0404 Heart Failure Nurses’ Perceptions of Cognitive Behavioral Therapy for Insomnia and the Feasibility of Providing it to Patients

Abstract Introduction People with heart failure (HF) often report insomnia. Despite strong evidence to support treatment with Cognitive Behavioral Therapy for Insomnia (CBT-I), few with HF have access to CBT-I programs. Access may be improved if it is offered where HF patients receive their medical care, but little is known about the feasibility of doing so. The purpose of this focus group study was to explore HF Nurses’ perceptions of: the importance of insomnia and the value of CBT-I to their patients; the feasibility of making CBT-I available in clinic settings and its delivery by HF nurses; and preferences for alternative modes of delivery. Methods We used a descriptive qualitative study design. We recruited focus group participants via electronic invitation to members of the American Association of Heart Failure Nurses and through requests to local nurse collaborators to distribute within their networks. We conducted virtual focus groups. After providing a brief description of the components of CBT-I and its efficacy in the HF population, we elicited participant perceptions of the value of providing CBT-I for HF patients in the clinic setting, facilitators and barriers to implementation, and ways to increase access to CBT-I. We audio-recorded the focus group discussions and used a professional transcription service. Two researchers coded the data and performed thematic content analysis. Results We conducted four focus groups with registered nurses and advanced practice nurses employed in HF clinics (N=23). Nurses endorsed the importance of sleep to HF patients, their interest in addressing sleep, perceived benefits of CBT-I, and the need for increased resources to address sleep in the clinic setting. They favored multiple modes of CBT-I delivery extending beyond the clinic. All nurses believed they had a role to play in addressing sleep, but differed in their views about the possibility of becoming CBT-I interventionists and the training and support needed to do so. Conclusion HF nurses recognize the importance of insomnia and support the implementation of CBT-I. Implementation studies are needed to identify effective methods of increasing access to evidence based CBT-I in the HF clinic setting, including appropriate support and training for nurses with interest in CBT-I delivery. Support (if any) R01NR01691