原著

Original Article

Maho, ICHIHARA

sleep-wake behavior

experimental single case study

The purpose of this study was to evaluate the usability of an innovative nursing intervention incorporating objective data from sleep-wake behavior assessment in order to improve family members' daily care for infants with severe disability. Using longitudinal and single case experimental designs, we analyzed 3 infants with severe disability and sleep problems in their homes. Data were collected from video recordings, oxygen saturation recordings, sleep diaries, andsemi-structured interviews with family members. Nursing intervention focusing on improving family members' dailycare was provided acording to the following three steps. First, individual sleep problems were assessed using an original sleep-wake behavior assessment tool. Second, characteristic components were extracted from objective data. Finally, nursing intervention sessions explaining the appropriate care for the child's sleep problems using the individual characteristic components were conducted by an Advanced Practice Nurse who was the researcher. Additional assessment and intervention sessions were conducted during the subsequent 6-month period and individual target behaviors were measured longitudinally. As a result of the intervention, all children improved their sleep-wake behavior. Each child had symptoms of central nervous system impairment that disturbed their sleep due to symptom intensification. However, the family members did not realize the actual cause of the sleep problems; therefore, the intervention was important because it gave the family members a deep understanding of the children's needs. We conclude that promoting family awareness of the child's symptoms and distress allowed the family to provide appropriate care for the child. These results demonstrate the usability of this nursing intervention that incorporates objective data from an original sleep-wake behavior assessment.