Sleep disturbance and psychological distress among hospitalized children in India: Parental perceptions on pediatric inpatient experiences

Purpose: Investigate parental perceptions of children's sleep disturbance and psychological distress associated with an inpatient stay in a low-resource hospital setting. Design and Methods: Demographic and validated survey instruments were adapted for administration to parents of children in the medical wards of a tertiary hospital in India. Parents proficient in English, Hindi, Tamil, or Telugu with a child age 4–12 years admitted for at least 48 h were eligible to participate. All respondents completed the Factors Affecting Sleep Disturbance Scale, Sleep Duration Questionnaire, Sleep Disturbance Scale, and Kessler Psychological Distress Scale. Data analysis entailed descriptive statistics, correlations, and multivariate regressions to analyze relationships across responses on demographics, sleep disturbance, and psychological distress. Results: Among 105 parents with hospitalized children, most had children 4–6 years old (54%), including 65% boys and 35% girls. Parents reported that their children slept overnight in the hospital for a mean of 8.3 ± 1.6 h. Children 4–6 year old (relative risk ratio [RRR] = 0.63, p =.004), dyspnea (RRR = 8.73, p =.04), previous hospitalization (RRR = 9.17, p =.03), nighttime procedures (RRR = 2.97, p =.03, and missing home (RRR = 6.78, p <.001) were the factors affecting sleep. Factors affecting psychological distress was nighttime medication administration (RRR = 4.92, p =.01). Sleep disturbances correlated with psychological distress (r = 0.56; p <.01). Conclusion: Sleep disturbance and associated psychological distress in hospitalized children were widely reported by parents queried in this low-resource hospital setting. Practical Implications: Nurses can lead efforts in ameliorating sleep in hospitalized children, including partnering with stakeholders on measures to reduce sleep disruption. Child-centered interventions may improve sleep hygiene and decrease psychological distress among children.