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Guo W, Nazari N, Sadeghi M. Cognitive-behavioral treatment for insomnia and mindfulness-based stress reduction in nurses with insomnia: a non-inferiority internet delivered randomized controlled trial. PeerJ 2024; 12:e17491. [PMID: 39071123 PMCID: PMC11283175 DOI: 10.7717/peerj.17491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/09/2024] [Indexed: 07/30/2024] Open
Abstract
Background Insomnia is a highly prevalent sleep disorder frequently comorbid with mental health conditions in nurses. Despite the effectiveness of evidence-based cognitive behavioral therapy for insomnia (CBT-I), there is a critical need for alternative approaches. This study investigated whether internet-delivered mindfulness-based stress reduction (IMBSR) for insomnia could be an alternative to internet-delivered CBT-I (ICBT-I). Objective The hypothesis was that the IMBSR would be noninferior to the ICBT-I in reducing the severity of insomnia among nurses with insomnia. Additionally, it was expected that ICBT-I would produce a greater reduction in the severity of insomnia and depression than IMBSR. Method Among 240 screened nurses, 134 with insomnia were randomly allocated (IMBSR, n = 67; ICBT-I, n = 67). The assessment protocol comprised clinical interviews and self-reported outcome measures, including the Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), the 15-item Five Facet Mindfulness Questionnaire (FFMQ), and the Client Satisfaction Questionnaire (CSQ-I). Results The retention rate was 55% with 77.6% (n = 104) of participants completing the study. At post-intervention, the noninferiority analysis of the ISI score showed that the upper limit of the 95% confidence interval was 4.88 (P = 0.46), surpassing the pre-specified noninferiority margin of 4 points. Analysis of covariance revealed that the ICBT-I group had significantly lower ISI (Cohen's d = 1.37) and PHQ-9 (Cohen's d = 0.71) scores than did the IMBSR group. In contrast, the IMBSR group showed a statistically significant increase in the FFMQ-15 score (Cohen's d = 0.67). Within-group differences showed that both the IMBSR and ICBT-I were effective at reducing insomnia severity and depression severity and improving mindfulness. Conclusion Overall, nurses demonstrated high levels of satisfaction and adherence to both interventions. The IMBSR significantly reduced insomnia severity and depression, but the findings of this study do not provide strong evidence that the IMBSR is at least as effective as the ICBT-I in reducing insomnia symptoms among nurses with insomnia. The ICBT-I was found to be significantly superior to the IMBSR in reducing insomnia severity, making it a recommended treatment option for nurses with insomnia.
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Affiliation(s)
- Wanran Guo
- School of Public Policy and Administration, Nanchang University, Nanchang, Nanchang, China
| | - Nabi Nazari
- Department of Psychology, Faculty of Human Sciences, University of Lorestan, Khorramabad, Lorestan, Iran
| | - Masoud Sadeghi
- Department of Psychology, Faculty of Human Sciences, University of Lorestan, Khorramabad, Lorestan, Iran
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Dolu İ, Açıkgöz S, Rıza Demirbaş A, Karabulut E. Circadian Rhythms Characteristics of Nurses Providing Direct Patient Care: An Observational Study. Saf Health Work 2024; 15:102-109. [PMID: 38496283 PMCID: PMC10944160 DOI: 10.1016/j.shaw.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/05/2023] [Accepted: 12/09/2023] [Indexed: 03/19/2024] Open
Abstract
Background In today's modern world, longer working hours, shift work, and working at night have become major causes of the disruption of our natural circadian rhythms. This study aimed to investigate the effects of the type of shift work (rotating vs. fixed day), duty period (on-duty vs. off-duty), and working period within each shift (nighttime vs. daytime) on the circadian rhythm characteristics of nurses who provide direct patient care. Methods This cross-sectional study used a purposive sampling method. Cosinor analysis was applied to analyze the actigraphy data of nurses providing direct patient care for seven consecutive days. The linear mixed effects model was then used to determine any variances between shift type, duty period, and working period within each shift for the nurses. Results The mesor value did not differ according to nurses' shift type, duty period, and working period within each shift. The amplitude was statistically higher in on-duty nurses and in daytime working hours. The acrophase was significantly delayed in nighttime working hours. As well as nurses in rotating shift had experience. Conclusion Our findings revealed that the peak activity of nurses occurs significantly later at night while working and nurses working during nighttime hours may have a weaker or less distinct circadian rhythm. Thus, this study suggests that limits be placed on the number of rotating nighttime shifts for nurses.
