How to Improve the Sleep of Hospitalized Pediatric Patients: Family and Staff Focus Groups

Abstract

Pediatric patients undergoing bone marrow transplant (BMT) face lengthy hospital stays designed to support healing. However, the hospital environment, treatment side effects, and care practices can disrupt sleep, negatively impacting patients' quality of life and recovery. Prior qualitative studies focused on staff or family feedback, but none have incorporated the viewpoints of both groups. This project sought to uniquely identify barriers and solutions acceptable to multiple stakeholders. Identify barriers to good quality sleep among hospitalized BMT patients and their families, as well as actionable intervention targets. Eight semi-structured focus groups were conducted with 15 family members of hospitalized BMT patients and 20 staff at Cincinnati Children's Hospital Medical Center. Focus groups were transcribed, coded using content analysis, and reviewed in consensus meetings involving medical staff and family partners of recently hospitalized children to ensure the credibility of findings. Participants described sleep as fragmented and of poor quality. Negative consequences of inadequate sleep included emotion dysregulation and reduced participation in rounds. Both family members and staff reported that medical interventions and environmental factors, such as noise and light, frequently disrupt rest. Suggested interventions included altering care schedules, improving staff-family communication, and environmental changes, like light dimming, noise reduction, and more comfortable beds. Family members were more likely to suggest interventions to support overall well-being, such as additional support for caregiver physical and mental health. Staff were more likely to suggest changing patient and family behaviors as a means to improve sleep, such as sleep schedules. Sleep quality in pediatric BMT patients and their families can be improved through environmental modifications and procedural adjustments, aligning with broader efforts to create sleep-friendly hospital environments. These strategies are adaptable to other care settings, improving overall patient and family well-being.

Keywords: Inpatient; Pediatric; Qualitative research; Quality of life; Sleep; Stem cell transplant.