scholarly journals Nursing and no Drug for the Management of Insomnia Treatment

2019 ◽  
Vol 18 (2) ◽  
pp. 512-532 ◽  
Author(s):  
Raquel Baides Noriega ◽  
Sara Noriega Camporro ◽  
Alicia Maria Inclán Rodríguez
Keyword(s):  
Complementary Therapy ◽  
Pharmacological Interventions ◽  
First Line ◽  
Pharmacological Management ◽  
Cognitive Behavioural ◽  
Management Procedures ◽  
Hygiene Measures ◽  
Insomnia Treatment ◽  
And Training ◽  
Primary Care Nursing

Introducción: El insomnio es definido como la incapacidad para iniciar y/o mantener el sueño. Es el trastorno del sueño más frecuente y puede producir consecuencias para la salud en todas las dimensiones. Las medidas no farmacológicas han mostrado mejor efecto a largo plazo para el manejo del insomnio, por lo que el uso de fármacos debe restringirse como segunda línea de tratamiento.Metodología: Con objeto de conocer procedimientos no farmacológicos para el manejo del insomnio desde Enfermería de Atención Primaria, se realizó una revisión bibliográfica a través de fuentes primarias y secundarias. Resultados: Como primera línea de tratamiento destacan las terapias conductuales y cognitivo-conductuales asociadas a la educación para la salud y medidas de higiene de sueño. Según algunos estudios, nueve consultas de 30 minutos, con intervenciones no farmacológicas, reducirían el insomnio crónico con efectividad del 70 al 80%. Además existen terapias alternativas que asociadas como terapias complementarias pueden ayudar al manejo del insomnio con nivel de evidencia suficiente.Conclusiones: Las medidas no farmacológicas deben utilizarse como primera línea de tratamiento. Sin embargo, en nuestro país, apenas se prescriben y existe un alto consumo de fármacos destinados a solucionar este problema, con las consiguientes consecuencias para la salud que producen. Para poder abordar la situación se considera fundamental una mejora de los recursos humanos profesionales y formación al respecto. Introduction: Insomnia is defined as the inability to initiate or maintain sleep. It is the most common sleep disorder and can produced consequences for health in all aspect. Non-pharmacological measures have shown better effect in the long management of insomnia, so the use of drugs should be restricted as a second-line treatment.Methodology: In order to learn about non-pharmacological management procedures of insomnia from primary care nursing, we conducer a literature review through primary and secondary sources.Results: As first line treatment include therapies behavioural and cognitive-behavioural associated with education for health and the sleep hygiene measures. According to some studies, nine 30-minute, non-pharmacological interventions queries, reduce chronic insomnia with effectiveness of 70 to 80%. Also there are alternative therapies such as the use of valerian to associate as complementary therapy can help the Management of insomnia with good level of evidence.Conclusions: Non- pharmacological measures should be used as a first line of treatment. However in our country to penalties are prescribed and there is high consumption of drugs for this problem, with the resulting consequences for the health of tolerance and dependence producing the maintained consumption of these dugs. Addressing the situation is considered essential to an improvement of the professional human resources and training.

scholarly journals P053 Management of insomnia by Australian psychologists

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A38-A38
Author(s):  
J Haycock ◽  
E Hoon ◽  
A Sweetman ◽  
L Lack ◽  
N Lovato
Keyword(s):  
Health Care Professionals ◽  
Well Being ◽  
Behavioural Therapy ◽  
Depression And Anxiety ◽  
Further Training ◽  
Structured Interviews ◽  
First Line ◽  
Cognitive Behavioural ◽  
Insomnia Treatment

Abstract Introduction Insomnia is the most common sleep disorder, 10–30% of adults have regular difficulties falling and/or staying asleep that cause significant daytime impairments. General Practitioner (GP) clinical guidelines recommend Cognitive Behavioural Therapy for insomnia (CBTi) as the first-line treatment rather than medications. However, most GPs do not have the time or training to administer CBTi, and consequently, many patients are prescribed sedative-hypnotic medicines. Psychologists have training in CBT and may be well placed to deliver behavioural therapy for insomnia. However, the amount of sleep-specific training, and knowledge of CBTi among Australian psychologists remains unknown. Identifying key barriers and enablers in the management of insomnia within psychology provides a first step in engaging with psychologists about the delivery of evidence-based insomnia treatment. Methods This qualitative study used a pragmatic inductive approach. Semi-structured interviews were conducted with 26 Australian psychologists. Interviews included case study scenarios to provide an in-depth exploration of psychologists’ knowledge and skills in the management of insomnia, and attitudes towards further training in CBTi. Interview transcripts were analysed using thematic analysis to identify themes. Results Preliminary themes identified in the data include; psychologists believe sleep is important for general well-being, insomnia is usually seen as secondary to other co-morbid disorders such as depression and anxiety that are the focus of treatment, most psychologists surveyed lack training and knowledge in CBTi. Discussion Most Australian psychologists are not well prepared to manage insomnia effectively with CBTi. Along with other primary health care professionals, psychologists need training in the management of insomnia.

scholarly journals Efficacy and moderators of efficacy of trauma-focused cognitive behavioural therapies in children and adolescents: protocol for an individual participant data meta-analysis from randomised trials

