Sleep problems in physically disabled children and burden on caregivers

The effect of humanistic behavior skills in nursing practice on caregiving competence

BackgroundThe need for care of patients is increasing day by day as societies age. In parallel with the increase in the need for care, the adequacy of the care provided and the factors affecting it gain importance.ObjectiveThis study aims to determine the effect of nurses' humanistic behavior skills on caregiving competence and the factors affecting it.MethodsThe study sample consisted of 445 nurses working in a state hospital and selected by random sampling method. The study data were collected between January and April 2023. Face-to-face interview method was used to collect the data. The questionnaire application was conducted in a period of approximately 15-20 min. The nurse information form including demographic characteristics, the humanistic behavior skills in nursing practice scale (HPAN) and the caregiving competence scale were used to collect the data.ResultsThe nurses' humanistic behavior skills affected their caregiving competence by 0.082. HPAN and age had an effect size of 0.084 on caregiving competence; HPAN, age and gender had an effect size of 0.124 in the triad model; HPAN, age, gender and average overtime worked in a month had an effect size of 0.136 in the quad model.ConclusionsIt was determined that as the humanistic behavior skills of the nurses increased, their caregiving competence also improved. The humanistic behavioral skills of the nurses affect care giving competence at a rate of 8.2%. In addition, age, gender, overtime work and working years also affect care giving competence.

Exploring the intersection of caregiving burden, parenting stress, and self-efficacy in caregivers of children born with esophageal atresia

AIMS

To examine the relationship between caregiving burden and parenting stress in caregivers of children with esophageal atresia and to identify factors associated with caregiving burden. Additionally, it explores whether self-efficacy mediates this correlation.

DESIGN

An analytical cross-sectional study.

METHODS

Data were collected from 139 caregivers using the Zarit Caregiving Burden Scale (ZCB), Coping Self-Efficacy Scale (CSE), and Parental Stress Scale (PS) between June and October 2023. Statistical analyses included structural equation modeling and logistic regression using IBM SPSS 28.0, SPSS Amos, and Jamovi software.

RESULTS

Among the participants, 68.3 % experienced a moderate-to-high caregiving burden. A statistically significant negative correlation was found between ZCB and CSE scores, while a moderate positive correlation was observed between ZCB and PS scores. Parenting stress was associated with caregiving burden; however, self-efficacy did not mediate this relationship.

CONCLUSION

Caregivers, particularly mothers with high parental stress, a history of miscarriage, and a gestational age above 30 weeks, should be prioritized for interventions addressing caregiving burden.

IMPLICATIONS FOR THE PROFESSION

Assessing caregiving burden and stress in outpatient clinics is critical for effective home care management. Standardized discharge education and psychosocial support should be provided to caregivers to alleviate their burden.

IMPACT

This study fills a research gap regarding caregivers of children with esophageal atresia and provides guidance for healthcare professionals, hospital administrators, and policymakers. Promoting community-based and personal care support services is essential for reducing caregiving burden and parental stress.

REPORTING METHOD

This study adhered to the STARD guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public involvement.

Challenges in Using Parent-Reported Bed and Wake Times for Actigraphy Scoring in Rett-Related Syndromes

Sleep problems are common in Rett syndrome and other neurogenetic syndromes. Actigraphy is a cost-effective, objective method for measuring sleep. Current guidelines require caregiver-reported bed and wake times to facilitate actigraphy data scoring. The current study examined missingness and consistency of caregiver-reported bed and wake times from paper sleep diaries and actigraphy event mark button presses in a sample of 38 individuals with Rett and related syndromes (aged 2-36 years, mean = 13.1) across two 14-day collection time points. Rates of missingness and discrepancy between the 2 sources were relatively high and correlated with clinical severity and quality of life. Overall, the results suggest a need for alternative actigraphy scoring methods that do not rely on caregiver report in this population.

