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  • 1.
    Siebmanns, Sandra
    et al.
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, HHJ. ADULT.
    Johansson, Peter
    Department of Health, Medicine and Care, Linköping University, Norrköping, Sweden; Department of Internal Medicine and Department of Health, Medicine and Care, Linköping University, Norrköping, Sweden.
    Ulander, Martin
    Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Johansson, Linda
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Andersson, Gerhard
    Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Broström, Anders
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    The effect of nurse-led Internet-based cognitive behavioural therapy for insomnia on patients with cardiovascular disease: A randomized controlled trial with 6-month follow-up2021Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 8, nr 4, s. 1755-1768Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To test the effect of nurse-led Internet-based cognitive behavioural therapy for insomnia (I-CBTI), tailored for patients with cardiovascular disease (CVD), with a 6-month follow-up.

    Design: A two-arm parallel-group randomized controlled trial (RCT) registered at clinicaltrials.gov (NTC03938805) and reported according to the CONSORT checklist.

    Methods: Forty-eight patients (mean age 72 years, 65% men) diagnosed with CVD and insomnia were randomized to either 9-week nurse-led I-CBTI with support, or an Internet-based self-study programme without support (control group). Insomnia Severity Index (ISI) and Short Form Health Survey (SF-12) were used as primary and secondary outcomes.

    Results: ISI showed a significant treatment effect of I-CBTI compared to the control group at 9-week follow-up. The mean ISI score in the I-CBTI group at 9 weeks post-treatment was maintained at the 6-month follow-up. Patients' adherence to I-CBTI was associated with a better effect on both the ISI and SF-12.

  • 2.
    Siebmanns, Sandra
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Ulander, M.
    Linkoping University Hospital, Department of clinical neurophysiology, Linkoping, Sweden.
    Sandberg, Jonas
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Johansson, Linda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Johansson, P.
    Linkoping University Hospital, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Insomnia in patients with cardiovascular disease - a review of causes, consequences and nursing interventions2017Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr Suppl. 1, s. S31-S31Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Insomnia is defined as a subjective complaint of difficulty to initiate sleep, difficulty to maintain sleep, and early morning awakenings that occur at a minimum of 3 nights per week for 3 months. The prevalence of insomnia in the general adult population is estimated to 12–20%. The prevalence is even higher among those with cardiovascular disease (CVD). Insomnia has a significant impact on the individual’s health and quality of life.

    Aim: To examine causes, consequences and nursing interventions for insomnia in patients with CVD.

    Design: Literature review.

    Method: Electronic search through PubMed and Cinahl for studies published 2001-2016. Insomnia, CVD, causes, consequences, interventions and nurse-led intervention were used as keywords. Detected duplicates, irrelevant studies and others (i.e., editorials, letters) were removed. “Insomnia and CVD” resulted in 214 hits, “insomnia and CVD and causes” in 394 hits, “insomnia and CVD and consequences” in 35 hits, and “insomnia and CVD and interventions” resulted in 51 hits.

    Results: Insomnia causes impaired daytime functioning, poorer cognitive function and a feeling of isolation. The pathophysiological consequences of insomnia are associated with increased risk for arteriosclerosis and CVD (i.e., caused by an increased inflammatory processes). Pharmacological treatment for insomnia have been used for some time (i.e., sedative, hypnotics and antidepressant), but there are concerns about tolerance and dependence, as well as other side effects (i.e., falls, cognitive changes and unusual sleep behaviours) which requires a thorough risk and benefit analysis before prescription. Non-pharmacological treatments such as Cognitive behavioural therapy (CBT) and internet-based CBT (I-CBT) for insomnia, led by therapists, is a less expensive intervention used in previous studies for othe rpatient groups. Despite positive results for both CBT andI-CBT (i.e., improved performance, increased quality of life and reduced symptom burden) in these studies no nurse-led interventions (i.e., of any type) intended for patients with CVD and insomnia were found.

