The Effect Of Cognitive Behavioral Therapy On Sleep Quality In Post-operation Renal Transplant Recipients

[Objective](1) To confirm the therapeutic intervention works theoretically, the researchers investigate the status of negative emotions and sleep quality, quality of life in Renal Transplant Recipients(RTRs), and then carry out to explore the correlation.(2) In order to be served as reference, the researchers determine the feasibility and effect of cognitive behavioral therapy on sleep quality RTRs.[Methods](1)This study used a cross-sectional design. A convenience sample of in total84 voluntary RTRs was recruited between July 2014 and May 2015 at a urology ward of a tertiary general hospital in Fujian, China. The Mental Status Scale in Non-psychiatric Settings(MSSNS) was used to measure the negative emotions,besides the sleep quality was measured by the Pittsburgh Sleep Quality Index(PSQI), and quality of life was evaluated by SF-12. Data were examined by descriptive statistics and Spearman correlation.(2)The study adopted a quasi-experimental design, with a comparison between an intervention group and a control group. Fifty-eight RTRs from a urology ward participated in this study, then who were allocated into intervention group(n=28)and control group(n=30) automatically. The data were collected from May 2015 to January 2016. The data collection tool comprised demographics data, the Mental Status Scale in Non-psychiatric Settings(MSSNS) and the Pittsburgh Sleep Quality Index(PSQI), SF-12. The intervention group received cognitive behavioural therapy for three weeks, while the control group received a routine nursing care.Data were analysed with t-test, and Mann-Whitney U test.[Results](1)The scores of PSQI and total of MSSNS, the physical component summaryand mental component summary of quality of life in RTRs were(8.27±3.86)and(55.79±14.65),(48.55±14.68)and(57.03±16.12)respectively.(1)Correlations were strong between anxiety and sleep latency, daytime dysfunction,PSQI; depression and daytime dysfunction, PSQI; daytime dysfunction and loneliness, anger; PSQI and anger.(2) There was a strong negative relationship between physical component summary and anxiety, depression; mental component summary and anxiety, depression, loneliness, anger.(3) physical component summary was significantly negative associated with daytime dysfunction, PSQI;mental component summary had significant negative association with sleep latency,sleep quality, sleep disturbance, daytime dysfunction, PSQI.(2)(1) The intervention group patients had significantly lower scores of depression and anger than those in the control group. No differences were found in anxiety, loneliness and total of MSSNS between the intervention group and the control group(P>0.05).(2)Participants in the intervention group had lower scores of PSQI and improved self-reported sleep quality, compared with those in the control group. In addition to significant increases in sleep duration, sleep latency and sleep efficiency, the cognitive behavioural therapy did not result in significant better off in other dimension of PSQI for who in the intervention group.(3)The cognitive behavioural therapy achieved significant improvements in the quality of life for the intervention group in mental component summary, whereas, it did not show significant changes in physical component summary.[Conclusion](1)The status of negative emotions in RTRs was similar to other inpatients.The sleep quality of RTRs was poor, more specifically sleep disturbance was common. Our results demonstrated the relationship among negative emotions,sleep quality and quality of life was overlapping.(2)There is still lack of sufficient evidence to fully support the validityand safety values of cognitive behavioural therapy in improving the sleep quality of RTRs, further research will be needed to confirm these efficacy.(3)Implementing cognitive behavioural therapy may have some positiveinfluence on the depression and anger in RTRs.(4) Sleep quality is benefited by providing cognitive behavioural therapy in RTRs.(5)Quality of life improved significantly in mental health after RTRs received cognitive behavioural therapy.