TY - JOUR
T1 - Insomnia treatment acceptability and preferences of male Iraq and Afghanistan combat Veterans and their healthcare providers
AU - Epstein, Dana R.
AU - Babcock-Parziale, Judith L.
AU - Haynes, Patricia L.
AU - Herb, Christine A.
PY - 2012
Y1 - 2012
N2 - Sleep difficulty is a prevalent problem among returning Veterans. Although there is strong evidence for the efficacy and durability of cognitive-behavioral treatment for insomnia (CBT-I) in the general population, the interventions require motivation, attention, and adherence from patients to achieve successful outcomes. Given the unique characteristics of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans who have experienced blast-related injuries and other trauma, CBT-I for these patients may require modification, including alternative delivery methods, to ensure effective implementation and positive outcomes. We interviewed 18 OIF/OEF Veterans who screened positive for mild traumatic brain injury and 19 healthcare providers to determine the acceptability of insomnia treatments and preferences for the interventions and treatment delivery. Veterans and providers had distinct preferences for insomnia treatment and its delivery. The treatments the Veterans found most acceptable were also the ones they preferred: relaxation treatment and pharmacotherapy. The providers identified relaxation therapy as the most acceptable treatment. Veterans preferred the individual treatment format as well as electronic methods of treatment delivery. Despite some differences between patients and providers, a compromise through modification of empirically supported behavioral treatments is feasible, and implications for preference-based insomnia intervention development and testing are discussed.
AB - Sleep difficulty is a prevalent problem among returning Veterans. Although there is strong evidence for the efficacy and durability of cognitive-behavioral treatment for insomnia (CBT-I) in the general population, the interventions require motivation, attention, and adherence from patients to achieve successful outcomes. Given the unique characteristics of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans who have experienced blast-related injuries and other trauma, CBT-I for these patients may require modification, including alternative delivery methods, to ensure effective implementation and positive outcomes. We interviewed 18 OIF/OEF Veterans who screened positive for mild traumatic brain injury and 19 healthcare providers to determine the acceptability of insomnia treatments and preferences for the interventions and treatment delivery. Veterans and providers had distinct preferences for insomnia treatment and its delivery. The treatments the Veterans found most acceptable were also the ones they preferred: relaxation treatment and pharmacotherapy. The providers identified relaxation therapy as the most acceptable treatment. Veterans preferred the individual treatment format as well as electronic methods of treatment delivery. Despite some differences between patients and providers, a compromise through modification of empirically supported behavioral treatments is feasible, and implications for preference-based insomnia intervention development and testing are discussed.
KW - Cognitive-behavioral treatment
KW - Healthcare provid-ers
KW - Insomnia
KW - OIF/OEF veterans
KW - Pharmacotherapy
KW - Poly-trauma
KW - Sleep
KW - Traumatic brain injury
KW - Treatment acceptability
KW - Treatment preference
UR - http://www.scopus.com/inward/record.url?scp=84868372481&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84868372481&partnerID=8YFLogxK
U2 - 10.1682/JRRD.2011.06.0114
DO - 10.1682/JRRD.2011.06.0114
M3 - Article
C2 - 23299258
AN - SCOPUS:84868372481
SN - 0748-7711
VL - 49
SP - 867
EP - 878
JO - Journal of Rehabilitation Research and Development
JF - Journal of Rehabilitation Research and Development
IS - 6
ER -