Parental functioning and pediatric sleep disturbance: An examination of factors associated with parenting stress in children clinically referred for evaluation of insomnia
Parental functioning and pediatric sleep disturbance: An examination of factors associated with parenting stress in children clinically referred for evaluation of insomnia
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DOI：
10.1016/j.sleep.2011.05.002
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发表时间：
2011-10-01
期刊：
影响因子：
4.8
通讯作者：
Noll, Jennie G.
中科院分区：
文献类型：
--
作者：
Byars, Kelly C.;Yeomans-Maldonado, Gloria;Noll, Jennie G.
背景：亲职压力是与临床环境相关的父母功能的一个方面。在行为睡眠医学的背景下，父母的压力的作用是不是很好理解。方法：前瞻性评估患者1.5-10岁的失眠。研究对象为156对父母-子女对，分别填写父母压力指数简表（PSI-SF）、儿童睡眠习惯问卷（CSHQ）和儿童行为量表（CBCL）。目的：（1）确定临床上因失眠而转诊的儿童的主要照顾者中临床上显著的育儿压力的患病率;（2）确定在育儿压力中起作用的儿童睡眠问题;（3）在行为睡眠医学诊所的背景下确定育儿压力的相关因素;（4）确定与育儿压力相关的最突出的儿童睡眠和行为变量。47%的主要照顾者有临床显著的养育压力。当研究儿童睡眠问题和父母压力之间的关系时，睡前阻力（p = 0.030）和白天嗜睡（p = 0.0003）单独作为与父母压力最显着的关联。当考虑更广泛的协变量时（儿童年龄和儿童性别）和临床相关变量（父母睡眠问题史、父母精神病史、儿童行为问题与儿童睡眠问题）在单因素回归方程中，均为儿童外化行为问题（β = 0.570，p < 0.0001）和儿童日间嗜睡（β = 0.152，p = 0.028）独立解释了父母压力的显著变化。结论：许多儿童临床失眠评估和治疗的主要照顾者有显著的父母压力。父母压力与失眠儿童的日间行为问题和嗜睡有关。与儿科失眠患者一起工作的临床医生应该仔细评估养育压力和儿童白天的行为，因为这些方面的功能可能会影响服务提供和治疗结果。(C)2011爱思唯尔有限公司版权所有。
Background: Parenting stress is an aspect of parent functioning relevant in clinical settings. Within the context of behavioral sleep medicine, the role of parenting stress is not well understood.Methods: Prospective evaluation of patients 1.5-10 years old with insomnia. Subjects were 156 primary caregiver-child pairs who completed the Parenting Stress Index-Short Form (PSI-SF), Child Sleep Habits Questionnaire (CSHQ) and Child Behavior Checklist (CBCL). Aims: (1) determine prevalence of clinically significant parenting stress in primary caregivers of children clinically referred for insomnia; (2) identify childhood sleep problems that play a role in parenting stress; (3) identify relevant correlates of parenting stress within the context of a behavioral sleep medicine clinic: and (4) identify the most salient child sleep and behavioral variables associated with parenting stress.Results: Forty-seven percent of primary caregivers had clinically significant parenting stress. When examining the relationship between child sleep problems and' parenting stress, bedtime resistance (p = 0.030) and daytime sleepiness (p = 0.0003) stood alone as having the most salient associations with parenting stress. When considering a broader range of covariates (child age and child gender) and clinically relevant variables (parent history of sleep problems, parent history of psychiatric conditions, child behavior problems and child sleep problems) in a single regression equation, both child externalizing behavior problems (beta = 0.570, p < 0.0001) and child daytime sleepiness (beta = 0.152, p = 0.028) independently explained significant variability in parenting stress.Conclusions: Many primary caregivers of children clinically-referred for insomnia evaluation and treatment have significant parenting stress. Parenting stress is associated with daytime behavioral problems and sleepiness in children with insomnia. Clinicians working with pediatric insomnia patients should carefully evaluate parenting stress and child daytime behavior as these aspects of functioning may have an impact on service delivery and treatment outcomes. (C) 2011 Elsevier B.V. All rights reserved.