臺灣慢性失眠症患者求助阻礙及其對於非藥物專業介入之態度研究

Barriers to Intervention-Seeking and Attitudes Toward Non-Pharmacological Intervention-Seeking for Chronic Insomnia Patients in Taiwan

心理行為因子對慢性失眠症（chronic insomnia disorder）的發展與維持扮演重要角色，然而個案接受非藥物專業介入（失眠的認知行為治療）之比率低。本研究探討慢性失眠症患者尋求非藥物專業介入之阻礙因素及態度。研究納入55名（男：女 = 7：48，平均年齡 = 40.91±12.94歲）具有慢性失眠症症狀及診斷之受訪者，填寫一量化問卷組及進行半結構式訪談。結果顯示缺乏對失眠症正確認知及缺乏可運用因應策略的知識為最常見之阻礙因素，其他因素包含：對污名化的擔憂、難實行醫師建議之非藥物專業建議、未有機會與醫院其他專業人員建立同盟關係等。所有受訪者均未具備有對失眠的認知行為治療之知識且無實際接受治療之經驗，其中僅27.3%有意願嘗試。此一結果與Stinson、Tang及Harvey（2006）研究結果相近，未來可納入曾具有非藥物介入經驗之受訪者延伸對慢性失眠症患者接受此一類介入的阻礙之認識。

 

The pathology of chronic insomnia disorder shows that psychosocial factors play an important role. However, non-pharmacologic interventions such as Cognitive Behavioral Therapy for Insomnia (CBTi) are seldom used in Taiwan. The purpose of this study was to explore the reasons why insomnia patients seldom use these interventions and their attitudes toward them. Fifty-five participants were recruited. All of them completed questionnaires wich were followed by a semi-structured interview. Results show that “a lack of knowledge regarding chronic insomnia and available treatment options” are the most commonly mentioned reasons. Other reasons include percieved stigma surrounding insomnia, the difficulties of following non-pharmacologic suggestions given by physicians, and a lack of opportunity to establish meaningful relationships with other medical professionals (such as clinical psychologists or therapists). At the time of the study, none of the participants had any knowledge of CBTi, and only 27.3% participants said they would want to use it after learning more about it. Reasons why patients drop out of nonpharmacologic interventions still need to be further explored.