BACKGROUND Insomnia is a common sleep complaint, with 10% of adults in the general population experiencing insomnia disorder, defined as lasting longer than three months in DSM-5. Up to 50% of patients attending family practice experience insomnia, however despite this, symptoms of insomnia are not often screened for, or discussed within this setting. We aimed to examine barriers to the assessment and diagnosis of insomnia in family practice from both the clinician and patient perspective. METHODS The present article identified research that has examined barriers to assessing insomnia from the clinician's and the client's perspectives following MEDLINE and Google Scholar searches, and then classified these barriers using the theoretical domains framework. RESULTS The most common barriers from the clinician's perspective were related to Knowledge, Skills, and the Environmental Context. From the patient perspective, barriers identified included their Beliefs about the consequences of Insomnia, Social Influences, and Behavioural Regulation of Symptoms. CONCLUSIONS Utilising this theoretical framework, we discuss options for bridging the gap between the identification and subsequent management of insomnia within the family practice setting. To assist clinicians and those in community health care to overcome the Knowledge and Skills barriers identified, this article provides existing relevant clinical criteria that can be utilised to make a valid diagnosis of insomnia.

中文翻译：

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临床医生和患者在家庭实践中认识失眠的障碍：使用理论领域框架分析的报道文献的叙述性总结。


背景技术失眠是一种常见的睡眠问题，一般人群中有 10% 的成年人患有失眠症，DSM-5 中将失眠症定义为持续时间超过三个月。高达 50% 参加家庭诊所的患者经历过失眠，但尽管如此，失眠症状并不经常在这种情况下进行筛查或讨论。我们的目的是从临床医生和患者的角度探讨家庭实践中失眠评估和诊断的障碍。方法 本文通过 MEDLINE 和 Google Scholar 搜索，从临床医生和客户的角度审视了评估失眠的障碍，然后使用理论领域框架对这些障碍进行了分类。结果 从临床医生的角度来看，最常见的障碍与知识、技能和环境背景有关。从患者的角度来看，发现的障碍包括他们对失眠后果的信念、社会影响和症状的行为调节。结论 利用这一理论框架，我们讨论了缩小家庭实践中失眠的识别和随后的治疗之间差距的选择。为了帮助临床医生和社区卫生保健人员克服已确定的知识和技能障碍，本文提供了现有的相关临床标准，可用于对失眠进行有效的诊断。