Impact of Insomnia Management Programme on Insomnia Severity in Older Persons with Heart Failure
Keywords:
management programme, cognitive and behavioural therapy, older persons with heart failure, insomniaAbstract
Objective: To examine the impact that an insomnia management programme had on insomnia severity in older persons with heart failure
Design: Two-group quasi-experimental study with a pretest and posttest
Methodology: The subjects were 48 male and female older persons with heart failure, aged between 60-75 years, treated in the outpatient department of a tertiary hospital from January to June 2021. The subjects were purposively sampled and equally assigned to a control group (24) and experimental group (24); however, one of the experimental group members withdrew from the study due to the Covid-19 situation. Whilst the control group received standard nursing care, the experimental group received both standard nursing care and the insomnia management programme, which had been developed by the researchers based on the concept of cognitive and behavioural therapy for insomnia and based on reviewed literature. The data collection tools consisted of a personal information record form and the Insomnia Severity Index (ISI). The ratio of older persons with heart failure was determined using McNemar’s Test, based on a comparison of their insomnia severity degrees before the intervention and in weeks 6 and 10 after the intervention. The ratio of heart failure incidence in older persons in the control group and the experimental group before the intervention and in weeks 6 and 10 after the intervention was determined using Fisher’s Exact Test.
Results: The degrees of insomnia severity in weeks 6 and 10 after the intervention were significantly lower in the subjects participating in the insomnia management programme than in those receiving only standard care (p < .05), and also significantly lower than all of the subjects’ average pre-intervention insomnia severity degree (p < .01).
Recommendations: Nurses and healthcare professionals are advised to receive special behavioural therapy training in order to apply this programme to caring for older persons with sleep problems. Further studies based on this or any similar framework should be designed to measure other related aspects, for example, performance of daytime functions, fatigue, quality of life, and sleep-related beliefs and attitudes.
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