Thome Marga, Skuladottir Arna
Faculty of Nursing, University of Iceland, Eirberg, Eiiksgattta 34, 101 Reykjavik, Iceland.
J Adv Nurs. 2005 Apr;50(1):5-11. doi: 10.1111/j.1365-2648.2004.03343.x.
This paper reports a study to describe changes in parents' distress after a family-centred intervention for sleep problems of infants.
Infant sleep problems are common and are related to depressive symptoms in mothers, but their impact on fathers has rarely been studied. Because childhood sleep problems and parental distress are associated, their interdependence should be recognized in research and in paediatric sleep practice.
All children hospitalized for sleep problems in a hospital in Iceland in 1997-1998 and their parents were studied using a pre- and post-test quasi-experimental design. The sample consisted of 33 infants (6-23 months of age), 33 mothers and 30 fathers. Parents' distress was assessed before and after treatment with regard to: (1) fatigue and resulting symptom distress; (2) parenting stress; (3) state-anxiety; and (4) depressive symptoms. Infants were treated for a variety of sleep problems by a paediatric nurse. The parents were simultaneously treated for distress by either the paediatric nurse or a specialist, depending on the nature of their problems.
Mothers and fathers experienced a high degree of distress before the intervention, with no significant difference between them. Two months after the intervention both parents' distress had significantly improved. Parents' degree of distress was at a psychopathological level before the intervention but was reduced to population norms 2 months after the intervention. The paediatric nurse intervention was sufficient to reduce distress for 83% of parents.
Health care professionals who care for infants with sleep problems should pay attention to the distressed responses of parents and support their recovery. An intervention such as that described here could be used by nurses for this purpose.
本文报告一项研究,旨在描述以家庭为中心的干预措施对婴儿睡眠问题的影响下父母苦恼程度的变化。
婴儿睡眠问题很常见,且与母亲的抑郁症状有关,但对父亲的影响很少被研究。由于儿童睡眠问题与父母苦恼相关,因此在研究和儿科睡眠实践中应认识到它们的相互依存关系。
采用前后测准实验设计,对1997年至1998年在冰岛一家医院因睡眠问题住院的所有儿童及其父母进行研究。样本包括33名婴儿(6至23个月大)、33名母亲和30名父亲。在治疗前后评估父母的苦恼程度,涉及以下方面:(1)疲劳及由此产生的症状苦恼;(2)育儿压力;(3)状态焦虑;(4)抑郁症状。儿科护士对婴儿的各种睡眠问题进行治疗。根据父母问题的性质,由儿科护士或专家同时对父母的苦恼进行治疗。
干预前,母亲和父亲都经历了高度苦恼,他们之间没有显著差异。干预两个月后,父母双方的苦恼都有显著改善。干预前父母的苦恼程度处于心理病理水平,但干预两个月后降至总体正常水平。儿科护士的干预足以减轻83%父母的苦恼。
照顾有睡眠问题婴儿的医护人员应关注父母的苦恼反应并支持他们恢复。护士可采用本文所述的干预措施来实现这一目的。