DOI
https://doi.org/10.25772/VSTX-E507
Defense Date
2016
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Psychology
First Advisor
Bruce Rybarczyk
Second Advisor
Laura Siminoff
Third Advisor
Paul Perrin
Fourth Advisor
Rosalie Corona
Fifth Advisor
Tamara Orr
Sixth Advisor
David Leszczyszyn
Abstract
Insomnia is defined as difficulty initiating or maintaining sleep, or nonrestorative sleep that lasts for at least one month and is accompanied by significant impairment in daytime functioning including fatigue, irritability, and/or difficulty concentrating. It is one of the most common complaints reported by individuals with cancer, especially around the time of cancer diagnosis and treatment. Yet it is often unrecognized and untreated, leading to adverse health consequences and increased healthcare costs. Cognitive Behavioral Therapy for Insomnia (CBT-I) has been recommended as the gold standard for treating insomnia among individuals with cancer. Multiple studies have tested and proven the efficacy and effectiveness of CBT-I among individuals with cancer. However, only one study has investigated the efficacy of CBT-I in individuals newly diagnosed with cancer who are undergoing cancer treatment. Moreover, previous studies have been limited by their focus on largely homogenous samples of White, well-educated women with breast cancer. The dissemination of CBT-I among individuals with cancer is greatly limited by the lack of available providers and resources needed to implement the standard face-to-face treatment. One strategy to address this shortage has been to abbreviate standard CBT-I into low-intensity modalities that require fewer resources and can be self-administered on the Internet. The current study sought to examine the feasibility and acceptability, as well as the efficacy of one such program, an online low-intensity CBT-I intervention, Sleeping Healthy Using the Internet (SHUTi), supplemented with clinician support, in a sample of individuals newly diagnosed with heterogeneous malignancies who were undergoing chemotherapy and/or radiation. Results yielded support for the feasibility and acceptability of addressing individuals’ insomnia with a low-intensity CBT-I intervention while they are undergoing cancer treatment. With regard to sleep, there were significant treatment effects observed on a global measure of insomnia severity and on subjective sleep consolidation. There were also significant treatment effects for depressive symptoms. Findings are discussed in the context of study limitations and for the purpose of expanding the literature on disseminating CBT-I early in the cancer care trajectory.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
8-8-2016