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Affiliation(s)
- İlknur Dolu
- Department of Nursing, Faculty of Health Science, 74100 Bartın University, Bartın, Turkey
| | - Serap Açıkgöz
- Department of Nursing, Faculty of Health Science, Çankırı Karatekin University, Çankırı, Turkey
| | - Ali Rıza Demirbaş
- Governors State University, Department of Health Administration and Informatics, United States
| | - Erdem Karabulut
- Hacettepe University, Faculty of Medicine, Basic Medical Sciences, Department of Biostatistics, Turkey
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Averill SL, Gomez EN, Belfi LM, Hui J, Mallak N, Chetlen A. Night and Day, Why Radiologists Need Play. Acad Radiol 2024; 31:360-370. [PMID: 38401981 DOI: 10.1016/j.acra.2023.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 02/26/2024]
Abstract
What is play and why does it matter for radiologists? Play can take many forms in the workplace, including organic, managed, task-related, diversionary, and resistive forms of play, and play may also take the form of authentic self-expression and creation. In this review article, we will discuss the benefits of play including improved problem solving, gaining perspective, and stress reduction, and also provide low-tech and high-tech examples of beneficial play for the radiology team in work and personal contexts.
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Affiliation(s)
- Sarah L Averill
- Associate Professor of Oncology and Radiology, Roswell Park Comprehensive Cancer Center, 665 Elm Ste, Buffalo, New York, USA (S.L.A.).
| | - Erin N Gomez
- Assistant Professor, Diagnostic Imaging Division, Program Director, Diagnostic Radiology and Molecular Imaging Residencies, Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland, USA (E.N.G.)
| | - Lily M Belfi
- Associate Professor of Clinical Radiology, Director of Medical Student Education, Division of Emergency/ Musculoskeletal Radiology, Weill Cornell Medicine, 525 East 68th Street, Room F-054, New York, New York, 10065, USA (L.M.B.)
| | - Jessica Hui
- R3 Radiology Resident University of Iowa Hospitals and Clinics, lowa city, lowa, USA (J.H.)
| | - Nadine Mallak
- Associate Professor, Department of Diagnostic Radiology, Molecular Imaging & Therapy, Body Imaging, PET/MRI Clinical Director, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon, 97239, USA (N.M.)
| | - Alison Chetlen
- Professor, Department of Radiology, Division of Breast Imaging, Vice Chair of Education, Department of Radiology, Breast Imaging Division Chief, Academic Radiology Group, Director, 3+5 DR-APPS Accelerated Pathway Program Penn State College of Medicine, Penn State Health, Hershey Medical Center, 30 Hope Drive, Suite 1800, EC 008, Hershey, Pennsylvania, 17033, USA (A.C.)
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Sutherland C, Smallwood A, Wootten T, Redfern N. Fatigue and its impact on performance and health. Br J Hosp Med (Lond) 2023; 84:1-8. [PMID: 36848155 DOI: 10.12968/hmed.2022.0548] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
An increasing body of evidence suggests that fatigue among healthcare staff is widespread, owing to a combination of high work intensity, long daytime hours and night-shift working. This has been linked to poorer outcomes for patients and longer inpatient stays, and to increased risks of work-related accidents, errors and injuries for practitioners. These include needlestick injuries and motor vehicle accidents, and other impacts on practitioner health, ranging from cancer, mental health problems, metabolic disorders to coronary disease. Other 24-hour safety-critical industries have fatigue policies that acknowledge the risks of staff fatigue and provide a system to manage it and mitigate harm, but these are still lacking within healthcare. This review explains the basic physiology behind fatigue and outlines its impacts on healthcare practitioners' clinical practice and wellbeing. It proposes methods to minimise these effects for individuals, organisations and the wider UK health service.
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Affiliation(s)
- Ceri Sutherland
- Sleep Service, James Cook University NHS Foundation Trust, Middlesbrough, UK
| | - Aidan Smallwood
- Department of Anaesthesia, Royal Victoria Infirmary, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Tom Wootten
- Department of Intensive Care, Hawke's Bay Fallen Soldier's Memorial Hospital, Hastings, New Zealand
| | - Nancy Redfern
- Department of Anaesthesia, Royal Victoria Infirmary, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Li Y, Nazari N, Sadeghi M. Internet delivered, non-inferiority, two-arm, assessor-blinded intervention comparing mindfulness-based stress reduction and cognitive-behavioral treatment for insomnia: a protocol study for a randomized controlled trial for nursing staff with insomnia. Trials 2022; 23:1020. [PMID: 36527137 PMCID: PMC9756716 DOI: 10.1186/s13063-022-06986-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 12/06/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Insomnia and poor sleep quality are highly prevalent conditions related to coronavirus disease 2019 (COVID-19) complications among clinical nurses. Although cognitive behavioral therapy for insomnia (CBT-I) is a first-line treatment, CBT-I suffers from several major drawbacks. This study investigates whether the application of the internet-delivered mindfulness-based stress reduction (iMBSR) intervention will produce effects that are non-inferior to the internet-delivered CBT-I (iCBT-I) intervention in reducing the severity of insomnia in clinical nurses with insomnia at the end of the study. METHODS This study protocol presents an internet-delivered, parallel-groups, assessor-blinded, two-arm, non-inferiority randomized controlled trial. The primary outcome is sleep quality, assessed by the Insomnia Severity Index. Secondary outcomes include depression, dysfunctional beliefs, five facets of mindfulness, and client satisfaction. CONCLUSION It is expected that this study may address several gaps in the literature. The non-inferiority study design is a novel approach to evaluating whether a standardized, complementary treatment (i.e., MBSR) is as practical as a gold standard treatment rather than its potential benefits. This approach may lead to expanded evidence-based practice and improve patient access to effective treatments. TRIAL REGISTRATION Trial registration number: ISRCTN36198096 . Registered on 24th May 2022.
