Study Objectives
The current review aims to examine factors that influence pediatric inpatient sleep and determine the effectiveness of sleep promotion interventions among hospitalized children.
Methods
A systematic literature search was conducted across PubMed, PsycINFO, CINAHL, Cochrane Central, Web of Science, Embase, and Scopus databases. Studies included children with a mean age between 1-18 years-old that either described factors affecting the sleep of children who are hospitalized on a non-intensive care unit or reported on sleep-related intervention outcomes. We conducted separate narrative reviews for each of the two aims and then synthesized findings from quantitative and qualitative studies across both aims.
Results
Forty-five articles were included for review. Despite most sleep disturbances being attributed to environmental disruptions (e.g., noise, staff interruptions), most interventions targeted the child-level using relaxation techniques. Although the majority of interventions were small pilot studies, preliminary findings appear to positively impact sleep duration. The Pediatric Inpatient Sleep Model was proposed to illustrate connections between sleep disturbances, factors influencing sleep, and existing intervention components.
Conclusions
Replication studies are needed, including larger-scale sleep promotion interventions among hospitalized children. Given the identification of environmental factors as a main cause of night wakings, environmental modifications are crucial. Additional research examining contributors to intraindividual variability in disrupted sleep patterns during hospitalizations as well as the consequences of these disturbances is warranted.
Objective: Caregiver-adolescent collaborative decision-making is a key component of effective self-management, although there is limited understanding of this relationship in pediatric asthma. The current study examined the association between parent and youth decision-making and asthma self-management behaviors. Method: Participants included 33 youth ages 12-15 years (M age ϭ 13.18, SD ϭ 1.16) with poorly controlled, persistent asthma and their caregivers. Participants completed the Family Asthma Management System Scale interview to assess core aspects of asthma management. The Decision Making Involvement Scale was administered to evaluate caregiver and adolescent behaviors during asthma-related decision-making. Results: Seventy percent of dyads reported discussing the adolescent's asthma in the past 2 weeks. Forty-seven percent of families reached a final decision during the discussion, and 18% made a partial decision. Either the caregiver (41%) or the dyad together (27%) made the final decision. Youth whose parents made the final decision reported poorer responses to acute asthma symptoms (p ϭ .03, d ϭ 0.99). Higher parental expression of information was associated with better family response to acute asthma symptoms, p ϭ .045, R 2 ϭ 0.69. Conclusions: Findings indicate that joint caregiver-youth collaborative decision-making and parent involvement in asthma-care decision-making were associated with better response to asthma exacerbations. A significant portion of families is not discussing their adolescent's asthma, and future research is needed to identify what families are at risk for reduced communication regarding asthmacare decision-making. Health professionals should assess both caregiver and adolescent decision-making involvement when addressing asthma self-management.
Implications for Impact StatementThis study advances the idea that caregiver and youth collaboration during healthrelated decision-making is important for fostering disease management within pediatric asthma. Findings also highlight the need for disease management interventions targeting increased caregiver-youth communication surrounding the adolescent's asthma care.
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