Sick and Tired: Understanding and Managing Sleep Difficulties in ...

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and medication use. A sound check was completed before commencing the interview to ensure the sounds quality was sufficient to enable accurate transcription. A brief semi- structured interview schedule (Table 11, p. 112) was developed to guide the interview, asking broad questions about the participant‟s illness, symptom experience and daytime functioning. The interview schedule enabled the researcher to explore areas relating to the research question, while providing the flexibility for the participant to talk about the issues that were important to them and for the researcher to explore interesting concepts emerging during the interview. In accordance with the IPA approach the questions remained broad, to enable the participant to express openly what the experience meant to them. Prompts were only used if they were required to facilitate the interview and to encourage the participant to talk about their experiences. All interviews were conducted at participants‟ home to enable participants to feel comfortable in their surroundings during the interview. Interviews were conducted with only the researcher and participant present, although it should be noted that for two participants, other people were present in other areas of the house which may have influenced how participants responded. The interviews were recorded using a digital voice recorder and were later transcribed verbatim and checked by an independent researcher for accuracy of transcription. All 16 participants who met the study criteria and expressed an interest in the study completed the interview. 111
Table 11. Interview schedule for the qualitative interviews How would you describe your quality of life with fibromyalgia? Prompts (to be used only if additional guidance is required); How did you receive your diagnosis? What are your main fibromyalgia symptoms? What do you believe to be the cause of your fibromyalgia? What effect does having fibromyalgia have on your life? Could you describe a typical day living with fibromyalgia? How would you describe the quality of your sleep? Prompts (to be used only if additional guidance is required); Can you tell me about your typical sleeping pattern? When would you usually go to bed? Could you describe a typical evening when you are preparing to go to bed? What effects your sleep quality? How does your sleep quality affect you? How do you cope with your fibromyalgia symptoms? Prompts (to be used only if additional guidance is required); Data Analysis Is there anything that helps you to manage your fibromyalgia? What support have you received? The data was analysed and coded by two researchers, independently using the recommended IPA approach (Smith, 2003). The interview transcripts were read several times to increase familiarity with the data and a layered analysis approach was used. All transcripts were typed into a table format with an empty column to the left and right of the transcript. Initial comments and preliminary interpretations of the data were noted in the right hand columns with key words and phrases highlighted within the transcript itself. These initial comments and preliminary interpretations were then used as a basis for analysis of subsequent 112
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Sick and Tired: Understanding and M
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Chapter Four. The Nature and Effect
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References ........................
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List of Tables Table 1. Participant
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Co-authored Works Although the stud
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Acknowledgments This thesis would n
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Intellectual Property Rights There
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Confidential Material No participan
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The role of sleep in FMS appears to
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little information was available as
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Psychophysiologic insomnia which is
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and are less able to inhibit the pa
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widely applied in clinical practice
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of fewer tender points; usually bet
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Current Management Strategies The t
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also likely to depend on a number o
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deep sleep (stages three and four)
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Although sleep moves through the sl
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Figure 3. The Integrative Model of
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However, conducting a blood test is
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As sleep is a complex process invol
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Sleep Diaries Sleep diaries are a k
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pain). Lentz et al (1999) revealed
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These results have also been suppor
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(McCracken & Iverson, 2002) which s
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Figure 4. Conceptual model of the d
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Clinical Implications Despite the p
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Chapter Three. Sleep in FMS As high
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& Penzien, 2003), although alpha wa
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pauses in breathing indicative of s
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Relationships between Sleep and Pai
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Managing Sleep Disturbance in FMS D
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may be possible to help patients im