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047212
Author(s):  
Anke de Haan ◽  
Caitlin Hitchcock ◽  
Richard Meiser-Stedman ◽  
Markus A Landolt ◽  
Isla Kuhn ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Risk Of Bias ◽  
Randomised Trials ◽  
First Line ◽  
Cognitive Behavioural ◽  
Individual Participant ◽  
Behavioural Therapies ◽  
First Line Treatment

IntroductionTrauma-focused cognitive behavioural therapies are the first-line treatment for posttraumatic stress disorder (PTSD) in children and adolescents. Nevertheless, open questions remain with respect to efficacy: why does this first-line treatment not work for everyone? For whom does it work best? Individual clinical trials often do not provide sufficient statistical power to examine and substantiate moderating factors. To overcome the issue of limited power, an individual participant data meta-analysis of randomised trials evaluating forms of trauma-focused cognitive behavioural therapy in children and adolescents aged 6–18 years will be conducted.Methods and analysisWe will update the National Institute for Health and Care Excellence guideline literature search from 2018 with an electronic search in the databases PsycINFO, MEDLINE, Embase, Cochrane Central Register of Controlled Trials and CINAHL with the terms (trauma* OR stress*) AND (cognitive therap* OR psychotherap*) AND (trial* OR review*). Electronic searches will be supplemented by a comprehensive grey literature search in archives and trial registries. Only randomised trials that used any manualised psychological treatment—that is a trauma-focused cognitive behavioural therapy for children and adolescents—will be included. The primary outcome variable will be child-reported posttraumatic stress symptoms (PTSS) post-treatment. Proxy-reports (teacher, parent and caregiver) will be analysed separately. Secondary outcomes will include follow-up assessments of PTSS, PTSD diagnosis and symptoms of comorbid disorders such as depression, anxiety-related and externalising problems. Random-effects models applying restricted maximum likelihood estimation will be used for all analyses. We will use the Revised Cochrane Risk of Bias tool to measure risk of bias.Ethics and disseminationContributing study authors need to have permission to share anonymised data. Contributing studies will be required to remove patient identifiers before providing their data. Results will be published in a peer-reviewed journal and presented at international conferences.PROSPERO registration numberCRD42019151954.

scholarly journals Moving from tradition-based to competence-based psychotherapy

2021 ◽  
pp. ebmental-2020-300219
Author(s):  
Winfried Rief
Keyword(s):  
Basic Science ◽  
Theoretical Framework ◽  
Psychological Interventions ◽  
Skills Acquisition ◽  
Relationship Patterns ◽  
Cognitive Behavioural ◽  
Training Programmes ◽  
New Research ◽  
And Training ◽  
Selection Of

Current education and training in psychological interventions is mostly based on different ‘schools’ (traditions such as cognitive–behavioural or psychodynamic therapy), and strong identification with these specific traditions continuously hinders a scientifically based development of psychotherapy. This review is selective rather than systematic and comprehensive. In addition to the consideration of other influential publications, we relied on a literature search in Web of Science using the following terms (update: 24 December 2020): (psychotherapy AND meta-analy* AND competence*). After summarising current problems, a pathway for solving these problems is presented. First, we have to recategorise psychological interventions according to the mechanisms and subgoals that are addressed. The interventions can be classified according to the foci: (1) skills acquisition (eg, communication, emotion regulation, mentalisation); (2) working with relationship patterns and using the therapeutic relationship to modify them; and (3) clarification of motives and goals. Afterwards, the training of psychotherapists can switch from focusing on one theoretical framework to learning the different competences for modification according to these new categories. The selection of topics to be addressed should follow best evidence-based mechanisms and processes of mental disorders and interventions. Psychology offers knowledge about these mechanisms that can be understood as a basic science for psychological treatments in general. This requires better connection with basic science, new research efforts that focus on treatment subgoals, theory-overarching optimisation of the selection and personalisation of treatments, and new types of training for psychotherapists that are designed to optimise therapists’ competences accordingly, instead of limiting training programmes to one single theoretical framework.

scholarly journals Therapist Characteristics and their Effect on Training Outcomes: What Counts?

2015 ◽  
Vol 43 (3) ◽  
pp. 374-380 ◽  
Author(s):  
Amanda Branson ◽  
Roz Shafran
Keyword(s):  
High Intensity ◽  
Clinical Performance ◽  
Clinical Skill ◽  
Individual Characteristics ◽  
Therapist Characteristics ◽  
Training Outcomes ◽  
Low Intensity ◽  
Cognitive Behavioural ◽  
The Impact ◽  
And Training

Background:Evidence exists for a relationship between individual characteristics and both job and training performance; however relationships may not be generalizable. Little is known about the impact of therapist characteristics on performance in postgraduate therapist training programmes.Aims:The aim of this study was to investigate associations between the grades of trainee Low-Intensity and High-Intensity cognitive behavioural therapists and individual characteristics.Method:Trainee Low-Intensity (n= 81) and High-Intensity (n= 59) therapists completed measures of personality and cognitive ability; demographic and course grade data for participants were collected.Results:Degree classification emerged as the only variable to be significantly associated with performance across assessments and courses. Higher undergraduate degree classifications were associated with superior academic and clinical performance. Agreeableness was the only dimension of personality to be associated (positively) with clinical skill. Age was weakly and negatively associated with performance.Conclusions:Relationships between individual characteristics and training outcomes are complex and may be context specific. These results could have important implications for the selection and development of therapists for Low or High-Intensity cognitive behavioural therapy (CBT) training.

