数字化失眠认知行为治疗在伴焦虑抑郁症状失眠患者中的质性研究

Qualitative research on digital cognitive behavioral therapy for insomnia in patients with insomnia combined with depressive and/or anxious symptoms

目的:探讨患者在数字化失眠认知行为治疗(digital cognitive behavioral therapy for insomnia,dCBT-I)自主操作使用中的身心体验、治疗依从性及使用阻碍,为dCBT-I技术范式开发和临床应用优化提供质性研究证据。方法:2021年7—11月,使用半结构式访谈提纲,对纳入研究的dCBT-I使用者(n=10)进行深度访谈,记录其具有原初性的使用感受,通过解释现象学的文本分析方法,探索研究参与者对dCBT-I的体验及认知。结果:对半结构式访谈录音的逐字稿进行文本分析、关键信息标定,提取出3个核心主题,分别为粘性因子、使用阻碍、优化方向;8个次级主题,分别为专业性、易得性、受益体验、任务执行困难、指令笼统、软件操作困难、丰富治疗内容、个性化指导。结论:研究参与者对dCBT-I治疗干预方法具有接受度,质性研究证实患者能从该治疗中获益,但dCBT-I仍有待优化改进,降低操作难度,探索更适宜的人工干预节点。

ObjectiveTo investigate the physical and mental experience,treatment compliance and use barriers of patients with insomnia in using digital cognitive behavioral therapy for insomnia(dCBT-I)in order to provide qualitative evidence for the development and application optimization of the dCBT-I technology paradigm.MethodsFrom July to November 2021,a semi-structured interview outline was used to conduct in-depth interviews with the dCBT-I users(n=10)to record their original feelings about the use of dCBT-I.Interpretative phenomenology's text analysis was used to explore the participants'experience and cognition of dCBT-I.ResultsText analysis and key information calibration were carried out on the verbatim transcripts of semi-structured interview recordings,and three core themes were extracted,namely stickiness factor,use barrier and optimization direction,as well as eight sub-themes,namely professionalism,accessibility,benefit experience,difficulty in task execution,instruction generalization,difficulty in software operation,enrich treatment content and personalized guidance.ConclusionThe present study showed that participants were receptive to the dCBT-I intervention and would be benefited from it.However,dCBT-I still needs to be optimized and improved to reduce the operating difficulty and explore more appropriate timing of manual intervention.