Christine A. Feeley, PhD

Advisor, Anne Turner-Henson, PhD, RN, FAAN

Sleep Quality, Stress, Caregiver Burden, and Quality of Life in Maternal Caregivers of Young Children with Bronchopulmonary Dysplasia

Mothers are usually the primary caregivers of young children with a chronic illness such as bronchopulmonary dysplasia (BPD), and may have no formal caregiver training. Children with BPD often require complex healthcare at home (complex medication regimens, oxygen via nasal cannula, Gastrostomy feedings, etc.), thus many maternal caregivers experience difficulty balancing the needs of their child with their own needs and other responsibilities. As such, maternal caregivers may report increased levels of stress and caregiver burden, as well as decreased quality of life (QOL). Additionally, a great number of maternal caregivers report poor sleep quality due to nighttime caregiving duties. The primary purpose of this study is to examine relationships between sleep quality, stress, caregiver burden, and QOL, as well as influences of these variables on QOL.

The sample consisted of 61 maternal caregivers, who were predominantly minority (67.2% African American) and had an average age of 29.59 years. The majority of maternal caregivers were single (62.3%), and 88.5% had a high school education or greater. The average age of the child with BPD was 13.93 months, and had been living at home for, on average, 8.79 months. Maternal caregivers reported sleeping less than 6 hours per night (average 5.8), and the majority (78.7%) reported disturbed sleep (as determined by a score of 5 or greater on the Pittsburgh Sleep Quality Index).

Significant Pearson's correlations were found between sleep quality and depressive symptoms (r =.529, p=.000), stress (r =.284, p =.027), and inversely QOL ( r = -.292, p =.022). Caregiver burden was significantly correlated with stress (r =.326, p =.010). Sleep quality (p =.000, t =-3.757) and depressive symptoms (p=.011, t=2.635) were found to be the most significant predictors of QOL using forced entry multiple linear regression in a model that explained 30% of the variance in QOL. Stress was not found to mediate the relationship between sleep quality and caregiver burden and QOL.

Improving sleep quality and depressive symptoms in maternal caregivers may help to improve QOL. Clinicians should assess caregiver's sleep and provide education on the importance of sleep for overall health.

The full abstract can be found here.