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Table 2 Positive aspects and difficulties of the intervention that were reported in both nominal groups or only in one nominal group

From: Assessing the feasibility and acceptability of a cluster-randomized study of cognitive behavioral therapy for chronic insomnia in a primary care setting

Both groups One group only
Positive aspects
 • PCPs provided valuable non-pharmacological treatment
 • There were opportunities to go deeper into the causes of insomnia
 • Other sociological and sleep hygiene problems were identified
 • The patient-therapist relationship improved
• There was positive support for treatment of insomnia
• The relaxation sessions had high value
• The “Manual of Interventions” was very helpful
Difficulties
 • Doctors considered the goals of the intervention as too ambitious
 • It required PCPs to change their roles, in that it they had to address emotional issues
 • The intervention did not permit deep examination of other problems that emerged during the sessions
 • There were too many sessions, and some patients withdrew for this reason
 • The sessions were too short
 • Some concepts were repeated in the different sessions
 • A reorganization of agendas is needed to continue the intervention
 • The tutorial material for PCPs was considered essential to structure the therapy, but was too dense. More simplified materials are needed
 • Written material for the patient about sleep hygiene, and control of stimuli and thoughts is needed
• More time and energy are required than a normal consultation. Therapy should be given when the therapist is less tired
• There was a need for preparations prior to the consultations
• There were many difficulties in the session on cognitive restructuring (Session 4)
• Simultaneous intervention and data collection was difficult
• The intervention was more feasible for nurses, because they have more time for consultation
• Patients were reluctant to work on a health problem if there is no immediate solution
• Patients who had little education had difficulties completing the sleep diary