    Conclusion: I-CBT for insomnia seems to be an accessible and effective treatment for other patient groups. The lack of nurse-led interventions, highlights the need for future studies in patients with CVD and insomnia.

  • 3.
    Siebmanns, Sandra
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Ulander, M.
    Linkoping Univ Hosp, Dept Clin Neurophysiol, Linkoping, Sweden.
    Sandberg, Jonas
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Johansson, P.
    Linkoping Univ, Dept Cardiol, Linkoping, Sweden.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Internet-based CBT for insomnia in the general population - a description of design, measurements and interventions in recent RCT studies2018Inngår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27, nr 1, SI, s. 290-291, artikkel-id P436Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives/Introduction: Internet-based cognitive behavioural therapy for insomnia (ICBTi) has been proposed as an effective, accessible, non-pharmacologic treatment for insomnia disorder. The objective was to perform a literature review of published randomized controlled trials (RCT).

    Methods: Literature review. PubMed was used to identify RCTs ofICBTi published since 2013. Keywords were insomnia, ICBT and RCT. The search resulted in 40 hits. Papers with study designs and methods not relevant to the objective were removed (n = 29). Reasons for exclusion were: only study protocol, not internet-based, and results based on old data.

    Results: Design: Recruitment were done via e-mail, from websites, online ads, and advertisements in local newspapers.

    Inclusion criteria: Six studies based their inclusion only on ISI score (from >7to>=15). 3 studies used a combination of ISI and DSM-IV. Two studies used DSM-IV only.

    Sample sizes: 4 studies had less than 100 participants, and 2 studies over 200, the mean number was 139 participants (48-303). The mean age varied from 15 to 52 years. Significantly more female participants in all studies.

    Data collection: ISI combined with sleep diary was the most commonly used primary or secondary outcome measurements (n =7), 2 used ISI only, and 2 used sleep diary only. Other common instruments were, PSQI, HADS, DBAS-16 and CES-D. All studies had pre- and post-treatment measurements, but none during the intervention. The follow-up-period varied between 8 weeks and 3 years. The most common follow-up time was 6 months (n = 4), with a range from 4 weeks3years.Intervention: Most of the studies (n = 10) used traditional ICBTi-treatments (i.e., stimulus control, sleep restriction, relaxation, sleep hygiene). One study did not include stimulus control. The treatment duration were six weeks (n = 8), eight weeks (n = 2) and nine weeks (n = 1). All except one used therapist guided support.

    Results: All studies showed significant post treatment improvements on sleep outcomes.

    Conclusions: All studies showed significant improvement with regard to sleep. The total number of participants in the studies was relatively low. Most studies are not based on clinical samples, which may affect the generalizability of the findings.

    Disclosure: Nothing to disclose

  • 4.
    Siebmanns, Sandra
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Ulander, M.
    Linkoping University Hospital, Department of clinical neurophysiology, Linkoping, Sweden.
    Sandberg, Jonas
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Johansson, P.
    Linkoping University Hospital, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Internet-based Intervention to treat insomnia in patients with cardiovascular disease2017Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr Suppl. 1, s. S75-S75Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Insomnia (i.e., trouble initiating sleep,maintaining sleep or difficulties getting enough sleep) is a prevalent problem among patients with cardiovascular disease (CVD). It is associated with physical and mental symptoms such as impaired daytime functioning, worries and depressive symptoms. Recent studies in other patient groups have described Internet-based Cognitive behavioral treatment (I-CBT) as a promising accessible and cost effective intervention. Few if any studies are conductedin CVD patients with insomnia despite the possibility of reduced symptom burden, reduced cardiovascular morbidity and improved quality of life (QoL).

    Aim: To describe the design, content and measures in theHit-IT study, an intervention developed to treat insomnia in patients with CVD.

    Design: An explorative design with 1 year followup including 200 primary care patients with CVD and insomnia from 4 centers. Patients will be randomized to 9 weeks of I-CBT, or to a control group receiving internetbased sleep hygiene without support.

