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Background: Neuropsychiatric conditions, such as insomnia, anxiety, depression, and pain are the most common symptoms experienced by nurses after acute infection of COVID-19. Although medication can assist nurses to improve these symptoms simultaneously in a short period of time, they are at risk of overuse of benzodiazepine hypnotics. Previous research supports the usefulness of cognitive behavioral therapy for insomnia (CBT-I) as self-management strategies in adults with insomnia, anxiety, depression, and pain. However, their effects on post COVID-19 condition have not been researched, and no previous head-to-head study compared the effects on these two approaches on insomnia and neuropsychiatric symptoms.
Aim: To investigate the effects of CBT-I on insomnia, anxiety, depression, and pain in nurses with post COVID-19 condition.
Methods: In this two-arm, parallel randomized controlled trial, 100 participants will be 1:1 randomly assigned to one of two groups (CBT-I and control). The intervention phase will last 6 weeks, followed by a three-month follow-up. Primary outcomes are insomnia severity and sleep quality, whereas anxiety, depression, pain, and health-related quality of life are secondary outcomes. These variables will be assessed before and after the intervention, and at 1, 2, and 3 months after the end of the intervention. Additionally, discontinuing benzodiazepine hypnotics will be measured at 3 months after the end of the intervention.
Discussion: This study will provide evidence of the effects of CBT-I on improving insomnia, anxiety, depression, and pain among nurses with post COVID-19 condition. Results could also enhance means by which to discontinue benzodiazepine hypnotics.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| cognitive behavioral therapy | Experimental | 6 weeks cognitive-behavioral therapy for insomnia |
|
| treat as usual | No Intervention | provide usual care |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| cognitive behavioral therapy | Behavioral | 6 weeks cognitive behavioral therapy |
|
| Measure | Description | Time Frame |
|---|---|---|
| insomnia severity | measured by Insomnia Severity Index before and after the intervention, and at 1, 2, and 3 months after the end of the intervention | 20 weeks |
| sleep quality | measured by Pittsburgh Sleep Quality Index | 20 weeks |
| sleep efficiency | measured by Fitbit Charge 5 | 20 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| anxiety | measured by Generalized Anxiety Disorder 7-Item | 20weeks |
| depression | measured by Patient Health Questionnaire 9 item | 20weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yu-Mu Hsien, PhD | Contact | 886-2-87923311 | 10552 | tsghirb@ndmctsgh.edu.tw |
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Data available on request due to privacy/ethical restrictions
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| ID | Term |
|---|---|
| D015928 | Cognitive Behavioral Therapy |
| ID | Term |
|---|---|
| D001521 | Behavior Therapy |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
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| health-related quality of life | measured by 36-Item Short Form Health Survey | 20weeks |