Children and adolescents hospitalized with chronic conditions: sleep patterns, resilience and quality of life

Xavier, Welker da Silva; Nunes, Michelle Darezzo Rodrigues; Abreu, Madalena Paulos; Nascimento, Lucila Castanheira; Rebustini, Flávio

doi:10.1590/1980-220X-REEUSP-2023-0363en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 58 • 2024 • https://doi.org/10.1590/1980-220X-REEUSP-2023-0363en copy

Children and adolescents hospitalized with chronic conditions: sleep patterns, resilience and quality of life^* * Extracted from the dissertation: Evaluation of sleep pattern, resilience and quality of life of hospitalized children and adolescents with chronic conditions. Faculty of Nursing, Rio de Janeiro State University, 2023.

Niños y adolescentes hospitalizados con enfermedades crónicas: patrón de sueño, resiliencia y calidad de vida

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate the sleep pattern of children and adolescents with chronic conditions during hospitalization and correlate it with resilience, quality of life, clinical and sociodemographic data.

Method:

Quantitative, descriptive and cross-sectional study. Data collection took place between May 2022 and January 2023, with children and adolescents with chronic conditions from two hospitals in Rio de Janeiro. The instruments used were the Actigraph, Sandra Prince-Embury’s Resilience Scale for Children and Adolescents and the Pediatric Quality of Life Inventory. Data analysis involved descriptive statistics and correlation tests.

Results:

40 hospitalized children and adolescents between the ages of nine and 18 took part. The results showed compromised sleep, especially in terms of duration and time awake after sleep onset. Quality of life scores were low and resilience levels were classified as medium to high. Correlations were found between resilience and sleep. In addition, sleep was influenced by diagnosis and treatment.

Conclusion:

Children and adolescents hospitalized with chronic conditions experience significant sleep disturbances and have a low quality of life, but have satisfactory levels of resilience.

DESCRIPTORS
Child; Adolescent; Chronic Disease; Sleep Wake Disorders; Pediatric Nursing

Subscales	N	Md	IQR	Amp	Min	Max	Mean ± SD
HRQOL
Physical functioning	40	64,06	38,28	93,75	3,12	96,87	60,62 ± 22,86
Emotional functioning	40	50,00	25,00	85,00	15,00	100,00	52,00 ± 20,62
Social functioning	40	77,50	26,25	70,00	30,00	100,00	74,75 ± 18,50
School functioning	40	50,00	31,25	80,00	10,00	90,00	50,05 ± 19,38
Total generic HRQoL	40	60,86	22,83	59,78	25,00	84,78	59,36 ± 15,18
Resilience
Control	40	52,00	20,50	54,00	22	76	50,44 ± 13,36
Relationship capacity	40	66,00	23,50	61,00	35	96	68,35 ± 15,67
Emotional reactivity	40	26,50	19,75	45,00	06	51	27,20 ± 13,54
Sleep variables
WASO	26	39,62	31,65	106,05	10,20	116,25	42,47 ± 26,14
Sleep duration	26	221,27	109,35	346,03	69,22	415,25	216,42 ± 87,59
Sleep, %	26	70,16	16,35	51,71	41,28	92,99	70,05 ± 14,91
Sleep efficiency	26	89,43	7,90	20,30	75,68	95,98	87,76 ± 5,89

Sleep variables	Factor	Statistics (H)	Df	P-value
WASO	Diagnostic	3,42	2	0,18
Sleep duration	Diagnostic	1,94	2	0,38
Sleep, %	Diagnostic	3,73	2	0,15
Sleep efficiency	Diagnostic	6,22	2	0,04^* *p < 0,05. Df: degrees of freedom; WASO: Wake After Sleep Onset.

Sleep variables	Comparisons	Z	Wi	Wj	Pbonf
WASO	Genetics – autoimmune	1,75	16,43	9,50	0,24
	Genetics – other	0,51	16,43	14,54	1,00
	Autoimmune – other	–1,42	9,50	14,54	0,47
Sleep duration	Genetics – autoimmune	0,43	12,71	11,00	1,00
	Genetics – other	–0,84	12,71	15,82	1,00
	Autoimmune – other	–1,36	11,00	15,82	0,53
Sleep, %	Genetics – autoimmune	0,37	11,86	10,37	1,00
	Genetics – other	–1,34	11,86	16,82	0,54
	Autoimmune – other	–1,81	10,37	16,82	0,21
Sleep efficiency	Genetics – autoimmune	–2,47	8,71	18,50	0,04^* * p < 0,05. Wi and Wj: sums of ranks in treatments i and j, respectively; Pbonf: Bonferroni’s p; WASO: Wake After Sleep Onset.
	Genetics – other	–1,13	8,71	12,91	0,77
	Autoimmune – other	1,57	18,50	12,91	0,35

Sleep variables	Groups	N	Md	IQR	Amp	Min	Max	Mean ± SD
WASO	Genetics	7	44,60	29,47	79,33	21,50	100,83	51,91 ± 27,31
	Autoimmune	8	28,66	17,18	60,80	10,20	71,00	29,52 ± 19,33
	Other	11	46,00	28,04	104,12	12,13	116,25	45,87 ± 28,10
Sleep duration	Genetics	7	199,57	82,36	207,07	88,50	295,57	200,64 ± 71,83
	Autoimmune	8	185,73	105,47	293,89	84,44	378,33	195,37 ± 96,54
	Other	11	246,44	68,72	346,03	69,22	415,25	241,78 ± 91,25
Sleep, %	Genetics	7	70,01	15,21	41,02	41,28	82,30	66,54 ± 14,89
	Autoimmune	8	63,92	17,97	48,30	42,70	91,00	64,46 ± 16,53
	Other	11	78,10	14,15	42,98	50,01	92,99	76,35 ± 12,42
Sleep efficiency	Genetics	7	83,55	2,26	18,81	75,68	94,49	84,22 ± 5,57
	Autoimmune	8	91,90	3,61	20,06	75,92	95,98	90,92 ± 6,42
	Other	11	88,84	4,06	15,02	78,10	93,12	87,71 ± 4,76
WASO	Medication	15	46,00	40,67	105,00	11,25	116,25	50,72 ± 29,96
WASO	Multiple	11	30,33	17,12	44,940	10,20	55,14	31,21 ± 14,48
Sleep duration	Medication	15	199,57	106,41	330,81	84,44	415,25	216,23 ± 89,14
Sleep duration	Multiple	11	230,71	96,49	309,11	69,22	378,3	216,69 ± 89,76
Sleep, %	Medication	15	70,31	15,38	51,60	41,28	92,88	70,08 ± 15,09
Sleep, %	Multiple	11	70,02	15,65	50,23	42,76	92,99	70,01 ± 15,40
Sleep efficiency	Medication	15	84,37	7,41	20,21	75,68	95,89	85,02 ± 6,29
Sleep efficiency	Multiple	11	91,00	1,95	8,08	87,90	95,98	91,50 ± 2,17

Sleep variables	Statistic (W)	Rank-biserial	VS-MPR	P-value
WASO	116,00	0,41	1,73	0,09
Sleep duration	80,00	–0,03	1,00	0,92
Sleep, %	85,00	0,03	1,00	0,92
Sleep efficiency	31,00	–0,62	11,31	0,01^* * p < 0,05. VS-MPR: Vovk-Sellke maximum p-ratio; WASO: Wake After Sleep Onset.

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Michelle Darezzo Rodrigues Nunes, Boulevard 28 de Setembro, 157, Vila Isabel, 20551-030, Rio de Janeiro, RJ de Janeiro, RJ, Brazil, mid13@hotmail.com