    CONTENT: The I-CBT intervention starts with a 1 week introduction, 2 weeks of psychoeducation (i.e., CVD and insomnia), followed by a 6 weeks treatment part (i.e., sleep hygiene, stimulus control and sleep restriction). Participants can communicate with a nurse and receive feedback during treatment. A psychologist will act as back-up.

    MEASURES: Questionnaires will be administered at baseline, during and post intervention at 6 and 12 months’. The questionnaires will focus on e.g., educational effects, as well as on effects regarding symptoms; sleep/insomnia (PSQI, ISI, ESS, sleep diary), depressive symptoms (PHQ-9), as well as QoL (SF12). The participants’ experience of the program will be explored by repeated interviews (at baseline, after 3 weeks, 6 weeks and after the intervention).

    Conclusion: Depending on its effectiveness a nurseled I-CBT program can be a possible tool for insomnia treatment in cardiovascular care.

  • 5.
    Siebmanns, Sandra
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Ulander, M.
    Linkoping Univ Hosp, Dept Clin Neurophysiol, Linkoping, Sweden.
    Sandberg, Jonas
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Johansson, P.
    Linkoping Univ, Dept Cardiol, Linkoping, Sweden.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    "You can’t always get what you want” - methodological challenges with an internet-based CBT intervention for insomnia among patients with cardiovascular disease2018Inngår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27, nr 1, SI, s. 291-291, artikkel-id P437Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives/Introduction: Internet‐based cognitive behavioural therapy for insomnia (ICBTi) is a frequently used intervention. Published studies are promising, but methodological limitations (e.g., heterogeneity, low number of participants, unclear adherence to the intervention) have been reported. The aim was to describe methodological challenges perceived in the Hit‐IT study, an ongoing ICBTi study for patients with insomnia and cardiovascular disease (CVD).

    The Hit‐IT study: Design: RCT with 1‐year follow‐up. All patients with CVD (i.e., myocardial infarction, heart failure, atrial fibrillation and angina) from 6 primary care centers are screened for insomnia and during a clinical examination diagnosed according to DSM‐V criteria.Intervention: 9 weeks I‐CBTi (1‐week introduction, 2 weeks psychoeducation on CVD/insomnia, 6 weeks of sleep hygiene, stimulus control and sleep restriction) vs 3 weeks internet‐based sleep hygiene education.Questionnnaires: Sleep (Pittsburg Sleep Quality Index, Insomnia Severity Index, sleep diary), depressive‐ and cardiac symptoms (Patient Health Qurestionnaire‐9, Cardiac Anxiety Questionnaire) and Quality of Life (SF‐12) at baseline, during and after intervention (after 6 and 12 months).

    Methods: Interim analysis with descriptive statistics.

    Results: Out of 2170 approached patients with diagnosed CVD1508 (70%) responded (No=1330/Yes=178). Of the 178 approvals (124 men/54 women), 54 did not complete internet‐based screening (no e‐mail, declined participation and for unknown reasons). Of the 124 participants who completed screening, 40 (34 men/6 women, age range 42‐84 years) were excluded (ISI < 8). In addition, 32 were excluded after telephone contact and clinical examination (declined participation n = 10, no clinical insomnia n = 14, sleep apnea n = 4,restless legs n = 2, epilepsy n = 1, pharmacological side effect n = 1). Currently 46 participants have been randomized in the Hit‐IT study (15 females, 31 males, mean age 71 years/Range 41‐92 years). 19 participants have completed control group (1 dropout related to technical problems, 3 in treatment). In the intervention group, 6 have completed, 4 intentions to treat, 3 dropouts (n = 2 unknown reason, n = 1 technical problems), 10 participants in treatment.

    Conclusions: Clear methodological challenges with regard to the strenuous patient inclusion process are identified. The current study has a higher mean age and higher number of participating men than current ICBTi studies in general population.

    Disclosure: Nothing to disclose.