The Relationship Between Care Burden and Spiritual Well-Being of Mothers of Children with Cerebral Palsy: A Cross-Sectional Study from Türkiye

This study was conducted to determine the relationship between care burden and spiritual well-being of mothers of children with cerebral palsy and the topics of support that mothers need. This study, which was conducted as a relationship seeker, was completed in approximately 7 months. Data were collected through interviews with 270 mothers of children with cerebral palsy. A questionnaire, Spiritual Well-Being Scale and Burden Interview Scale was used to collect data. It was found that mothers needed a lot of support, such as requesting an increase in physical therapy hours and the need for financial support. There was a moderate negative relationship between SWBS and BIS (r =  - 0.39, p = 0.01). According to the results of this study, we can say that spiritual well-being is related to the care burden of mothers, so nurses caring for these children should understand the burden of the mothers of these children and evaluate spiritual well-being.

Burden of caregivers of patients with neuronopathic and non-neuronopathic Gaucher disease in Japan: A survey-based study

Background

Gaucher disease (GD), a rare lysosomal storage disorder, is associated with considerable patient and caregiver burden. We examined the applicability of existing caregiver questionnaires and assessed the level of burden in caregivers of patients with GD.

Methods

This cross-sectional, non-interventional study was conducted in Japan. Caregivers of patients with confirmed GD (any type) were recruited (patient association group and referral) for pre-testing (May 2021) or the main survey (October-December 2021). Caregivers completed the Caregiver Impact Questionnaire (CIQ; 30 items) and Zarit Caregiver Burden Interview (ZBI; 22 items) on paper. Total CIQ and ZBI scores and subscores were determined overall and by GD type. Inter-item correlations and test-retest reliability (2 rounds, 2 weeks apart) were calculated. The relationship between caregiving duration and caregiver burden was also analyzed.

Results

Nine caregivers (type 2 [GD2]: n = 6; type 3 [GD3]: n = 3) and 25 caregivers (type 1 [GD1]: n = 2; GD2: n = 17; GD3: n = 6) completed the pre-test and main survey, respectively. In the main survey, mean total CIQ score, all CIQ subscores (except emotional function), and total ZBI score were highest in caregivers of patients with GD2 compared with caregivers of patients with GD1/GD3. High test-retest reliability (Kappa >0.6) was observed for 15 CIQ items and 16 ZBI items. CIQ and ZBI scores appeared to be positively correlated with each other and negatively correlated with caregiving duration.

Conclusions

The CIQ and ZBI are applicable, reliable measures to assess burden in caregivers of patients with GD in Japan. Caregiver burden was highest in caregivers of patients with GD2 and decreased with caregiving duration.

Sleep quality, anxiety, symptoms of depression, and caregiver burden among those caring for patients with Dravet syndrome: a prospective multicenter study in Germany

BACKGROUND

This study measured sleep quality among caregivers of patients with Dravet syndrome (DS) and assessed the impacts of mental health problems and caregiver burden on sleep quality.

METHODS

This multicenter, cross-sectional study of patients with DS and their caregivers throughout Germany consisted of a questionnaire and a prospective 4-week diary querying disease characteristics, demographic data, living conditions, nocturnal supervision, and caregivers' work situations. Sleep quality was assessed using the Pittsburgh Sleeping Quality Index (PSQI). The Hospital Anxiety and Depression Scale (HADS) and the Burden Scale for Family Caregivers (BSFC) were used to measure anxiety, symptoms of depression, and caregiver burden.

RESULTS

Our analysis included 108 questionnaires and 82 four-week diaries. Patients with DS were 49.1% male (n = 53), with a mean age of 13.5 ± 10.0 years. Caregivers were 92.6% (n = 100) female, with a mean age of 44.7 ± 10.6 years. The overall mean PSQI score was 8.7 ± 3.5, with 76.9% of participants (n = 83) scoring 6 or higher, indicating abnormal sleep quality. The HADS for anxiety and depression had overall mean scores of 9.3 ± 4.3 and 7.9 ± 3.7, respectively; 61.8% and 50.9% of participants scored above the cutoff value of 8 for anxiety and depression, respectively. Statistical analyses revealed caregiver anxiety levels and patients' sleep disturbances as major factors influencing PSQI scores. The overall mean BSFC score of 41.7 ± 11.7 indicates a moderate burden, with 45.3% of caregivers scoring 42 or higher.

