1Byrdine F. Lewis School of Nursing, Georgia State University, Atlanta, GA, USA.
Biol Res Nurs. 2013 Oct;15(4):398-406. doi: 10.1177/1099800412445612. Epub 2012 May 15.
Having a low-birth-weight (LBW) infant in a neonatal intensive care unit (NICU) can intensify a mother's sleep disturbances due to both stress and the dim lighting in the ICU setting, which desynchronizes circadian rhythms. The purpose of this pilot study was to examine the effectiveness of a 3-week bright light therapy intervention on sleep and health outcomes of mothers with LBW infants in the NICU. Controlled stratified randomization was used to assign 30 mothers to a treatment or control group. Data were collected at pretreatment (second week postpartum) and after the 3-week intervention. Sleep data were assessed by wrist actigraph (total sleep time [TST], circadian activity rhythms [CARs]) and the General Sleep Disturbance scale. Other outcome variables were measured by the Lee's Fatigue scale, Edinburgh Postpartum Depression scale, and the Medical Outcomes Short Form 36, version 2. Mothers averaged 26.6 (SD = 6.3) years of age, and the majority were Black (73%). The mean gestational age for the infants was 27.7 (SD = 2.0) weeks. Small to large effect sizes were found when comparing the pre- to posttreatment differences between groups. Although none of the differences were statistically significant in this small sample, for mothers in the treatment group nocturnal TST (d = .33), CAR (d = 1.06), morning fatigue (d = .22), depressive symptoms (d = .40), physical health-related quality of life (d = .33), and mental health-related quality of life (d = .60) all improved compared to the control group. Bright light therapy is feasible for mothers with infants in an NICU. Clinically significant improvements have been evidenced; a larger-scale trial of effectiveness is needed.
在新生儿重症监护病房(NICU)中,有一个低出生体重(LBW)婴儿会加剧母亲的睡眠障碍,这既是由于压力,也是由于 ICU 环境中的昏暗灯光,这种灯光会使昼夜节律不同步。本初步研究的目的是检验为期 3 周的强光治疗干预对 NICU 中 LBW 婴儿母亲的睡眠和健康结果的有效性。使用对照分层随机化将 30 名母亲分配到治疗组或对照组。在治疗前(产后第二周)和 3 周干预后收集数据。通过腕部活动记录仪评估睡眠数据(总睡眠时间 [TST]、昼夜活动节律 [CARs])和一般睡眠障碍量表。其他结果变量由 Lee 的疲劳量表、爱丁堡产后抑郁量表和医疗结果简短形式 36 版(第 2 版)测量。母亲的平均年龄为 26.6(SD = 6.3)岁,大多数是黑人(73%)。婴儿的平均胎龄为 27.7(SD = 2.0)周。在比较组内治疗前后的差异时,发现小到中等的效果量。尽管在这个小样本中,没有一个差异具有统计学意义,但与对照组相比,治疗组的母亲夜间 TST(d =.33)、CAR(d = 1.06)、早晨疲劳(d =.22)、抑郁症状(d =.40)、与身体健康相关的生活质量(d =.33)和与心理健康相关的生活质量(d =.60)均有所改善。强光疗法对于 NICU 中的母亲来说是可行的。已经有证据表明有明显的临床改善,需要进行更大规模的有效性试验。