  • 6.
    Öberg, Sandra
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, HHJ. ADULT.
    The Hit-IT project: The development and evaluation of an internet-based complex intervention for primary healthcare patients with cardiovascular disease and insomnia2022Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    There is a need to explore insomnia among patients with cardiovascular disease (CVD), since they have increased risk for disease deterioration, poor quality of life and a shorter lifetime expectancy. Cognitive behavioral therapy (CBT) is the main recommended insomnia treatment, although it is a rare treatment choice in the healthcare due to lack of certified CBT therapists.

    The aim of the thesis was therefore to investigate a nurse-led internet-based CBT for insomnia (I-CBTI) tailored for patients with CVD, that includes qualitative and quantitative measures to explore the patients’ characteristics and treatment motive, insomnia experience, treatment effect, adherence and the usability of a complex intervention called the Hit-IT program.

    The first paper had a mixed study design to investigate the participants (n=126) sleep, physical and psychological characteristics in relation to insomnia via baseline questionnaires, as well as interviews (n=19) covering their motivation and expectations when participating in the Hit-IT treatment study. The second paper was a qualitative study using a Critical incident technique, to capture the experience of the participants (n=20) with CVD and insomnia sleep situation, and determine how they managed their insomnia. The third paper included 48 participants who were randomised to test the nine-week nurse-led I-CBTI treatment, tailored for patients with CVD or a three-week of self-studies (control group) without support. Paper four was a qualitative study to explore the experience and management of the Hit-IT program.

    The thesis findings showed that the participants were primarily male participants of older age, and that insomnia symptoms were significantly associated with worse somatic symptom severity, reduced physical quality of life, increased levels of depressive symptoms and cardiac anxiety. The participants were motivated to engage in the Hit-IT study, but were concerned the comorbid condition would be a hindering factor for the required behavioral change if randomized to the nine-week Hit-IT program. The participants also experience physical and cognitive insomnia triggers caused by cardiac symptoms at night. However, the participants in the Hit-IT program group significantly improved their insomnia symptoms compared to the three-week self-study control group. Also, the participants adherent to the Hit-IT program significantly increased their physical quality of life compared to those not adherent to treatment. Moreover, the results showed that the participants had trust in the Hit-IT program and experienced the intervention as very interesting yet challenging. The major treatment adherence facilitator was to experience improved sleep during the course of treatment.

    The thesis findings conclude that nurses have the skills to deliver a nurse-led I-CBTI treatment, tailored for patients’ with CVD with a sleep improvement outcome. The findings also confirm that primary healthcare patients of older age living with CVD and insomnia, are interested in and able to use internet-based complex interventions to improve their sleep.

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  • 7.
    Öberg, Sandra
    et al.
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, HHJ. ADULT.
    Broström, Anders
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, HHJ. ADULT.
    Georgsson, Mattias
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Sandberg, Jonas
    Johansson, Linda
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    The experience of a Nurse-led Internet-based Cognitive Behavioral Therapy for Insomnia on Patients with Cardiovascular Disease: A qualitative studyManuskript (preprint) (Annet vitenskapelig)
  • 8.
    Öberg, Sandra
    et al.
    Jönköping University, Hälsohögskolan, HHJ, Avdelningen för omvårdnad. Jönköping University, Hälsohögskolan, HHJ. ADULT.
    Johansson, Linda
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Georgsson, Mattias
    Jönköping University, Hälsohögskolan, HHJ, Avdelningen för omvårdnad.
    Sandberg, Jonas
    Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden.
    Broström, Anders
    Jönköping University, Hälsohögskolan, HHJ, Avdelningen för omvårdnad. Jönköping University, Hälsohögskolan, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Primary care patients with cardiovascular disease eligible for nurse-led internet-based cognitive behavioural therapy for insomnia: Characteristics and motives for participation2023Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 10, nr 7, s. 4676-4689Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To describe demographic, physical and psychological characteristics associated with insomnia in patients with cardiovascular disease (CVD) participating in nurse-led Internet-based cognitive behavioural therapy for insomnia (I-CBTI), and their motives and expectations regarding participation in I-CBTI.

