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| Title: | 嬰幼兒照顧者主觀覺知嬰幼兒睡眠問題之相關因素探討
The Factors Associated with Caregivers` Perception of Infant Sleep Problems |
| Authors: | 張哲虹
Chang, Jhe Hong |
| Contributors: | 楊建銘
Yang, Chien Ming
張哲虹
Chang, Jhe Hong |
| Keywords: | 嬰幼兒睡眠
照顧者困擾
教養態度一致性
嬰幼兒睡眠知識量
睡眠品質
憂鬱情緒
Infant sleep
parents’ distress
consistency of care attitude
knowledge of infant sleep
sleep quality
depression |
| Date: | 2013 |
| Issue Date: | 2014-03-03 15:31:01 (UTC+8) |
| Abstract: | 研究目的：
嬰幼兒的睡眠狀態常讓照顧者感到困擾，嬰幼兒睡眠問題越嚴重，照顧者困擾程度越高。然而，跨文化研究與前驅研究的結果發現，台灣嬰幼兒睡眠狀態與照顧者主觀感受之間的關係較不一致，有些孩子的睡眠狀態並沒有太大問題，照顧者仍報告自己感到嚴重的困擾。因此，本研究以網路問卷的方式，分別探討外在環境因素（如：睡眠環境安排、居住型態、與配偶及祖輩教養態度的一致性）及照顧者個人因素（如：照顧者睡眠品質、憂鬱狀態、對嬰幼兒睡眠的知識及失功能信念）是否存在中介及調節的效果，影響照顧者的主觀感受。
研究方法：
本研究以網路進行問卷調查，透過網路招募共計607位0-3歲嬰幼兒之父母填寫問卷。其問卷內容包括自編睡眠問卷用以了解嬰幼兒睡眠狀態及人口學變項；匹茲堡睡眠品質量表、睡眠知識量表、睡眠認知量表及流行病學研究中心憂鬱量表用以了解父母的睡眠品質、認知及情緒狀態。統計方式則以階層迴歸分析分別探討外在環境因素及個人內在因素的中介及調節效果。
研究結果：
在照顧者知覺的睡眠問題與嬰幼兒睡眠狀態的關聯性部分，本研究發現當詢問照顧者孩子「是否」有睡眠問題，其結果與嬰幼兒的睡眠狀態無相關或僅有非常低的相關，但若詢問照顧者受嬰幼兒睡眠困擾的「程度」，其結果與嬰幼兒的睡眠狀態則有中度以上的相關。在其他外在因素的部分，睡眠環境安排、與配偶及祖輩教養態度一致性部分對嬰兒睡眠狀態與照顧者主觀困擾程度的預測力扮演調節的角色，除此之外也有部分則是能直接預測照顧者的困擾程度；居住型態則未存在任何調節或直接預測的效果。在照顧者個人內在因素的部分，照顧者睡眠品質存在部分中介的效果，照顧者憂鬱狀態、嬰幼兒睡眠知識量及失功能信念對嬰幼兒睡眠狀態對照顧者主觀困擾程度的預測力亦有部分扮演調節的角色，部分則是直接能預測照顧者主觀困擾。
研究結論：
本研究結果顯示，過去研究發現照顧者主觀感受與嬰幼兒睡眠狀態間不一致的現象部分可能是因為詢問方法所造成的，照顧者受嬰幼兒睡眠困擾的程度仍然會受到其孩子睡眠狀態的影響。然而，照顧者的困擾程度仍無法完全以嬰幼兒的睡眠狀態來解釋，還會受到外在環境與個人內在因素的影響。在可能影響照顧者困擾程度的因素當中，照顧者嬰幼兒睡眠知識量的影響是最一致的，照顧者的嬰幼兒睡眠知識量少者，孩子睡眠狀態對其主觀困擾程度的預測力較低，也就是說，父母較無法依照孩子實際的睡眠狀態反應其困擾程度；此外，與配偶及祖輩教養態度越不一致、照顧者的睡眠品質越差、憂鬱程度及憤怒相關的失功能信念越高，皆可預測照顧者主觀受嬰幼兒睡眠困擾的程度越高。整體來說，此結果顯示照顧者的認知及情緒因素在嬰幼兒睡眠狀態所帶來的困擾上扮演重要的角色。應用於臨床上，建議未來協助父母處理嬰幼兒睡眠問題時，除了評估嬰幼兒的睡眠狀況外，需進一步了解照顧者所處環境及個人內在狀態的影響，依照顧者的個別狀態給予協助，例如：提供睡眠衛教以增加嬰幼兒睡眠相關知識、協助增加與配偶及祖輩教養態度的一致性、討論與修正其失功能信念、提升睡眠品質及憂鬱情緒的介入等，以降低照顧者受嬰幼兒睡眠困擾的程度。
OBJECTIVE:
Sleep problem in infants and children is a common complaint of their caregivers. It is generally assumed that caregeivers’ perceived distress should be associated with the condition of their children’s sleep. However, the results of a previous study and our pilot study showed an inconsistent relationship between infants’ sleep and their parents’ level of distress about their children’s sleep in Taiwan. Some of the parents perceived severe distress even though their children had normal sleep. Thus, the aim of this study is to explore whether some environmental factors (sleep arrangement, family composition, and the consistency of caregiving attitude between couples and grandparents) and internal factors of the caregivers (sleep quality, depression level, knowledge of infant sleep and dysfunctional beliefs of the caregivers) play a mediating or moderating role in the relationship between infant sleep and parents’ level of distress.
METHOD:
Six hundred and seven parents of infants aged from birth to 3 years were recruited via internet and completed a web-based online questionnaire about their children. The contents of the questionnaire include a self-constructed sleep questionnaire about children`s sleep status and demographic data, the Pittsburgh Sleep Quality Index (PSQI) to measure parents’ sleep quality, the Parents Sleep Knowledge Inventory (PSKI) to measure parents’ knowledge of infant sleep, the Maternal Cognitions about Infant Sleep Questionnaire (MCISQ) to measure dysfunctional beliefs of infant sleep, and the Center for Epidemiologic Studies Depression Scale (CES-D) to measure parents’ depression level. The data was analyzed with hierarchical regression to explore whether environmental and internal factors serve as a mediator or moderator for the association between infant’s sleep condition and parents’ level of distress.
