2.50
Hdl Handle:
http://hdl.handle.net/10755/157361
Type:
Presentation
Title:
INFLUENCE OF TREATMENT PREFERENCES ON OUTCOMES
Abstract:
INFLUENCE OF TREATMENT PREFERENCES ON OUTCOMES
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Sidani, Souraya, PhD
P.I. Institution Name:Ryerson University
Title:Professor
Contact Address:350 Victoria Street, Toronto, ON, M5B2K3, Canada
Co-Authors:Dana R. Esptein; Patricia Moritz
PURPOSES/AIMS: The specific aims of this methodological study was to compare the sleep outcomes for participants who received minimal intervention (sleep education and hygiene) or experimental intervention (cognitive-behavioral therapy) on the basis of chance or preference.
RATIONALE/CONCEPTUAL BASIS/BACKGROUND: Preferences for treatment represent participants' choices of treatment, derived from their understanding of the treatment options and perception of treatment acceptability. Treatment preferences are implicated as potential threats to internal validity in intervention research. Participants assigned to non-preferred treatment experience disappointment and are less motivated to adhere to treatment, leading to poor outcome achievement. Participants assigned to treatment of choice are satisfied with and adhere to treatment, resulting in the expected improvement in outcomes. This study examined the influence of preferences on the sleep outcomes of behavioral interventions for managing insomnia.
METHODS: The data were obtained from two sites that participated in a larger methodological study. The two sites had participants with comparable baseline characteristics and implemented the same interventions, but differed in the method of assigning participants to treatment. Participants (n = 242) were middle-aged, non-married white women, with moderate level of insomnia severity. Minimal intervention consisted of sleep education and hygiene (SEH) given in a form of booklet. Experimental intervention involved stimulus control instructions and sleep restriction therapy, given in group format in 6 sessions. The method of assignment to treatment was random in site 1 and based on participants' preferences in site 2. Sleep outcomes were assessed with daily sleep diary (sleep onset latency - SOL; wake after sleep onset - WASO, sleep efficiency - SE) and the Insomnia Severity Index, at pretest and posttest. Analysis of covariance, controlling for pretest scores was used to examine differences in posttest outcomes between method of assignment (random vs. preference) and type of treatment (minimal vs. experimental).
RESULTS: Significant method of assignment x type of treatment interaction effect was found for sleep efficiency (F(1,230) = 7.1, p < .01). Significant method of assignment main effect was observed for WASO (F(1,230) = 5.3, p <.05) and significant type of intervention main effects were noted for all outcomes. The results indicate that overall, participants who received the experimental intervention showed greater improvement in the sleep outcomes, and participants who were allocated to the intervention of their preference had lower WASO and higher SE than those randomized to treatment.
IMPLICATIONS: The findings provide evidence of the influence of treatment preferences on outcomes and have implications for the design of intervention studies. Treatment preferences have to be accounted for to enhance the validity and clinical relevance of intervention research results.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleINFLUENCE OF TREATMENT PREFERENCES ON OUTCOMESen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157361-
dc.description.abstract<table><tr><td colspan="2" class="item-title">INFLUENCE OF TREATMENT PREFERENCES ON OUTCOMES</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Sidani, Souraya, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Ryerson University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">350 Victoria Street, Toronto, ON, M5B2K3, Canada</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">ssidani@ryerson.ca</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Dana R. Esptein; Patricia Moritz</td></tr><tr><td colspan="2" class="item-abstract">PURPOSES/AIMS: The specific aims of this methodological study was to compare the sleep outcomes for participants who received minimal intervention (sleep education and hygiene) or experimental intervention (cognitive-behavioral therapy) on the basis of chance or preference. <br/>RATIONALE/CONCEPTUAL BASIS/BACKGROUND: Preferences for treatment represent participants' choices of treatment, derived from their understanding of the treatment options and perception of treatment acceptability. Treatment preferences are implicated as potential threats to internal validity in intervention research. Participants assigned to non-preferred treatment experience disappointment and are less motivated to adhere to treatment, leading to poor outcome achievement. Participants assigned to treatment of choice are satisfied with and adhere to treatment, resulting in the expected improvement in outcomes. This study examined the influence of preferences on the sleep outcomes of behavioral interventions for managing insomnia. <br/>METHODS: The data were obtained from two sites that participated in a larger methodological study. The two sites had participants with comparable baseline characteristics and implemented the same interventions, but differed in the method of assigning participants to treatment. Participants (n = 242) were middle-aged, non-married white women, with moderate level of insomnia severity. Minimal intervention consisted of sleep education and hygiene (SEH) given in a form of booklet. Experimental intervention involved stimulus control instructions and sleep restriction therapy, given in group format in 6 sessions. The method of assignment to treatment was random in site 1 and based on participants' preferences in site 2. Sleep outcomes were assessed with daily sleep diary (sleep onset latency - SOL; wake after sleep onset - WASO, sleep efficiency - SE) and the Insomnia Severity Index, at pretest and posttest. Analysis of covariance, controlling for pretest scores was used to examine differences in posttest outcomes between method of assignment (random vs. preference) and type of treatment (minimal vs. experimental). <br/>RESULTS: Significant method of assignment x type of treatment interaction effect was found for sleep efficiency (F(1,230) = 7.1, p &lt; .01). Significant method of assignment main effect was observed for WASO (F(1,230) = 5.3, p &lt;.05) and significant type of intervention main effects were noted for all outcomes. The results indicate that overall, participants who received the experimental intervention showed greater improvement in the sleep outcomes, and participants who were allocated to the intervention of their preference had lower WASO and higher SE than those randomized to treatment. <br/>IMPLICATIONS: The findings provide evidence of the influence of treatment preferences on outcomes and have implications for the design of intervention studies. Treatment preferences have to be accounted for to enhance the validity and clinical relevance of intervention research results.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:48:13Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:48:13Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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