Behavior-analytic intervention for women with fibromyalgia and insomnia: a single subject design

Kirchner, Luziane de Fátima; Reis, Maria de Jesus Dutra dos

doi:10.1186/s41155-020-00169-2

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Research • Psicol. Reflex. Crit. 34 • 2021 • https://doi.org/10.1186/s41155-020-00169-2 copy

Behavior-analytic intervention for women with fibromyalgia and insomnia: a single subject design

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study evaluated the effects in the pain and sleep, and the clinic significance after an analytic-behavioral intervention to manage the condition of the physical and interpersonal environment related to pain. Four women with fibromyalgia and insomnia participated in a study with intervention withdrawal multiple baseline design and initial, intermediate, final, and follow-up assessments. Self-report instruments were used to assess pain intensity and disability, sleep quality, and insomnia severity, besides the actigraphy. Data showed that the intervention (20 sessions) was effective in reducing the sleep and pain problems in all participants by shifting two participants from clinical to non-clinical status in sleep indicators. The gains were maintained or increased in follow-up measures. However, the results should take into consideration the clinical condition and other variables that may have individually impacted the results.

Keywords:
Fibromyalgia; Insomnia; Behavioral intervention

	P1	P2	P3	P4
Age	47 years old	59 years old	47 years old	58 years old
Schooling	Unfinished elementary school	Finished elementary school	Finished high school	Finished elementary school
Marital status	Common-law marriage	Married	Divorced	Married
FM diagnostic time	8 years	13 years	10 years	25 years
Insomnia nature	Beginning/maintenance	Maintenance	Beginning/maintenance	Maintenance
Other health problems	Osteoarthritis, column deviation	Spinal deviation hypertension	Carpal tunnel, inflate sciatic nerve, nephritis tricuspid valve tube	Synovial cyst, duodenal ulcer, osteoarthritis
Current medications	Anti-inflammatory	Anti-depressant, analgesic, anti-vertigo, anti-hypertensive	Anti-ulcer, analgesic	Anti-inflammatory
Treatments/ current activities	None	None	None	Labor activity at work (20 min)
Profession/ current condition	Access controller/ unemployed	Housewife/working	Lunch lady/working	Producing assistant/ working

Participant evaluation		Sleep onset latency (min)	Sleep efficiency (%)	Wake time after sleep onset (min)	Number of awakenings
P1
	Initial	33	87	53	14
	Intermediate	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data
	Final	17	97	14	5
	Follow-up	^▬ ▬ The participant did not use the actigraph at night	^▬ ▬ The participant did not use the actigraph at night	^▬ ▬ The participant did not use the actigraph at night	^▬ ▬ The participant did not use the actigraph at night
P2
	Initial	19	96	14	8
	Intermediate	15	88	17	30
	Final	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data
	Follow-up	10	96	33	15
P3
	Initial	54	88	53	16
	Intermediate	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data
	Final	30	96	23	12
	Follow-up	24	82	45	19
P4
	Initial	53	82	33	13
	Intermediate	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data
	Final	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data	^# # The actigraph did not record the participants data
	Follow-up	^▬ ▬ The participant did not use the actigraph at night	^▬ ▬ The participant did not use the actigraph at night	^▬ ▬ The participant did not use the actigraph at night	^▬ ▬ The participant did not use the actigraph at night

Curso de Pós-Graduação em Psicologia da Universidade Federal do Rio Grande do Sul Rua Ramiro Barcelos, 2600 - sala 110, 90035-003 Porto Alegre RS - Brazil, Tel.: +55 51 3308-5691 - Porto Alegre - RS - Brazil
E-mail: prc@springeropen.com

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[1] *Correspondence: luzianefk@gmail.com