CONCLUSIONS

Sleep quality is severely affected among caregivers of patients with DS, correlating with anxiety, comorbidities, and patients' sleep disturbances. A holistic therapeutic approach should be implemented for patients with DS and their caregivers, focusing on the sleep quality and mental health of caregivers.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS), DRKS00016967. Registered 27 May 2019, http://www.drks.de/DRKS00016967.

Sex Specific Sleep Parameters Among People With Substance Use Disorder

INTRODUCTION

Sleep can have substantial impacts in substance use disorder (SUD) pathogenesis, treatment, and recovery. Sex differences exist in both sleep and SUD, but how sleep is uniquely associated with SUD by sex is not known. The study objective was to compare, within sex, sleep parameters between individuals with SUD and non-substance misusing controls.

METHODS

Secondary analyses of a parent cross-sectional study examining the feasibility and acceptability of a novel neurocognitive phenotyping assessment battery were completed. SUD and control subjects were recruited through local advertising and an established research registry. Subjects with SUD were also recruited through a university-based outpatient SUD treatment clinic. Self-reported sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Sex-stratified t-tests compared sleep between SUD and control subjects while Crosstab analyses explored group differences in the proportion of individuals reporting poor sleep (defined as PSQI ≥ 5).

RESULTS

Data from 162 males (44 controls, 118 SUD) and 146 females (64 controls, 82 SUD) were included in the present study. For females only, a significantly lower proportion of controls reported PSQI-defined poor sleep than individuals with any SUD or specifically with opioid use disorder. Male, but not female, controls reported shorter sleep latency, longer sleep duration, and less sleep disturbance than males with each SUD type.

DISCUSSION/IMPLICATIONS

Sleep holds promise as an avenue to address SUD within a biopsychosocial model. Future work at the intersection of SUD and sleep should prioritize investigations of their interplay with sex to identify targets for tailored SUD interventions.

Parental perceived child sleep problems: A concept analysis

PURPOSE

This paper aims to delineate a conceptual analysis of parental perceived child sleep problems.

DESIGN AND METHODS

Rodger's evolutionary approach to concept analysis was employed. A systematic literature search of PubMed, CINAHL, Medline, and PsycINFO was conducted from inception to June 2020. Peer-reviewed papers written in English focusing on parental perception of their children's sleep problems were included.

RESULTS

A total of 47 papers were included for analysis. Parental perceived child sleep problems can be defined as parental reliance on their observations and beliefs, and perceived locus of control to appraise an array of children's sleep-related signs and behaviors, which may contain bias but still reflects certain aspects of children's sleep health status. A wide range of physiological, psychosocial, familial, environmental, and cultural factors may contribute to parental perceived child sleep problems, which may further contribute to parent-child dyads' physical and mental health as well as the whole family's general wellness.

PRACTICE IMPLICATIONS

Defining the concept of parental perceived child sleep problems facilitate health professionals a foundation for consistent use, understanding, and evaluation of parent-reported child sleep outcome. Future research on the standard conceptual and operational definition of parental perceived child sleep problem, and its potential antecedents and consequences is warranted. The characteristic of parental perceived sleep problems, together with child sleep history and objective sleep measures should be integrated to evaluate child sleep health.

Evaluation of care burden among mothers of children with a disability: Correlation between physical activity, quality of life, and sleep quality; a cross-sectional study

PURPOSE

The aim of the study was to determine the correlation between care burden and physical activity, quality of life, and sleep quality of mothers with disabled children.

DESIGN AND METHODS

The study was conducted with 165 mothers in a private rehabilitation center.

FINDINGS

There was a significant correlation between care burden and quality of life and sleep quality among mothers with disabled children.

PRACTICE IMPLICATIONS

It is necessary for nurses to consult parents in terms of social support and to provide psychological support for families with disabled children to reduce the care burden of parents.

Association between children's sleep patterns and problematic behaviors at age 5

BACKGROUND

Night-shift lifestyles affect children as well as adults, and are associated with sleep and behavioral problems among children. This study aimed to investigate associations among sleep patterns, individual/environmental factors, and problematic behaviors in children at age 5 years.