RESULTS:
The results show no or very low association between parents’ rating on question asking whether their childrens have sleep problems and their children’s sleep condition. However, when asking to rate the level of distress, there was a moderate correlation between the rating and their children’s sleep condition. Among the environmental factors, sleep arrangement and the consistency of care attitude between couples or grandparents is a moderator between infant sleep and parents` level of distress. These factor also plays a role in predicting of parents’ level of distress directly. On the other hand, living composition showed no significant predicting or moderating effects on caregivers’ level of distress. Among the internal factors, parents’ sleep quality was found to be a mediator. Parents’ depression level, parents’ knowledge and dysfunctional beliefs of infant sleep was found to be a moderator between infant sleep and parents` level of distress. These factors were also shown to be a predictor of parents’ level of distress.
CONCLUSIONS:
In conclusion, the inconsistent relationship between infant sleep and parents’ level of distress in the previous studies maybe due to the wording of questioning. Parents` level of distress was shown to be influenced by infants` sleep. However, parents` level of distress is not explained only by infants` sleep but also by some environmental and internal factors. Parents` knowledge of infant sleep is the most consistent factor that influences parents` level of distress. The less correct the parents’ sleep knowledge, the lower the predictability of infants` sleep on parents` level of distress. In addition, lower consistency of care attitude between couples and grandparents, poorer sleep quality and higher depression level, and higher dysfunctional belief about anger are associated with higher level of distress. Overall, parents` cognitive and emotional factors play an important role in the perceived distress about their childrens’ sleep. The results imply that in clinical intervention for infants’ sleep problem, the environmental and internal factors of parents need to be considered. The intervention may need to include procedures targeting these factors, such as increasing consistency of care attitude between couples and grandparents, giving sleep hygience education to increase knowledge of infant sleep, discussing and modifying the dysfunctional beliefs, improving parents’ sleep quality and treating depression. |
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| Description: | 碩士
國立政治大學
心理學研究所
98752007
102 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0098752007 |
| Data Type: | thesis |
| Appears in Collections: | [心理學系] 學位論文
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