Article

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

cognitive behavioral therapy, breast cancer, insomnia, rural, telemedicine
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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