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Kalvas LB, Harrison TM. Screen time and sleep duration in pediatric critical care: Secondary analysis of a pilot observational study. J Pediatr Nurs 2024; 76:e101-e108. [PMID: 38307758 PMCID: PMC11081838 DOI: 10.1016/j.pedn.2024.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/04/2024]
Abstract
PURPOSE Quantify and describe screen time (screen type, child engagement, adult co-viewing) in eight critically ill children and determine its association with sleep duration before (parent report) and during (actigraphy) a 24-h period in the PICU. DESIGN AND METHODS Exploratory secondary analysis of 24-h video and actigraphy recordings in eight children 1-4 years old in the PICU. Videos were coded for screen time using Noldus Observer XT® software. Screen time was compared to American Academy of Pediatrics recommendations (0 h/day <2 years, ≤1 h/day 2-5 years). Parents completed the Brief Infant Sleep Questionnaire-Revised-Short Form (BISQ-R-SF) to understand children's pre-hospital sleep. Actigraphy was used to measure PICU sleep duration. Associations between screen time and sleep were determined with bivariate analyses. RESULTS Average age was 23.1 months (SD = 9.7). Daily screen time was 10.7 h (SD = 7), ranging from 2.4 to 21.4 h. Children (15.1% of sampling intervals) and adults (16.3%) spent little time actively engaged with screen media. BISQ-R-SF scores ranged from 48.9 to 97.7. Children had an average of 7.9 (SD = 1.2) night shift (19:00-6:59) sleep hours. Screen time was associated with worse pre-hospital sleep quality and duration with large effect sizes (rs= -0.7 to -1) and fewer nighttime sleep hours with a medium effect size (rs= -0.5). CONCLUSIONS All children exceeded screen time recommendations. Screen time was associated with worse pre-hospital sleep quality and duration, and decreased PICU sleep duration. Large-scale studies are needed to explore PICU screen time and sleep disruption. PRACTICE IMPLICATIONS Clinicians should model developmentally appropriate screen media use in PICU.
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Affiliation(s)
- Laura Beth Kalvas
- The Ohio State University Center for Clinical & Translational Science, 236A Newton Hall, 333 W. 10(th) Ave., Columbus, OH 43210, USA.
| | - Tondi M Harrison
- The Ohio State University College of Nursing, 360 Newton Hall, 1585 Neil Avenue, Columbus, OH 43210, USA.
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Lepage C, Gaudet I, Doussau A, Vinay MC, Gagner C, von Siebenthal Z, Poirier N, Simard MN, Paquette N, Gallagher A. The role of parenting stress in anxiety and sleep outcomes in toddlers with congenital heart disease. Front Pediatr 2022; 10:1055526. [PMID: 36683797 PMCID: PMC9853386 DOI: 10.3389/fped.2022.1055526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/25/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES This retrospective cohort study investigates how parenting stress, measured at 4 months of age by use of a classic three-dimensional parent-reported scale (Parenting Stress Index, 4th Ed. or PSI-4), can predict anxiety symptoms and quality of sleep at 24 months in toddlers with congenital heart disease (CHD). STUDY DESIGN Sixty-six toddlers with CHD followed at our cardiac neurodevelopmental follow-up clinic were included in this study. As part of their systematic developmental assessment program, parents completed questionnaires on their stress level (PSI-4) when their child was 4 months old, and on their child's anxiety symptoms and quality of sleep at 24 months. Eight multiple linear regression models were built on the two measures collected at 24 months using the PSI-4 scores collected at 4 months. For each measure, four models were built from the PSI-4 total score and its three subscales (Parental Distress, Parent-Child Dysfunctional Interaction, Difficult Child), controlling for sex and socioeconomic status. RESULTS The PSI-4 Difficult Child subscale, which focuses on parenting anxiety related to the child's behavioral problems and poor psychosocial adjustment, accounted for 17% of the child's anxiety symptoms at 24 months. The two other PSI-4 subscales (Parental Distress and Parent-Child Dysfunctional Interaction) and the PSI-4 total score did not contribute significantly to the models. None of the four regression models on perceived quality of sleep were significant. It is important to note that 33% of parents responded defensively to the PSI-4. CONCLUSIONS Parenting stress related to the child's behavioral problems and poor psychosocial adjustment, measured when the child is 4 months old, is associated with the child's ulterior anxiety symptoms. As very few standardized tools are available to assess the behavioral and psychoaffective development of infants, this study highlights the importance of early psychosocial screening in parents of infants with CHD. The high rate of significant Defensive Responding Indices reminds us to not take parent reports at face value, as their actual stress levels might be higher.
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Affiliation(s)
- Charles Lepage
- Research Center, Sainte-Justine University Hospital Research Center, Montréal, QC, Canada.,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Isabelle Gaudet
- Research Center, Sainte-Justine University Hospital Research Center, Montréal, QC, Canada.,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Amélie Doussau
- Clinique d'investigation neurocardiaque (CINC), Sainte-Justine University Hospital, Montréal, QC, Canada
| | - Marie-Claude Vinay
- Clinique d'investigation neurocardiaque (CINC), Sainte-Justine University Hospital, Montréal, QC, Canada
| | - Charlotte Gagner
- Clinique d'investigation neurocardiaque (CINC), Sainte-Justine University Hospital, Montréal, QC, Canada
| | - Zorina von Siebenthal
- Clinique d'investigation neurocardiaque (CINC), Sainte-Justine University Hospital, Montréal, QC, Canada
| | - Nancy Poirier
- Research Center, Sainte-Justine University Hospital Research Center, Montréal, QC, Canada.,Clinique d'investigation neurocardiaque (CINC), Sainte-Justine University Hospital, Montréal, QC, Canada.,Department of Surgery, Division of Cardiac Surgery, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Marie-Noëlle Simard
- Research Center, Sainte-Justine University Hospital Research Center, Montréal, QC, Canada.,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Natacha Paquette
- Research Center, Sainte-Justine University Hospital Research Center, Montréal, QC, Canada.,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Anne Gallagher
- Research Center, Sainte-Justine University Hospital Research Center, Montréal, QC, Canada.,Department of Psychology, Université de Montréal, Montréal, QC, Canada
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