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Affiliation(s)
- Yaling Li
- grid.499351.30000 0004 6353 6136Mental Health Education and Counseling Center, Shenzhen Technology University, Shenzhen, 518118 Guangdong China
| | - Nabi Nazari
- grid.411406.60000 0004 1757 0173Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran
| | - Masoud Sadeghi
- grid.411406.60000 0004 1757 0173Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran
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Christopher N, Tamplin J. The Use of Kinesthetic Empathy with Adults Living with Treatment Resistant Depression: A Survey Study. AMERICAN JOURNAL OF DANCE THERAPY 2022; 44:115-142. [PMID: 36187342 PMCID: PMC9510258 DOI: 10.1007/s10465-022-09371-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 11/29/2022]
Abstract
Dance/movement therapy is an embodied healing practice which has been found to foster recovery from depression and boost quality of life. Although kinesthetic empathy holds great potential for addressing emotional dysregulation, it is an under-utilized dance/movement therapy intervention in health optimization, especially in adults living with treatment-resistant depression. The aim of this study was to collect data from dance/movement therapist on how they use kinesthetic empathy to foster self-regulation in adults living with treatment-resistant depression. A survey design was used to obtain this data. Eight dance/movement therapists (practicing in India, Philippines, Barbados, and the United States of America) were recruited. The participant demographics of the survey challenges the centrality of master’s level trained dance/movement therapists primarily practicing in Eurocentric cultures. The survey included open answer questions, and responses received were grouped into four categories: (i) dance/movement therapists’ rationale for using kinesthetic empathy (ii) therapist-described client responses to kinesthetic empathy, (iii) changes in self-regulation patterns of clients, and (iv) potential links between employing kinesthetic empathy as an intervention and witnessing emotional regulation in clients. Overall, kinesthetic empathy was described as a core part of the participants’ dance/movement therapy practice with this population. The identified client responses to kinesthetic empathy were categorized based on deWitte’s et al. (Frontiers in Psychology, 2021) therapeutic factors of change. ‘Observable client responses’, such as, use of metaphors, verbalization of body sensations and engaging in mirroring were categorized under specific therapeutic factors of dance/movement therapy. Alternatively, ‘emotionally felt client responses’ such as, increase in safety and trust within the therapeutic alliance were categorized under both ‘specific’ and ‘mixed-type’ factors based on the model. Finally, this article discusses movement interventions that may be incorporated by dance/movement therapists while working with this population. Further research is required to identify the long-term effect/s of kinesthetic empathy as an intentional intervention to foster self-regulation in adults living with treatment-resistant depression.
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Affiliation(s)
- Neha Christopher
- University of Melbourne, Melbourne, Australia
- Indian Association of Dance Movement Therapy, Chennai, Tamil Nadu India
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de Almondes KM, Castro EDAS, Paiva T. Morbidities Worsening Index to Sleep in the Older Adults During COVID-19: Potential Moderators. Front Psychol 2022; 13:913644. [PMID: 35832914 PMCID: PMC9271867 DOI: 10.3389/fpsyg.2022.913644] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/06/2022] [Indexed: 12/02/2022] Open
Abstract
Older adults were considered a vulnerable group for the COVID-19 infection and its consequences, including problems with sleep.