METHODS

Data for sleep patterns, individual / environmental factors, and problematic behaviors for 8,689 5-year-old children were collected from health-checkup records. Problematic behaviors investigated were anxious behavior (being afraid, difficulty being separated from the mother), developmental behavior (violence, restlessness, rebellious behavior, restrictive diet, stereotypic play), personal habits (thumb-sucking, nail-biting, tic, masturbation), and excretory problems. The relationships between sleep patterns (bedtime, sleep duration) and the presence of these behaviors were analyzed. Individual / environmental factors that affected problematic behaviors were statistically identified using a tree-form model.

RESULTS

Late bedtime and short sleep duration showed significant adverse effects on children's problematic behaviors - odds ratio (OR): 1.07, 95% confidence interval (CI): 1.03-1.11 and OR: 0.92, 95% CI: 0.87-0.97, respectively. Long television watching time, abnormality at birth, and lack of father's support also showed significant adverse effects on problematic behaviors (OR: 2.34, 95% CI: 1.87-2.94), and significantly affected late bedtime and short sleep duration.

CONCLUSIONS

There were significant associations among sleep patterns, individual / environmental factors, and problematic behaviors in 5-year-old children. Improving children's sleep patterns, reducing the duration of television watching, and improving support from fathers may reduce problematic behaviors.

Sleep problems and solution seeking for children with cerebral palsy and their parents

AIM

Sleep problems are common in school-aged children with cerebral palsy (CP). Despite the significant impact of sleep disturbance and deprivation, there is a paucity of research in the area. The aims of this study were to (i) investigate the frequency of sleep problems in children with CP and their parents and (ii) understand what happens when parents ask for help with sleep problems from their health-care professionals.

METHODS

This was a prospective cohort study using an online survey sent to parents/primary care givers of children with CP aged 6-12 years recruited through the Victorian Cerebral Palsy Register. The following sleep assessment tools: The Children's Sleep Habits Questionnaire, the Pittsburgh Sleep Quality Index and the Gross Motor Function Classification System Parent Rating Tool were administered along with custom-designed questions that were informed by a preceding qualitative scoping study.

RESULTS

Complete data sets were received from 126 parents/care givers. Almost half (46%) of the parents reported their child had sleep problems. Of the 64 parents who reported seeking help for a child's sleep problem, only 21 indicated that their attempt was successful. If a child had poor sleep, the parent was more likely to have a sleep problem than parents who did not report poor child sleeping.

CONCLUSION

Sleep problems are common in children with CP and their parents. Parents do not always seek help, and those who do may not find an effective solution. Future research should explore how sleep problems can be effectively prioritised for children with CP and their parents/care givers.

Sour sleep, sweet revenge? Aggressive pleasure as a potential mechanism underlying poor sleep quality's link to aggression

Sleep quality is a critical component of successful human functioning. Poor sleep quality is associated with aggressive behavior, yet the psychological mechanisms that drive this effect are incompletely understood. We tested the prediction that the association between poor sleep quality and aggression would be explained, in part, by a magnified experience of positive affect during aggression. We conducted 2 cross-sectional studies (Study 1, N = 388; Study 2, N = 317) and a third preregistered study (N = 379), which tested for mediation across 2 waves that were separated by 14-42 days. Across all 3 studies, we replicated the positive association between poor sleep quality and aggression. However, we did not observe compelling or consistent evidence that poor sleep quality is linked to greater positive affect during aggression. Such aggressive pleasure was temporally stable and predicted subsequent increases in aggressive behavior. These findings support a reinforcement model of aggressive affect, in which the pleasure of aggression promotes greater aggression over time-perhaps explaining why some individuals are more dispositionally aggressive than others. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Role of Sleep Quality in the Psychological Well-Being of Final Year UndergraduateStudents in China

There are increasing numbers of university students in China suffering from poor sleep and psychological well-being problems. In particular, the issues are more severe among the final year undergraduate students, because they are experiencing a transitory period from university life to the workplace. However, extant research has rarely explored sleep quality and psychological well-being of final year university students. To better understand the role of sleep quality in psychological well-being, we examined the association between different sleep quality and mental health. Based on a cross-sectional survey of 2495 full-time final year university students in China, we employed multivariable logistic regression to assess association between sleep quality and psychological well-being by controlling for sociodemographic factors such as age, gender, education, marital or relationship status, household conditions, place of birth, study subjects and etc. According to the research results, we can find strong association between sleep quality and psychological well-being. Having normal sleep quality is associated with lower level of psychological well-being problems. By contrast, poor sleep quality is associated with high level of negative psychological well-being. Poor sleep quality has higher potency than normal sleep quality due to negative bias. Among covariates, age, gender and education have significant effects on psychological well-being.

