Instant Message-delivered Cognitive Behavioural Therapy for Insomnia (CBT-I)Stroke Caregivers
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ClinicalTrials.gov Identifier: NCT05952245 |
Recruitment Status :
Not yet recruiting
First Posted : July 19, 2023
Last Update Posted : July 19, 2023
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Condition or disease | Intervention/treatment | Phase |
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Stroke Insomnia Depressive Symptoms Caregiver Burnout Psychological Distress Mobile Phone Use | Behavioral: iCBTI-based EMI | Not Applicable |
Existing studies reported that 40-95% of family caregivers had clinically significant insomnia symptoms including reduced total sleep duration, prolonged sleep onset latency, frequent night awakenings, and poor sleep efficiency and quality.
Cognitive-behavioural therapy for insomnia (CBT-I) has shown a large effect in reducing insomnia among adults. Innovative and interactive technologies, such as Internet-delivered CBT-I (iCBT-T), have therefore been incorporated into CBT-I, which was identified to have similar effects to that of traditional CBT-I.
In the proposed trial, screened stroke caregivers will be recruited from community centres, rehabilitation centres, and tertiary hospitals in HK. The intervention group will receive CBTI-based EMI through instant messaging applications( e.g., WhatsApp) as personalised and real-time psychological support led by nurses for 12 weeks. The control group will only receive stroke education messages and chat-based psychological support without the CBT-I content. The primary outcomes are Sleep Condition Indicator (SCI) and Insomnia Severity Index (ISI) scores. Secondary outcomes will include sleep quality, depressive symptoms, anxiety symptoms, caregiver's burden, and quality of life. A post-trial qualitative study will be conducted to understand the participants' experience of and compliance with the EMI.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 138 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Double (Participant, Investigator) |
Primary Purpose: | Other |
Official Title: | The Effect of Instant Message-delivered Brief Cognitive Behavioural Therapy for Insomnia (CBT-I) in Stroke Family Caregivers: a Mixed Method Study |
Estimated Study Start Date : | August 1, 2023 |
Estimated Primary Completion Date : | July 15, 2024 |
Estimated Study Completion Date : | October 15, 2024 |
Arm | Intervention/treatment |
---|---|
Experimental: Intervention Group
Receiving CBT-I based EMI messages.
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Behavioral: iCBTI-based EMI
Including brief iCBT-I for sleep support, stroke care education, and nurse-led real-time chat-based support messages, which were delivered according to participants' preferences (e.g., time and frequency). |
No Intervention: Control Group
Receiving stroke education messages.
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- Sleep Condition Indicator (SCI) [ Time Frame: 24 weeks ]An eight-item rating scale that was developed to screen for insomnia disorder based on DSM-5 criteria. Possible total score ranges from 0 to 32, with higher values indicative of better sleep.
- Insomnia Severity Index (ISI) [ Time Frame: 24 weeks ]A 7-item scale with scoring ranging from 0-28, a higher score indicate more severe insomnia symptoms
- Sleep quality (Pittsburgh Sleep Quality Index [PSQI]) [ Time Frame: 24 weeks ]A 19-item scale ranging from 0 to 21 with the higher total score (referred to as global score) indicating worse sleep quality
- Depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]): [ Time Frame: 24 weeks ]A 9-item scale with score ranging from 0 to 27, higher scores indicate higher severity of depressive symptom
- Anxiety symptoms (Generalized Anxiety Disorder-7 [GAD-7]) [ Time Frame: 24 weeks ]A 7-item scale with score ranging from 0 to 21, higher scores indicate higher severity of anxiety symptom
- Caregiver's burden (Zarit Burden Interview [ZBI-4]) [ Time Frame: 24 weeks ]A 4-item scale with score ranging from 0 to 16, higher scores indicate higher severity of caregiving burden
- Quality of life (EuroQol 5-dimension 5-level questionnaire [EQ-5D-5L]) [ Time Frame: 24 weeks ]A generic tool for Patient-Reported Outcomes measurement that can assess patients' quality of life, irrespective of the disease.
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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Primary family caregiver (Aged ≥18) of stroke survivor
- Able to read and communicate in Chinese
- Engaged caregiving roles for > 4 hours per day;
- Able to use a smartphone messaging app (e.g., WhatsApp and WeChat)
- SCI ≤ 20 scores (i.e., clinically significant insomnia)
Exclusion Criteria:
- Has provided care for <1 month prior to recruitment
- Has a diagnosis of psychiatric disease or is currently taking psychotropic drugs
- Currently taking medication to help with sleep
- Currently participating in any type of psychological intervention
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05952245
Contact: Jung Jae LEE | +852 3917 6971 | leejay@hku.hk |
Hong Kong | |
Hong Kong PHAB Association | |
Hong Kong, Hong Kong | |
Contact: Gary Lau 24268338 garypau@hkphab.org.hk | |
Hong Kong Stroke Association | |
Hong Kong, Hong Kong | |
Contact: Ming Chui 23078257 hk_stroke_a@yahoo.com | |
NT West Community Centre | |
Hong Kong, Hong Kong | |
Contact: So 24569577 ncrc.sw@naac.org.hk | |
Queen Mary Hospital | |
Hong Kong, Hong Kong | |
Contact: Gary Lau 22554249 gkklau@hku.hk | |
The Hong Kong Society for Rehabilitation | |
Hong Kong, Hong Kong | |
Contact: Mike Cheung 22056336 mike.cheung@rehabsociety.org.hk |
Responsible Party: | The University of Hong Kong |
ClinicalTrials.gov Identifier: | NCT05952245 |
Other Study ID Numbers: |
CBTI2023 |
First Posted: | July 19, 2023 Key Record Dates |
Last Update Posted: | July 19, 2023 |
Last Verified: | June 2023 |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Stroke Sleep Initiation and Maintenance Disorders Depression Caregiver Burden Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases |
Vascular Diseases Cardiovascular Diseases Sleep Disorders, Intrinsic Dyssomnias Sleep Wake Disorders Mental Disorders Behavioral Symptoms Stress, Psychological |