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Feasibility of a Telemedicine-Delivered Cognitive Behavioral Therapy for Insomnia in Rural Breast Cancer Survivors

Michaela S. McCarthy
Ellyn E. Matthews
Catherine Battaglia
Paula M. Meek
ONF 2018, 45(5), 607-618 DOI: 10.1188/18.ONF.607-618

Objectives: To evaluate a nurse-led, telemedicine-delivered cognitive behavioral therapy for insomnia (CBTI) in rural breast cancer survivors (BCSs).

Sample & Setting: 18 BCSs diagnosed with stage I–III breast cancer in the rural western United States.

Methods & Variables: In this prospective, pre-/post-test, quasiexperimental feasibility pilot trial, BCSs attended six weekly sessions of CBTI via Internet videoconference. Feasibility was assessed using recruitment and acceptability of the intervention. Primary outcomes were diary-based sleep efficiency (SE), sleep latency (SL), total sleep time, wake after sleep onset, and number of nightly awakenings; secondary outcomes included quality of life (QOL), mental health, and daily functioning.

Results: Following the intervention, participants reported improvements in sleep outcomes, including SE and SL. QOL and daily functioning improved, but anxiety and depression did not.

Implications for Nursing: Nurse-led, telemedicine-delivered CBTI for rural BCSs is feasible and may be effective in managing insomnia. Additional research is needed to determine widespread effectiveness and best practices for dissemination and implementation.

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