    Design: A mixed method design was applied, including primary care patients with angina pectoris, myocardial infarction, heart failure, atrial fibrillation and atrial flutter or arrhythmia in southern Sweden.

    Methods: Data on demographics, insomnia severity and physical and psychological characteristics were collected through self-rated validated questionnaires (n = 126). Motives and expectations were collected through interviews (n = 19) and analysed using the ‘personas’ model.

    Results: Physical symptoms and psychological characteristics were associated with insomnia. Three personas were identified: the pragmatist (a curious and optimistic persona), the philosopher (a problem-solving persona) and the philanthropist (an altruistic persona). Expectations were positive among the three personas, but comorbid conditions reduced the perceived ability to make necessary behavioural changes.

  • 9.
    Öberg, Sandra
    et al.
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, HHJ. ADULT.
    Johansson, Linda
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Georgsson, Mattias
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Sandberg, Jonas
    Broström, Anders
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, HHJ. ADULT.
    Primary healthcare patients with cardiovascular disease eligible for nurse-led internet-based cognitive behavioral therapy for insomnia: characteristics and motives for participationManuskript (preprint) (Annet vitenskapelig)
  • 10.
    Öberg, Sandra
    et al.
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, HHJ. ADULT.
    Johansson, Linda
    Jönköping University, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköping University, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Sandberg, Jonas
    Department of Nursing Science, Sophiahemmet University, Stockholm; and Faculty of Medicine, Department of Health Sciences, Lund University, Sweden.
    Johansson, Peter
    Departments of Social and Welfare Studies, Internal Medicine, and Medical Health Sciences, Linköping University, Norrköping, Sweden.
    Broström, Anders
    Jönköping University, Hälsohögskolan, HHJ, Avd. för omvårdnad. Jönköping University, Hälsohögskolan, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Sweden.
    Experiences and management of incidents that influence sleep in patients with cardiovascular disease and insomnia2020Inngår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 35, nr 4, s. 364-374Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Insomnia is a global problem and an important risk factor for patients living with cardiovascular disease (CVD), causing poor well-being and worsening disease prognosis. Yet, there is a lack of effective intervention strategies targeting sleep problems. To deliver patient-centered interventions and achieve good quality of sleep for this group, the own experiences of patients with CVD need to be understood.

    OBJECTIVE: The aim of this study was to describe experiences that influence the sleep situation and management of sleep problems among patients with CVD and insomnia.

    METHOD: A qualitative descriptive design with critical incident technique methodology was used. Twenty patients (13 men and 7 women; mean age, 73 years; range, 47-83 years) with single or multiple verified CVD diagnoses and insomnia were included.

    RESULTS: Four underlying categories of sleep disruptors were identified: cognitive, social, physical, and behavioral. Participants experienced distress from the heart condition at night, physically and cognitively, with high levels of concern about its consequences for themselves and their families. Participants' sleep management preferences and responses included cognitive, behavioral, and pharmacological management strategies. Participants preferred their own nonpharmacological insomnia management over professional advice.

    CONCLUSION: Patients with CVD and insomnia experienced both physical and cognitive distress from their heart condition and chose to adopt nonpharmacological insomnia management. Tailored professional support is needed to change precipitating behavioral factors to be able to treat insomnia, improve sleep, reduce symptom burden, and enhance quality of life.

  • 11.
    Öberg, Sandra
    et al.
    Jönköping University, Hälsohögskolan, HHJ, Avdelningen för omvårdnad.
    Odzakovic, Elzana
    Jönköping University, Hälsohögskolan, HHJ, Avdelningen för omvårdnad. Jönköping University, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Sov bättre med digital terapi2024Inngår i: Äldre i centrum, ISSN 1653-3585, nr 1, s. 48-51Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [sv]

    Ingress: Äldre personer som är långvarigt sjuka har ofta svårt att sova, vilket kan påverka deras hälsa negativt. Med digital kognitiv beteendeterapi kan de få hjälp, kunskap och möjlighet till egenvårdsbehandling som kan få dem att må bättre.

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