Dissertation

Early Prevention for Infant Sleep Disturbances Through Improving Parent-Child Interactions

Jiao, Nana

2024

Overview

Infant sleep disturbances are prevalent and can adversely affect child development and family well-being. Current behavioral and educational intervention programs have demonstrated efficacy in improving sleep disturbances, however, these interventions are best applied to infants older than six months. Responsive parenting intervention indicated mixed findings on improving infant sleep consolidation, including frequency and duration of night awakenings, bedtime routines, self-soothe to sleep, sleep durations, and the parent-child relationship. Based on the infant sleep transactional model, this dissertation study aimed to address the gaps in the literature through a systematic review, a secondary longitudinal path analysis, and a pilot study testing an adapted responsive parenting intervention to improve infant sleep.The systematic review searched PubMed, Cochrane, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and PsycINFO. This study included 10 articles and identified the impact of responsive interventions among infants, which showed improvement in infant sleep outcomes, including infant sleep consolidation, sleep durations, and sleep practice during bedtime and nighttime. Further, the path analysis showed that the 3-month greater maternal Stress was not related to 6-month WASO (Wake After Sleep Onset) and WAKES (night awakenings) directly, but indirectly related to 6-month WASO through PBQ (Postpartum Bonding Questionnaire) impaired bonding subscale (β=0.28, 95%CI:0.009-0.54]) and PBQ total score (β=0.30, 95%CI:0.04-0.57]), and also indirectly related to 6-month WAKES through PBQ total score (β=0.24, 95%CI:0.03-0.45]). Further, the 3-month greater maternal Depression was not directly, but indirectly related to 6-month WASO (β=0.26, 95%CI:0.06-0.59]) and WAKES (β=0.19, 95%CI:0.03-0.47]) through PBQ Rejection subscale. Additionally, the pilot study showed that 37% (34/92) of participants participated in this study, and 88.2% (30/34) retained. The 7-day actigraphy wear was feasible with 75% valid data at both the pre-and post-intervention assessments. The main barrier to completing the study was the busy family schedule. Parents reported 96.7% moderate acceptability.Future research directions could integrate parent-child interactive interventions, maternal psychological and parent-infant bonding support, and technology tools into research on improving infant sleep. Researchers can develop innovative and holistic approaches to address the complex interplay between parental well-being, parent-child interactions, and sleep health.

• Publisher: ProQuest Dissertations & Theses
• Subject: Health care management / Nursing / Obstetrics / Obstetrics and gynecology / Womens studies
• ISBN: 9798383607053