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Affiliation(s)
- Katie Moraes de Almondes
- Department of Psychology and Postgraduate Program in Psychobiology, AMBSONO Sleep Clinic, Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
- *Correspondence: Katie Moraes de Almondes,
| | | | - Teresa Paiva
- CENC –Sleep Medicine Center, Lisbon, Portugal
- ISAMB – Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Universidade Nova de Lisboa, Lisbon, Portugal
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Nazari N, Sadeghi M, Samusenkov V, Aligholipour A. Factors associated with insomnia among frontline nurses during COVID-19: a cross-sectional survey study. BMC Psychiatry 2022; 22:40. [PMID: 35038999 PMCID: PMC8763304 DOI: 10.1186/s12888-022-03690-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/06/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Research predominantly suggests that nurses are at high risk of developing psychopathology. The empirical data show that the occurrence rate of problem-related sleep quality among clinical nurses is high. Therefore, this study was conducted to address the lack of information on the relationship between the coronavirus disease 2019 (COVID-19) pandemic and insomnia. METHODS A convenience sample of nurses (n = 680) completed an online survey that included the Insomnia severity index, the COVID-19-related psychological distress scale, the general health questionnaire, neuroticism, dysfunctional beliefs, attitudes about sleep scale, and difficulties in emotion regulation scale. RESULTS The results showed that 35.8% (n = 253) of nurses were classified as individuals with moderate to severe clinical insomnia. The results showed that the psychological distress generated by COVID-19 predicted insomnia (β = .47, SE = 0.02, P < .001, t = 13.27, 95% CI 0.31-0.46). Additionally, the association is mediated by psychopathology vulnerabilities, emotion dysregulation, dysfunctional beliefs about sleep, and neuroticism. Moreover, female nurses exhibited higher levels of insomnia (Cohen's d = .37), neuroticism (Cohen's d = 30), psychopathology vulnerability (Cohen's d = .26), and COVID-19-related psychological distress (Cohen's d = .23). CONCLUSION The present study's findings help to explain how pandemic consequences can be associated with insomnia. Additionally, the findings make a significant contribution to better understanding the role of neuroticism, emotion dysregulation, beliefs, and psychopathology vulnerability in the development of insomnia among nurses. The findings suggest the potential influence of cognitive behavioral therapy for insomnia (CBT-I) and transdiagnostic integrated therapies that could be incorporated into therapeutic programs designed to develop as a way of inhibiting or preventing insomnia among clinical nurses.
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Affiliation(s)
- Nabi Nazari
- Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran.
| | - Masoud Sadeghi
- Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran
| | - Vadim Samusenkov
- Department of Prosthetic Dentistry, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Akram Aligholipour
- Departments of Psychology, Faculty of Human Sciences, Allameh Tabatabai University, Tehran, Iran
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Abstract
PURPOSE OF REVIEW We reviewed current evidence on the impact of coronavirus disease 2019 (COVID-19) pandemic on sleep of different populations. RECENT FINDINGS Several studies demonstrated that sleep deprivation may cause immune system dysregulation, which deteriorates the course of COVID-19. The increased prevalence of sleep disorders among COVID-19 patients has been associated with more severe disease and worse clinical outcomes. Healthcare workers who were subjected to atypical workload and more nightshifts developed sleep disorders which associated with work-related errors and COVID-19 infection susceptibility. In general population, circadian misalignment and excessive stressors impaired sleep quality. Sleep dysfunction has been recorded due to the pandemic. It is essential to implement interventions in order to alleviate pandemic-related sleep disorders. Telemedicine, cognitive behavioral therapy, and sleep hygiene practices appear to be helpful. Psychotropic medication should be cautiously administered, while other pharmacological agents, such as melatonin, have shown promising results.
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Baek S, Yu H, Roh J, Lee J, Sohn I, Kim S, Park C. Effect of a Recliner Chair with Rocking Motions on Sleep Efficiency. SENSORS (BASEL, SWITZERLAND) 2021; 21:8214. [PMID: 34960304 PMCID: PMC8706869 DOI: 10.3390/s21248214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022]
Abstract
In this study, we analyze the effect of a recliner chair with rocking motions on sleep quality of naps using automated sleep scoring and spindle detection models. The quality of sleep corresponding to the two rocking motions was measured quantitatively and qualitatively. For the quantitative evaluation, we conducted a sleep parameter analysis based on the results of the estimated sleep stages obtained on the brainwave and spindle estimation, and a sleep survey assessment from the participants was analyzed for the qualitative evaluation. The analysis showed that sleep in the recliner chair with rocking motions positively increased the duration of the spindles and deep sleep stage, resulting in improved sleep quality.
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Affiliation(s)
- Suwhan Baek
- Department of Computer engineering, Kwangwoon University, Seoul 01897, Korea
| | - Hyunsoo Yu
- Department of Computer engineering, Kwangwoon University, Seoul 01897, Korea
| | - Jongryun Roh
- Digital Transformation RnD Department, Korea Institute of Industrial Technology, Ansan 15588, Korea
| | - Jungnyun Lee
- Digital Transformation RnD Department, Korea Institute of Industrial Technology, Ansan 15588, Korea
| | - Illsoo Sohn
- Department of Computer Science and Engineering, Seoul National University of Science and Technology, Seoul 01811, Korea
| | - Sayup Kim
- Digital Transformation RnD Department, Korea Institute of Industrial Technology, Ansan 15588, Korea
| | - Cheolsoo Park
- Department of Computer engineering, Kwangwoon University, Seoul 01897, Korea
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