ผลของโปรแกรมการบำบัดความคิดและพฤติกรรมต่ออาการนอนไม่หลับ    ของผู้ป่วยสูงอายุโรคซึมเศร้า

เยาวนาถ คำแก้ว; รังสิมันต์ สุนทรไชยา; มุทิตา พนาสถิตย์

Authors

เยาวนาถ คำแก้ว
รังสิมันต์ สุนทรไชยา
มุทิตา พนาสถิตย์

Keywords:

cognitive-behavioral therapy program, insomnia, elderly patients with major depressive disorder

Abstract

This randomized controlled study aimed to examine the effects of a cognitive-behavioral therapy program on insomnia among elderly patients with major depressive disorder. The sample consisted of 60 elderly patients with major depressive disorder drawn from the Geriatric Hospital in Bangkok, Thailand. To be eligible for the study, the participant had to meet the following criteria: (a) elderly patients with mild to moderate insomnia, and (b) 60 years of age or older. Thirty participants were randomly assigned to the experimental group and 30 to the control group. The experimental group received the cognitive-behavioral therapy program for 5 sessions, once a week, with each session lasting 60-90
minutes, whereas the control group received routine nursing care. The research instruments were:1) the cognitive-behavioral therapy program, which was content validated by 3 experts; and 2) the Insomnia Severity Index (ISI) Thai version, the CVI was 0.81 and validated by 3 experts and the Cronbach’s
alpha coefficient reliability was 0.73 and examined by 30 elderly patients with major depressive disorder. Data were analyzed using descriptive statistics and t-test.

Research findings were as follows: 1) The mean score for insomnia among elderly patients with major depressive disorder in the experimental group after participating in the cognitive-behavioral therapy program (Mean = 6.70, SD.=3.04)
was statistically significant lower than that before participating in the program (Mean = 14.43, SD.=3.30) (t=16.22, p<.001). 2) The mean difference in insomnia among elderly patients with major depressive disorder between the pretest and posttest in the experimental group after participating in the cognitive-behavioral therapy program ( = 7.73, S.D.=2.62) was statistically significant higher than the mean difference in insomnia in the control group ( = .40, S.D.=1.07) (t=14.23, p<.001). Findings of this study suggest that this cognitive-behavioral therapy program had a significant impact to reduce insomnia among elderly patients with major depressive disorder. Healthcare providers could apply this program as an alternative intervention to reduce insomnia among elderly patients with major depressive disorder.

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