title: Nurses' views of factors affecting sleep for hospitalized children and their families: A focus group study.
abstract: Light, noise, and interruptions from hospital staff lead to frequent awakenings and detrimental changes to sleep quantity and quality for children who are hospitalized and their parents who stay with them overnight. An understanding of nurses' views on how care affects sleep for the hospitalized child and parent is crucial to the development of strategies to decrease sleep disturbance in hospital. The purpose of this descriptive qualitative study was to gain an understanding of nurses' views on their role in and influence on sleep for families; perceived barriers and facilitators of patient and parent sleep at night; strategies nurses use to preserve sleep; the distribution, between parent and nurse, of care for the child at night; views of the parent as a recipient of nursing care at night; and the nature of interactions between nurses and families at night. Thirty registered nurses from general pediatric and critical care units participated in one of four semi-structured focus groups. Four main influences on sleep were identified: child factors; environmental factors; nurse-parent interaction factors; and nursing care factors. Some of these restricted nurses' ability to optimize sleep, but many factors were amenable to intervention. Balancing strategies to preserve sleep with the provision of nursing assessment and intervention was challenging and complicated by the difficult nature of work outside of usual waking hours. Nurses highlighted the need for formal policy and mentoring related to provision of nursing care at night in pediatric settings.
authors.affiliation: Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Room 288, 155 College Street, Toronto, Ontario, Canada, M5T 1P8.|Adjunct Scientist, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Robyn
authors.initials: R
authors.lastname: Stremler
authors.affiliation: Nurse Practitioner, Paediatric Medicine Complex Care Program, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Sherri
authors.initials: S
authors.lastname: Adams
authors.affiliation: Clinical Nurse Specialist, Bereavement Coordinator, Critical Care, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Dryden-Palmer
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D017144:Focus Groups; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008027:Light / Q000009:adverse effects*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009622:Noise / Q000009:adverse effects*; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data*; D010371:Pediatric Nursing / Q000379:methods*; D011368:Professional-Family Relations; D036301:Qualitative Research; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000451:nursing* / Q000517:prevention & control; D055815:Young Adult
keywords: child; hospitalization; parent; pediatric nursing; qualitative; shift work; sleep