Sleep Characteristics in Mothers of Children With Developmental Disabilities

Impaired sleep can contribute to conditions such as cardiometabolic disorders, depression, and decreased immune function. Mothers of children with developmental disabilities (DDs) may be at greater risk for impaired sleep due to the sleep problems of their children. This cross-sectional study described the self-reported sleep characteristics of mothers of children (ages 6-12) with DDs by using a sleep diary and the Pittsburgh Sleep Quality Index (PSQI) as quantitative and qualitative measures of sleep in these mothers. The Consensus Sleep Diary was modified to ascertain how the child's sleep and needs for care during the night impacted the mother's sleep. The results showed that mothers had short sleep duration (nearly 40% slept <7 hours per night), woke up an average of 2.2 times per night (most commonly due to caregiving needs of children), and had poor sleep quality (mean PSQI global score of 7.9 [SD=4.8]). The sleep problems of children with DDs may influence mothers' sleep.

A systematic review of studies on the prevalence of insomnia in university students

OBJECTIVES

Many studies have shown that insomnia is a common problem among university students, but there are wide variations in the prevalence of insomnia. In this systematic review, we aimed to explore the prevalence of insomnia among university students using scientific and conclusive methods.

STUDY DESIGN

A systematic review is designed to analyze the studies reporting on prevalence of insomnia among university students.

METHODS

Systemic searches were conducted in PubMed, BioMed Central, EBSCO, ScienceDirect, Ovid LWW and Medline databases between January 2000 and July 2014, The Meta analyst software was used to calculate the prevalence rate of each study, the pooled means of prevalence rates and 95% CIs across studies were then calculated and presented.

RESULTS

Seven articles that met the inclusion and exclusion criteria were selected. The overall sample size in the current review was 16,478, with a minimum of 219 and a maximum of 10,322. The prevalence rates of the seven studies ranged between 9.4% (95%CI 8.8-10.0%) and 38.2% (95% CI 35.4-41.1%). Overall, the total students studied with a weighted mean prevalence of 18.5% (95% CI 11.2-28.8%), considerably higher than rates of 7.4% (95% CI 5.8-9.0%) reported in general population.

CONCLUSIONS

This review emphasized that insomnia prevalence in university students is considerably higher than that in general population, suggested that more attention should be paid to insomnia in university students.

Patterns and predictors of sleep quality before, during, and after hospitalization in older adults

STUDY OBJECTIVES

The impact of hospitalization on sleep in late-life is underexplored. The current study examined patterns of sleep quality before, during, and following hospitalization, investigated predictors of sleep quality patterns, and examined predictors of classification discordance between two suggested clinical cutoffs used to demarcate poor/good sleep.

METHODS

This study included older adults (n = 163; mean age 79.7 ± 6.9 years, 31% female) undergoing inpatient post-acute rehabilitation. Upon admission to inpatient post-acute rehabilitation, patients completed the Pittsburgh Sleep Quality Index (PSQI) retrospectively regarding their sleep prior to hospitalization. They subsequently completed the PSQI at discharge, and 3 months, 6 months, 9 months, and 1 year post discharge. Patient demographic and clinical characteristics (pain, depression, cognition, comorbidity) were collected upon admission.

RESULTS

Using latent class analysis methods, older adults could be classified into (1) Consistently Good Sleepers and (2) Chronically Poor Sleepers based on patterns of self-reported sleep quality pre-illness, during, and up to 1 year following inpatient rehabilitation. This pattern was maintained regardless of the clinical cutoff employed (> 5 or > 8). Logistic regression analyses indicated that higher pain and depressive symptoms were consistently associated with an increased likelihood of being classified as a chronic poor sleeper. While there was substantial classification discordance based on clinical cutoff employed, no significant predictors of this discordance emerged.

