGoogle ScholarPubMed
Carlsson, M.E. & Nilsson, I.M. (2007). Bereaved spouses' adjustment after the patients' death in palliative care. Palliative & Supportive Care, 5, 397404.CrossRefGoogle Scholar
Carter, P. (2005). Bereaved caregivers description of sleep: Impact on daily life and the bereavement process. Oncology Nursing Forum, 32, E70E75.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention. (2008). Death rates by age and age-adjusted death rates for the 15 leading causes of death in 2005: United States 1999–2005. Retrieved July 9, 2008, from http://www.disastercenter.com/cdc/Leading%20Cause%20of%20Death%201999-2005.html.Google Scholar
Dumas, J.E., Lynch, A.M., Laughlin, J.E., et al. (2001). Promoting intervention fidelity: Conceptual issues, methods, and preliminary results from the EARLY ALLIANCE prevention trial. American Journal of Preventive Medicine, 20, 3847.CrossRefGoogle ScholarPubMed
Edinger, J., Wohlgemuth, W., Radtke, R., et al. (2001). Cognitive behavioral therapy for treatment of chronic primary insomnia: A randomized controlled trial. JAMA, 285, 18561864.CrossRefGoogle ScholarPubMed
Emanuel, E.J., Fairclough, D.L., Wolfe, P., et al. (2004). Talking with terminally ill patients and their caregivers about death, dying and bereavement. Archives of Internal Medicine, 164, 19992004.CrossRefGoogle ScholarPubMed
Family Caregiver Alliance. (2008). Selected caregiver statistics. Retrieved July 9, 2008, from http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=439.Google Scholar
Foley, D.J., Monjan, A.A., Brown, S.L., et al. (1995). Sleep complaints among elderly persons: An epidemiologic study of three communities, Sleep, 18, 425432.CrossRefGoogle ScholarPubMed
Ford, D.E. & Cooper-Patrick, L. (2001). Sleep disturbances and mood disorders: An epidemiologic perspective. Depression and Anxiety, 14, 36.CrossRefGoogle ScholarPubMed
Germain, A., Caroff, K., Buysse, D.J., et al. (2005). Sleep quality in complicated grief. Journal of Traumatic Stress, 18, 343346.CrossRefGoogle ScholarPubMed
Hardison, H.G., Neimeyer, R.A. & Lichstein, K.L. (2005). Insomnia and complicated grief symptoms in bereaved college students. Behavioral Sleep Medicine, 3, 99111.CrossRefGoogle ScholarPubMed
Kiresuk, T.J., Smith, A. & Cardillo, J.E. (1994). Goal attainment scaling. Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
Middelkoop, H.A., Smilde-van den Doel, D.A., Neven, A.K., et al. (1996). Subjective sleep characteristics of 1485 males and females aged 50–93: Effects of sex age, and factors related to self-evaluated quality of sleep. The Journals of Gerontology. Series A, Biological Science & Medical Sciences, 51, M108M115.CrossRefGoogle Scholar
Monk, T.H., Begley, A.E., Billy, B.D., et al. (2008). Sleep and circadian rhythmus in spousally bereaved seniors. Chronoboiology International, 25, 8398.CrossRefGoogle Scholar
Morin, C.M., Bootzin, R.R., Buysse, D.J., et al. (2006). Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998–2004). Sleep, 29, 13981413.CrossRefGoogle ScholarPubMed
Pasternak, R.E., Reynolds, C.F. 3rd, Hoch, C.C., et al. (1992). Sleep in spousally bereaved elders with subsyndromal depressive symptoms. Psychiatry Research, 43, 4353.CrossRefGoogle ScholarPubMed
Radloff, L.S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385401.CrossRefGoogle Scholar
Reynolds, C.F. 3rd, Hoch, C.C., Buysse, D.J., et al. (1993). Sleep after spousal bereavement: A study of recovery from stress. Biological Psychiatry, 34, 791797.CrossRefGoogle ScholarPubMed
Santacroce, S.J., Maccarelli, L.M. & Grey, M. (2004). Intervention fidelity. Nursing Research, 53, 6366.CrossRefGoogle ScholarPubMed
Spielman, A.J., Yang, C. & Glovinsky, P.B. (2000). Assessment techniques for insomnia. In Principles and Practice of Sleep Medicine, Kryger, M.H., Roth, T., & Dement, W.C. (eds.), pp. 12391250. Philadelphia, PA: W.B. Saunders Company.Google Scholar
Waldrop, D.P. (2007). Caregiver grief in terminal illness and bereavement: A mixed-methods study. Health & Social Work, 32, 197206.CrossRefGoogle ScholarPubMed