Pharmacological Management of Seizures and Status Epilepticus in Critically Ill Patients

2010 ◽  
Vol 23 (5) ◽  
pp. 441-454 ◽  
Author(s):  
Eljim P. Tesoro ◽  
Gretchen M. Brophy
Keyword(s):  
Status Epilepticus ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Neurological Disease ◽  
Medical Emergency ◽  
Significant Morbidity ◽  
First Line ◽  
Short Term ◽  
Pharmacological Management ◽  
First Line Treatment

Seizures are serious complications seen in critically ill patients and can lead to significant morbidity and mortality if the cause is not identified and treated quickly. Uncontrolled seizures can lead to status epilepticus (SE), which is considered a medical emergency. The first-line treatment of seizures is an intravenous (IV) benzodiazepine followed by anticonvulsant therapy. Refractory SE can evolve into a nonconvulsive state requiring IV anesthetics or induction of pharmacological coma. To prevent seizures and further complications in critically ill patients with acute neurological disease or injury, short-term seizure prophylaxis should be considered in certain patients.

scholarly journals Spreading of Excellence in SARNET Network on Severe Accidents: The Education and Training Programme

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Sandro Paci ◽  
Jean-Pierre Van Dorsselaere
Keyword(s):  
Nuclear Power ◽  
Power Plants ◽  
Training Programme ◽  
Education And Training ◽  
Severe Accident ◽  
Research Network ◽  
Safety Issues ◽  
Severe Accidents ◽  
Management Procedures ◽  
And Training

The SARNET2 (severe accidents Research NETwork of Excellence) project started in April 2009 for 4 years in the 7th Framework Programme (FP7) of the European Commission (EC), following a similar first project in FP6. Forty-seven organisations from 24 countries network their capacities of research in the severe accident (SA) field inside SARNET to resolve the most important remaining uncertainties and safety issues on SA in water-cooled nuclear power plants (NPPs). The network includes a large majority of the European actors involved in SA research plus a few non-European relevant ones. The “Education and Training” programme in SARNET is a series of actions foreseen in this network for the “spreading of excellence.” It is focused on raising the competence level of Master and Ph.D. students and young researchers engaged in SA research and on organizing information/training courses for NPP staff or regulatory authorities (but also for researchers) interested in SA management procedures.

Psychological and other non-pharmacological approaches

2019 ◽  
pp. 74-84
Author(s):  
Navneet Kapur ◽  
Robert Goldney
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Behaviour Therapy ◽  
Pharmacological Interventions ◽  
Interpersonal Therapy ◽  
Problem Solving Therapy ◽  
Cognitive Behavioural ◽  
Volunteer Organizations

This chapter discusses psychological and non-pharmacological interventions for suicidal behaviour in more detail. All people who present with suicidal thoughts and behaviour warrant some treatment, but the nature and intensity of this will depend on individual needs. Psychological treatments may include cognitive behavioural therapy, interpersonal therapy, problem-solving therapy, and mindfulness-based cognitive behavioural therapy. Dialectical behaviour therapy is specifically designed for those with a diagnosis of borderline personality disorder. Broader non-pharmacological approaches such as crisis centres, volunteer organizations, brief-contact interventions, and safety plans may be promising but require further research. Common therapeutic elements include a non-judgemental approach, empathy, respect, warmth, and genuineness.

scholarly journals Cognitive–behavioural therapy: a survey of the training, practice and views of Scottish consultant psychiatrists

2001 ◽  
Vol 25 (11) ◽  
pp. 425-428 ◽  
Author(s):  
Peter David Le Fevre ◽  
Rainer Goldbeck
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Current Practice ◽  
Behavioural Therapy ◽  
Postal Survey ◽  
Formal Training ◽  
Exact Form ◽  
Cognitive Behavioural ◽  
Training Opportunities ◽  
And Training ◽  
Training Practice

Aims and MethodA postal survey of all consultant psychiatrists employed by the NHS in Scotland was performed with the aim of determining the numbers and characteristics of consultant psychiatrists who have received training in cognitive–behavioural therapy (CBT). Additional aims were to ascertain the current practice of CBT, along with general attitudes towards practice and training issues.ResultsNine per cent of consultant psychiatrists had received formal training in CBT. An additional 20% had received informal tuition with supervision of cases. For consultants appointed within the previous five years, 48% had received the recommended amount of supervised experience. In practice, consultants were unable to devote significant amounts of time to formal CBT but were actively using CBT techniques and supported the availability of training opportunities.Clinical ImplicationsThe survey suggests that the current Royal College of Psychiatrists' guidelines do not appear to have been fully implemented for the area surveyed. Further debate is needed to ascertain the exact form that training in CBT should take.

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