Poster Presentation Cancer Survivorship Conference 2023

Protocol for a single-arm feasibility study of a group-based telehealth cognitive behavioural therapy program for insomnia in Vietnamese-speaking cancer survivors (#166)

Mei Tran 1 , Maria Ftanou 1 2
  1. Psychosocial Oncology Program, Peter MacCallum Cancer Centre, Parkville, VIC, Australia
  2. The University of Melbourne, Melbourne, VIC, Australia

Background: The prevalence of significant sleep disturbances, such as insomnia, in head and neck cancer survivors is double that reported in the general population1. Insomnia is associated with myriad adverse outcomes2,3, highlighting the importance of providing an intervention for insomnia among head and neck cancer survivors. Cognitive Behavioural Therapy for Insomnia (CBT-I) is the gold standard treatment for insomnia4. Despite people from Vietnamese-speaking backgrounds reporting worse insomnia outcomes compared to Caucasian populations5, CBT-I has not yet been adapted and trialled in relevant cancer survivors, leading to inequalities in accessing evidence-based health care. This study aims to evaluate the feasibility and potential efficacy of the first manualised, group-based CBT-I intervention for Vietnamese-speaking cancer survivors delivered via telehealth. 

Methods: We aim to recruit twenty Vietnamese-speaking people who have completed definitive treatment for head and neck cancer from the Head and Neck outpatient clinics at Peter MacCallum Cancer Centre. Eligible survivors will have clinically significant insomnia symptoms as indicated by the Pittsburgh Sleep Quality Index (PSQI ≥ 5)6 and low risk of sleep disorders not amenable to CBT-I (restless legs syndrome, obstructive sleep apnoea). Participants will complete the manualised CBT-I intervention7, which includes six group sessions delivered via telehealth by a Vietnamese-speaking clinical psychologist. The intervention will be evaluated in terms of 1) feasibility (consent and recruitment rates; compliance with study measures; intervention adherence); 2) acceptability (participant satisfaction and experiences); 3) intervention fidelity (delivery of CBT-I as planned); and 4) changes in sleep quality assessed by the Vietnamese PSQI. 

Conclusion: This study will be the first to evaluate a manualised group-based CBT-I intervention for Vietnamese-speaking cancer survivors. If the intervention is found to be feasible and acceptable, this has the potential to address a significant unmet need for Vietnamese-speaking people with cancer.

  1. Santoso AMM, Jansen F, de Vries R, Leemans CR, van Straten A, Verdonck-de Leeuw IM. Prevalence of sleep disturbances among head and neck cancer patients: A systematic review and meta-analysis. Sleep Medicine Reviews. 2019;47:62-73
  2. Daley M, Morin CM, LeBlanc M, Grégoire JP, Savard J, Baillargeon L. Insomnia and its relationship to health-care utilization, work absenteeism, productivity and accidents. Sleep Medicine. 2009;10(4):427-38.
  3. Lis CG, Gupta D, Grutsch JF. The relationship between insomnia and patient satisfaction with quality of life in cancer. Supportive Care in Cancer. 2008;16(3):261-6.
  4. Siebern AT, Manber R. New developments in cognitive behavioral therapy as the first-line treatment of insomnia. Psychology Research and Behavior Management. 2011;4:21-8.
  5. Nguyen SY. Comparison of Sleep Attitudes and Beliefs among Older Adult Vietnamese Migrants and Australians with and without Insomnia. Melbourne, Victoria, Australia: Victoria University; 2017.
  6. Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research. 1989;28(2):193-213.
  7. Savard J, Simard S, Ivers H, Morin CM. Randomized Study on the Efficacy of Cognitive-Behavioral Therapy for Insomnia Secondary to Breast Cancer, Part I: Sleep and Psychological Effects. Journal of Clinical Oncology. 2005;23(25):6083-96.