Date of Award

Summer 8-4-2015

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Dr. Patricia Clark

Abstract

Problem: Mothers of children with developmental disabilities (DDs) experience high levels of stress, such as parenting stress and caregiving burden, due to their children with DDs’ life-long care needs. The high levels of stress results in impaired sleep as well as poor well-being among mothers raising children with DDs. Mothers’ sleep may be an important mediator in linking maternal stress to health-related well-being. The purpose of this study was to examine the mediating effect of mothers’ sleep between maternal stress and well-being after controlling for child behavior problems in a community sample of mothers of middle age children (ages 6-12) with DDs. This study used the integrated model, which proposes both the individual differences to the stress response and the cumulative effects of stress on health.

Methods: A cross-sectional, correlational design was used. Forty mothers of middle age children with DDs (M = 8.8 ± 2.2 years) from various community settings volunteered and completed a set of questionnaires and a 5-day sleep diary. Instruments measured parenting stress, caregiving burden, perceived sleep quality, child behavior problems, depressive symptoms, and physical as well as mental well-being. A series of regression analyses were used to test the mediation.

Results: Mothers were in early 40’s (M = 42.1 ± 5.3 years), married (75%), White (70%), well-educated (88% with college degree), and with a high income (73% were $75,000 or greater). Children were mostly boys (74%) and diagnosed with autism, Down syndrome, or cerebral palsy. Although the mothers’ physical well-being scores fell around the U.S. norm scores, their mental well-being scores were almost 1 SD below the general population. Mothers also reported on average poor sleep quality (PSQI > 5, M =7.9 ± 4.8), high parenting stress, moderate to severe caregiving burden, and high levels of depressive symptoms (CES-D > 16, 53%). Mothers’ perceived sleep quality only mediated in the relationship between caregiving burden and depressive symptoms.

Conclusions: The study results call for close monitoring of mothers’ sleep and provide a direction for interventions designed to improve sleep and well-being in mothers of children with DDs.

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