The purpose of this study was to describe how school-age children perceive mental illness. The specific aims of this study were to describe the impact of age and sex on children's ability to identify and classify deviant behavior, and to identify how school-age children perceive mental illness by looking at how they define the concept, characterize the mentally ill, and understand causality and treatment. The random sample consisted of 90 school-age children. Thirty children were in grade 1, 30 in grade 4, and 30 in grade 7. A multimethods approach combining qualitative and quantitative techniques was used to analyze data. Major study findings indicated that age was not a significant factor in children's ability to classify deviant behavior; however, there was a sex main effect: Boys were able to better identify deviant behaviors than girls. A developmental trend was noted in children's ability to be aware of what mental illness is, to acknowledge characteristics of people who are mentally ill, to differentiate between mental illness and mental retardation, to identify various etiologies of mental illness, and to choose appropriate treatment modalities.

Factors associated with the attempted length, disturbance, effectiveness, and nap supplementation of sleep were analyzed in 97 patients recovering from cardiac surgery a few days before hospital discharge. Patients rated sleep for the prior night and factors that impaired their sleep after transfer from the critical care unit. The group averaged little sleep, with moderate disturbance and effectiveness and low nap supplementation. The disturbance, effectiveness, and attempted length of sleep were associated with an inability to perform their usual routine before sleep, inability to get comfortable, pain, noises, procedural care, and an unfamiliar bed. Patients encounter difficulties with sleep, even near discharge from the hospital. Interventions should be tested to mitigate specific factors that affect selected dimensions of sleep.

BACKGROUND: Effective management of sleep disturbances after cardiac surgery requires insight into patients perceptions of which factors disturb sleep in the intensive care unit and after transfer from the intensive care unit. OBJECTIVE: To describe patients perceptions of environmental factors that disturbed sleep after cardiac surgery. SAMPLE: A convenience sample of 102 patients was surveyed in a 300-bed, acute-care teaching hospital. METHOD: Patients were interviewed several days before discharge from the hospital and rated the extent to which specific factors disturbed their sleep while in the intensive care unit and after transfer. RESULTS: The group mean for the extent of disturbance scores, averaged across all 35 environmental factors studied, was low during and after stay in the intensive care unit. However, selected items such as pain, and inability to get comfortable and perform a familiar nighttime routine, were moderately disturbing to many patients across phases of recovery. Patients varied widely in the number of factors, ranging from 0 to 33 factors, that disturbed sleep at least to some extent. Patients added factors that were not included in the original monitoring instrument. CONCLUSIONS: Patients attribute disturbed sleep to specific factors after cardiac surgery. The number of factors that disturb sleep varies among patients. Nurses can modify many of the factors that disturb sleep to promote an environment that will facilitate improved sleep, thereby enhancing the acute phase of recovery from cardiac surgery.

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