%0 Journal Article
%T 失眠认知行为疗法病例总结并文献综述<br>Summary of Insomnia CBTI Cases and Literature Review
%A 程涵蓉
%A 魏永莉
%A 杨汉芸
%A 林少芳
%A 温申萍
%A 郑水霞
%A 唐玉鸣
%J Advances in Clinical Medicine
%P 2053-2060
%@ 2161-8720
%D 2020
%I Hans Publishing
%R 10.12677/ACM.2020.109308
%X <div style=\"text-align:justify;\">
	目的：美国医师学会(ACP)将认知行为疗法(CBT-I)确定为治疗失眠的一线疗法。探讨失眠认知行为疗法应用现状。方法：对深圳市人民医院呼研所睡眠医学中心2019年10月至2020年2月60例失眠患者行CBTI，进行总结并结合文献综述失眠认知行为疗法的获取途径和利用率。结果：60例患者中55名失眠患者睡眠效率提高，总睡眠时间延长，ISI评分显著下降，其中5例患者中途退出CBTI治疗。结论：尽管CBT-I改善了睡眠质量并降低了安眠药依赖的风险，但目前患者很少接受这种治疗。在常规医疗环境中提供CBTI的三种不同类别的障碍。首先，系统障碍导致接触CBT-I和行为睡眠医学(BSM)提供者的机会有限。其次，由于缺乏知识、治疗信念以及缺乏评估和治疗失眠的动机，普通医护人员没有充分筛查睡眠问题并适当转诊。最后，患者的问题：由于缺乏知识、治疗信念以及获取CBTI的途径有限，患者参与CBT-I受限。结论：在实际工作中增加失眠患者应用CBT-I需要一个成熟的、系统的研究计划，在多个层次上开发和尝试实施干预措施。<br />
Purpose: The American College of Physicians (ACP) identified cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment for insomnia, to explore the application status of cognitive behavioral therapy for insomnia. Methods: From October 2019 to February 2020, 60 patients with insomnia underwent CBTI in the Sleep Medical Center of Shenzhen People’s Hospital. The access and utilization rate of cognitive behavioral therapy for insomnia were reviewed in combination with literature. Results: Among the 60 patients, 55 patients with insomnia significantly improved their sleep efficiency, total sleep time and ISI score, of which 5 patients withdrew from CBTI treatment midway. Conclusion: Although CBT-I improves sleep outcomes and reduces the risks associated with reliance on hypnotics, patients are rarely referred to this treatment. Most research focused on pre-implementation work that revealed the complexity of delivering CBT-I in routine healthcare settings due to three distinct categories of barriers. First, system barriers result in limited access to CBT-I and behavioral sleep medicine (BSM) providers. Second, primary care providers are not adequately screening for sleep issues and referring appropriately due to a lack of knowledge, treatment beliefs, and a lack of motivation to assess and treat insomnia. Finally, patient barriers, including a lack of knowledge, treatment beliefs, and limited access, prevent patients from engaging in CBT-I. Increasing the application of CBT-I to insomnia patients in practical work requires a mature and systematic plan to develop and try to implement interventions at multiple levels.
</div>
%K 失眠，实施，失眠的认知行为疗法<br>Insomnia
%K Implementation
%K Cognitive Behavioral Therapy for Insomnia
%U http://www.hanspub.org/journal/PaperInformation.aspx?PaperID=37724