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person to initiate an action (such
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and Nicassio et al (1995) only expl
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1) Poor sleep quality, defined by t
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elow 0.7 are acceptable. Therefore
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heart disease (Epstein et al., 1999
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Page 79 and 80: questionnaire 78 (77.2%) of the par
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Page 83 and 84: Older age and longer length of illn
Page 85 and 86: Table 2. Correlations between demog
Page 87 and 88: Logistic Regression As 97% of the s
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Page 91 and 92: Relationship between Negative Affec
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Page 97 and 98: eactions are most likely to be detr
Page 99 and 100: It has been suggested that the auto
Page 101 and 102: For both groups, participants were
Page 103 and 104: with and without chronic medical co
Page 105 and 106: As previously described on page 61,
Page 107 and 108: Figure 7. Scree plot for the explor
Page 109 and 110: Figure 8. Scree plot for the explor
Page 111 and 112: Table 6. Participant characteristic
Page 113 and 114: Table 7. Measures of central tenden
Page 115 and 116: CON = DBAS-10 Dysfunctional beliefs
Page 117 and 118: The Exp (B) values revealed that hi
Page 119 and 120: has explored the use of napping on
Page 121 and 122: It became clear, through the analys
Page 123 and 124: interventions. With this in mind, t
Page 125 and 126: The philosophy of phenomenology was
Page 127: Methods Participants were given a w
Page 131 and 132: Rigour The interview transcripts we
Page 133 and 134: “The main symptom is this overwhe
Page 135 and 136: Theme Two. Inter-relationship betwe
Page 137 and 138: where I live, so I don‟t know, I
Page 139 and 140: Participants also described how the
Page 141 and 142: “XXXX (name of person) planned a
Page 143 and 144: A strong theme that emerged in this
Page 145 and 146: conducted at several time points, w
Page 147 and 148: Chapter Seven. Investigating the Ef
Page 149 and 150: activities because they no longer f
Page 151 and 152: Therefore as this was a feasibility
Page 153 and 154: Self-reported sleep quality was ass
Page 155 and 156: The progressive muscle relaxation (
Page 157 and 158: Exploring the baseline data, there
Page 159 and 160: Consequently, univariate analysis w
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Page 163 and 164: people with FMS (Perlis, Giles, Men
Page 165 and 166: The aim of this study was to explor
Page 167 and 168: observed in perceived overall sleep
Page 169 and 170: elaborated on in Chapter Six, which
Page 171 and 172: Four) revealed that global sleep qu
Page 173 and 174: Modifications to the Call-Schmidt a
Page 175 and 176: MBSR programme in people with FMS (
Page 177 and 178: diagnostic criteria for these sleep
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comprehensive measures to look at t
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References Abad, V. C., Sarinas, P.
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Brand, S., Gerber, M., Beck, J., Ha
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Crofford, L. J., & Demitrack, M. A.
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Goldenberg, D. L., Kaplan, K. H., N
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Johns, M. W. (2002). Sleep propensi
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Leung, Y. Y., Ho, K. W., Zhu, T. Y.
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Mease, P. J. (2005). Fibromyalgia s
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symptoms in healthy subjects; Corre
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approach with illustration to the h
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Thomas, E. N., & Blotman, F. (2010)
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Yunus, M. B., Masi, A. T., & Aldag,
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Appendices Appendix A: Search Strat
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Sleep and Fibromyalgia Syndrome Con
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190
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The following questions relate to y
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There are lots of ways to try to de
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42. I try hard to prevent other thi
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During the past month have you had
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Appendix E: Published paper of Stud
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Sleep and Fibromyalgia Syndrome Con
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Appendix H: Participant Questionnai
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Below are 10 statements reflecting
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The questions in this scale ask you
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Appendix I. Published Paper for Stu
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Appendix K. Information Sheet and C
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Sleep in Fibromyalgia Syndrome Cons
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Appendix L: Letter of Ethical Appro
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Appendix M. Letter to GPs for Study
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What are the side effects of any tr
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Appendix O: Poster Advertising Stud
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Appendix Q: Participant Questionnai
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HAD Scale Read each item and place
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During the past month have you had
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Appendix R. Letter from Dr Mark Cro
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PUBLICATIONS Peer Reviewed Journal
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and panic-like episodes, Faculty of
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