Conceptualizing Cognitive-Behavioral Therapy as a Supportive-Educative Nursing System for Patients with Insomnia

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Self-Care and Dependent-Care Nursing, Vol: 22, Issue: 1

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Kurtz, Christine; Schmidt, Nola
Orem; self -care deficit nursing theory; insomnia; cognitive-behavioral therapy for insomnia; Nursing
article description
Difficulty initiating and maintaining sleep is one of the most common health complaints of the general population. Approximately 35-50% of people experience occasional insomnia symptoms (Walsh et al., 2011) while 12-20% have insomnia disorder (Morin, et al., 2011; Roth et al., 2011). An effective treatment is cognitive behavioral therapy for insomnia (CBT-I; Schutte-Rodin, Broch, Buysse, Dorsey, & Sateia, 2008), a nonpharmacological, evidence-based intervention aimed at changing sleep behaviors. The purpose of this paper is to frame CBT-I as a nursing intervention for insomnia within the context of Orem’s self-care deficit nursing theory (Orem, 2001). Orem’s theory provides a framework from which to view the process of improving patients’ sleep using CBT-I as a supportive-educative nursing system. Through the therapies of CBT-I, patients develop the power components of selfcare agency resulting in behavior change, which is consistent with Orem’s notion of deliberate action and self-care. Because holistic patient care, support, and patient teaching are fundamental aspects of nursing care to which nurses are acculturated, nurses are ideally suited to provide CBT-I.