Thesis (M.S.)--University of Michigan, 1990.

Thesis (PH. D.) Columbia university. / Bibliography: p. 37-39.

Thesis Ph.D. - University of Queensland, 2005. / Includes bibliographical references.

Thesis (M.D.)--University of Hong Kong, 2006.

Thesis (M. Ed.)--University of Canterbury, 2009. / Typescript (photocopy). "February 2009." Includes bibliographical references (leaves 66-70). Also available via the World Wide Web.

Cardiac post-surgery inpatients lack the amount and quality of sleep needed for optimal recovery. I aimed to investigate the non-pharmacological sleep promotion practices used by nurses and the factors that influence their use. Guided by the Theoretical Domains Framework, I developed and administered a survey to registered nurses working in the Cardiac Intensive Care Unit and the cardiac surgery ward in one cardiac centre. Findings revealed that common sleep promotion practices included orientating inpatients to the room (n=88, 96.7%), and providing additional bedding (n=86, 96.6%). The most common enablers were knowledge regarding its benefits (n=72, 100%) and an understanding of its importance (n=77, 98.7%); the most common barriers were an absence of recognition from important healthcare professionals (n=61, 85.9%) and having competing priorities (n=60, 83.3%). These findings can be used in the development of interventions to promote nurses’ use of sleep promotion practices and to improve inpatients’ sleep quality.

京都大学 / 0048 / 新制・課程博士 / 博士(文学) / 甲第18633号 / 文博第657号 / 新制||文||607(附属図書館) / 31547 / 京都大学大学院文学研究科文献文化学専攻 / (主査)教授 佐々木 徹, 教授 家入 葉子, 准教授 森 慎一郎 / 学位規則第4条第1項該当 / Doctor of Letters / Kyoto University / DFAM

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INTRODUCTION: Poor sleep quality is a significant risk factor for the development of postpartum depression. This thesis examined the impact of a post-delivery intervention which promoted and protected sleep during the immediate postpartum period on maternal mood, sleep quality, and anxiety. METHODS: 41 women with lifetime or current mood and/or anxiety disorders (12 receiving the intervention) were enrolled in this prospective naturalistic cohort study from the third trimester of pregnancy until 24 weeks postpartum. Depression, the primary outcome, was measured using the Edinburgh Postnatal Depression Scale at 12 weeks postpartum. Remaining outcomes (sleep quality and anxiety) were measured using self-report questionnaires (Insomnia Severity Index and State-Trait Anxiety Inventory, respectfully), and objective measures (i.e., actigraphy for sleep quality). RESULTS: There were no significant differences between the comparison and intervention group in depressive symptomatology at postpartum week 12 (primary outcome). On our secondary outcomes, we found that there were no significant differences in subjective and objective sleep quality at postpartum week two, or anxiety symptomatology at postpartum week eight between the two groups. There were also no significant differences in breastfeeding rates between the two groups at postpartum week 24. CONCLUSION AND FUTURE DIRECTIONS: Floor effects, specialized perinatal psychiatric treatment for a specific population, and low statistical power offer explanations for the observed null results. Strengths of our study include diagnosis of mood/anxiety disorders using the gold-standard (i.e., clinician diagnosis), and use of objective sleep measures. Future studies may benefit from implementing this intervention in resource-poor settings, using adequately powered research designs. / Thesis / Master of Science (MSc) / While the arrival of a child is a celebrated and joyous occasion, it can also be a source of duress and anguish, particularly for the mother. Postpartum depression is a mood disorder experienced by 10-15% of mothers after childbirth. One of the strongest risk factors for the development of postpartum depression is disrupted postpartum sleep quality. This thesis examined the impact of an intervention designed to protect and promote sleep of mothers during the postpartum period in an effort to improve mood, sleep quality, and anxiety symptomatology. By improving maternal mental health, not only do women benefit, but their children, their partners, and the healthcare system.

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