CONCLUSIONS

Clinicians should exercise caution in assessing sleep quality in inpatient settings. Alterations in the cutoffs employed may result in discordant clinical classifications of older adults. Pain and depression warrant detailed considerations when working with older adults on inpatient units when poor sleep is a concern.

Is functional dependence of Duchenne muscular dystrophy patients determinant of the quality of life and burden of their caregivers?

OBJECTIVE

The relationship between functional dependence and quality of life (QOL) in Duchenne muscular dystrophy (DMD) patients and burden and QOL in caregivers is not clear. This study investigated possible relationships between functional dependence/QOL of DMD patients and QOL/burden of caregivers.

METHOD

This study included 35 boys (6-17 years) and respective caregivers (above 21 years). Caregivers answered to World Health Organization Quality of Life and Zarit Burden Interview questionnaires. Patients were assessed with the Motor Function Measure and the Autoquestionnaire Qualité de vie Enfant Imagé. Spearman correlations and linear regressions were run to investigate relationships between the variables.

RESULTS

The occurrence of lower QOL and higher burden among the caregivers of patients with Duchenne muscular dystrophy was evidenced. The functional dependence of patients was not considered a determinant factor. Higher caregivers' burden was related to lower caregivers' QOL and to higher patients' ages.

Cross-cultural comparison of maternal sleep

BACKGROUND

To characterize cross-cultural sleep patterns and sleep problems in a large sample of mothers of children (ages birth to 6 years) in multiple predominantly Asian and predominantly Caucasian countries.

METHODS

Mothers of 10,085 young children (predominantly Asian countries/regions: China, Hong Kong, India, Korea, Japan, Malaysia, Philippines, Singapore, Thailand; predominantly Caucasian countries: Australia, Canada, New Zealand, United Kingdom, United States) completed an internet-based expanded version of the Pittsburgh Sleep Quality Index.

RESULTS

Mothers in predominantly Asian countries/regions had later bedtimes, decreased number and duration of night wakings, more nighttime sleep, and more total sleep than mothers from predominantly Caucasian countries, P < 0.001. More than half (54.7%) of mothers reported having poor sleep, ranging from 50.9% of mothers in Malaysia to 77.8% of mothers in Japan. Sleep disturbance symptoms were quite common, especially symptoms related to insomnia, and were more likely to be reported by mothers in predominantly Caucasian countries. However, psychosocial factors, including having children of a younger age, being unemployed, and having a lower education level were the best predictors of poor sleep, whereas culture was not a significant predictor.

CONCLUSIONS

Overall, mothers in predominantly Asian countries/regions reported later bedtimes but sleeping better and longer than mothers from predominantly Caucasian countries, which is dissimilar to cross-cultural findings of young children. Psychosocial factors were found to be the best predictors of poor sleep, irrespective of culture. Further studies are needed to understand the impact of these findings.

Sleep habits and sleep problems among Palestinian students

AIM

The aim of this study was to describe sleep habits and sleep problems in a population of undergraduates in Palestine. Association between self-reported sleep quality and self-reported academic achievement was also investigated.

METHODS

Sleep habits and problems were investigated using a convenience sample of students from An-Najah National University, Palestine. The study was carried out during spring semester, 2009. A self-administered questionnaire developed based on The Diagnostic and Statistical Manual of Mental Disorders IV criteria and Pittsburgh Sleep Quality Index was used.

RESULTS

400 students with a mean age of 20.2 ± 1.3 were studied. Reported mean duration of night sleep in the study sample was 6.4 ± 1.1 hours. The majority (58.3%) of students went to bed before midnight and 18% of the total sample woke up before 6 am. Sleep latency of more than one hour was present in 19.3% of the students. Two thirds (64.8%) of the students reported having at least one nocturnal awakening per night. Nightmares were the most common parasomnia reported by students. Daytime naps were common and reported in 74.5% of the study sample. Sleep quality was reported as "poor" in only 9.8% and was significantly associated with sleep latency, frequency of nocturnal awakenings, time of going to bed, nightmares but not with academic achievement.

CONCLUSION

Sleep habits among Palestinian undergraduates were comparable to those reported in European studies. Sleep problems were common and there was no significant association between sleep quality and academic achievement.