Doctor of Philosophy (PhD) in Occupational Therapy
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College of Health Care Sciences – Occupational Therapy Department
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Nova Southeastern University
Brandi M. Fulwider. 2020. Implications of a Multicomponent Sleep Program After Brain Injury: A Mixed Methods Study. Doctoral dissertation. Nova Southeastern University. Retrieved from NSUWorks, College of Health Care Sciences – Occupational Therapy Department. (78)
Decreased sleep can negatively affect mental and physical health and can significantly disrupt participation in daily occupations and leisure interests. Even though sleep is an area of occupation, there is limited evidence on the effectiveness of occupational therapy interventions for sleep. The purpose of this embedded mixed methods research study was to identify how disruptions in sleep affected daily occupational performance and to understand the effectiveness of occupational therapy- directed non-pharmacological sleep interventions for three participants in a community re-entry program for brain injury. This study utilized a single-subject research design during a 4- to 5-week multicomponent sleep program using multiple sleep-related outcome measures and daily sleep diary and Fitbit data. Semi-structured interviews were also utilized. Identified qualitative themes were changes in sleep patterns and living with sleep disturbance. Participants reported decreased energy and fatigue after disrupted sleep but also reported still being able to complete daily occupations. Quantitative results yielded variable changes in sleep, with overall positive responses to interventions noted in a cumulative effect over time. The most significant improvements were in sleep efficiency and total sleep time for all three participants using sleep diary data. Additionally, two participants reported decreased sleepiness and increased functional outcomes after participating in the sleep interventions. In conclusion, simple behavioral, occupational, and environmental adaptations can improve sleep after brain injury. This study also further supports the role of occupational therapy in addressing sleep in education, practice, and research.
Multicomponent sleep program, Brain injury