Associations Between Diaper Need and Child Sleep in Under-resourced Families.

OBJECTIVE: Sleep is critical for child health, but factors related to poverty create barriers to the achievement of healthful sleep. In this study, we examined the associations of insufficient diaper supply, a measure of material hardship, with child sleep. METHODS: This cross-sectional study included 129 parents of very young children. Each participant responded to an online material hardship assessment and the Brief Infant Sleep Questionnaire-Revised. Multiple linear regression was used to analyze the relationship between diaper need and sleep. RESULTS: Controlling for family and socioeconomic variables, diaper need was associated with disrupted, shorter sleep periods (ß = -11.95, p < 0.001) and lower total sleep scores (ß = -6.49, p = 0.004). High diaper need was associated with parent perception of poor sleep (ß = -7.28, p = 0.017). CONCLUSION: The findings suggest that an inadequate supply of diapers adversely affects children's sleep. Further research should evaluate how screening and connecting families to resources may improve pediatric sleep.

Parent Perspectives on Sleep and Sleep Habits Among Young Children Living With Economic Adversity.

OBJECTIVE: To examine the perspectives of ethnically diverse, low-income parents of young children regarding sleep, sleep habits, and preferences for sleep promotion for themselves and their children. METHOD: We recruited a sample of mothers who had a 15- to 60-month-old child enrolled in the Special Supplemental Nutritional Program for Women, Infants and Children in a Northeastern U.S. city. We used a convergent mixed-methods design to conduct semistructured interviews and questionnaires to measure parent sleep quality (Pittsburgh Sleep Quality Index), sleep apnea (Berlin Apnea Questionnaire), mood (Centers for Epidemiological Studies of Depression), children's sleep (Children's Sleep Habits Questionnaire), and behavior (Child Behavior Checklist). RESULTS: Thirty-two mothers (M age = 30.97 [SD 6.34] years; n = 21 [65%] African American) and children (N = 14 [44% female]; M age =38 [SD 12.63] months) participated. Children's average sleep duration was 10 hr, which is below the recommendation for this age group; overall sleep difficulty was high despite most mothers reporting that their children had normal sleep. Five children had abnormal Child Behavior Checklist scores, suggesting internalizing and externalizing behaviors. More than half of the mothers had poor sleep quality and 24 (75%) were at high risk for sleep apnea. Mothers viewed sleep as important for themselves and their children and identified both effective and ineffective practices to promote sleep, including practices learned from their own families. CONCLUSIONS: Ethnically diverse mothers who are living with economic adversity value sleep for themselves and their children. The high value placed on sleep, despite misconceptions about normal sleep, suggest opportunities to promote sleep interventions. The content and delivery methods should be tailored to their knowledge, preferences, and cultural practices.

Maternal stress and psychological status and sleep in minority preschool children.

OBJECTIVES: Minority women living in inner city environments may be at more risk for psychological distress. Maternal stress, anxiety, depression, and psychological trauma can influence the preschool child's behavior and may have a negative impact on the preschool child's sleep patterns. The purpose of the study was to: (a) examine objective and subjective preschool children sleep patterns and (b) explore the relationship between objective and subjective sleep patterns in preschool children and maternal psychological status. DESIGN AND SAMPLE: A cross-sectional observational design was used. Descriptive analyses and correlations were conducted to examine the data. Twenty-one minority women were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children Program. MEASURES: Preschool children wore wrist actigraphs, and their sleep efficiency, time in bed, and sleep periods were analyzed. Mothers completed measures on depression, anxiety, stress, and psychological trauma. RESULTS: Mothers' self-report of their children's sleep habits indicated at risk scores for sleep problems. Life stress in the mothers was statistically significant and negatively related to preschool child's sleep duration. Mild to severe symptoms of depression and mild anxiety were reported and criteria for Post Traumatic Stress Disorder were found in 12 of the 21 mothers. The results of the study indicate that parent education on sleep and the minority preschool child should be part of community interventions and screening preschool parents for psychological distress should be considered with referrals for support services.

The evolution of the advanced practice role in psychiatric mental health in New Jersey: 1960-2010.

This historical perspective is focused on the contribution of Hildegard E. Peplau in laying the foundation for advanced practice nursing and the development of the roles of clinical nurse specialists and psychiatric nurse practitioners. An overview is provided of legal developments within the state that enabled Advanced Practice Nurses to provide mental health services. A description of a recent specialized state-funded initiative is outlined, focused on the development and contributions of psychiatric advanced practice nurses in community settings in New Jersey. Implications for the advanced practice nursing role in New Jersey are presented based on national and state initiatives.

Psychiatric nursing practice and the recovery model of care.

This article provides an overview of the national actions by key groups on recovery from psychiatric disability and how a shift is needed to transform health care service delivery in mental health. Fundamental components of recovery are outlined, and examples are provided from the literature in nursing and related disciplines that reflect similar research and evidence-based practice interventions. It is recommended that professional nursing include consumers as active participants in the design of evidence-based practices in all settings.

Sleep patterns and psychological distress in women living in an inner city.

Psychological distress, including symptoms of anxiety, depression, and psychological trauma, is common in women living in inner cities and can be associated with disturbed sleep. The purposes of the study of 115 women were to examine: (a) objective and subjective sleep patterns; (b) extent of psychological distress; and (c) the relationship between objective and subjective sleep patterns and psychological distress. Wrist actigraphs were worn. High levels of life stress, sleep pattern disturbance, and psychological distress were common. Self-reported sleep patterns, but not objective sleep pattern variables, explained 12.5% to 44% of the variance in psychological distress, suggesting the importance of screening for sleep and psychological distress. These findings suggest that interventions focusing on sleep or psychological distress may reduce symptoms.

Sleep and trauma: an overview.

Sleep disturbance is common after traumatic events of various types, such as combat, physical trauma, and sexual abuse, and closely intertwined with Posttraumatic Stress Disorder (PTSD), a common outcome of severe and prolonged trauma. This paper reviews the current literature on the significance and characteristics of sleep disturbance occurring in the context of trauma, examines the relationship between sleep disturbance and PTSD, identifies gaps in knowledge relative to the role of sleep disturbance in trauma and PTSD, and discusses the implications of this body of knowledge for clinical practice.

Working together to improve care: collaboration between a state psychiatric hospital and an academic institution.

This article describes a collaboration between state mental health services division and a state university that focuses on the improvement of patient care services in state psychiatric hospitals. The collaboration is different from other initiatives linking state institutions and academia as it is composed of a team of psychiatrists, advanced practice nurses, and master's prepared psychiatric rehabilitation practitioners. The historical development and accomplishments are described and the process of working with a state psychiatric hospital is explored.