Parents' knowledge, attitudes, and practices regarding sleep in babies discharged from the neonatal unit
DOI:
https://doi.org/10.4025/ciencuidsaude.v24i1.76864Keywords:
Knowledge; Sleep; Parents; Child; Neonatal Nursing.Abstract
Objective: to compare parents' knowledge, attitudes, and practices regarding the sleep of babies discharged from the Neonatal Unit, before and after the application of an educational booklet with variables related to hospitalization and the child's sleep. Method: quasi-experimental, single group, before and after study, conducted in a specialized pediatric outpatient clinic with 50 parents of children discharged from the neonatal unit in 2020. Data collection took place at two moments: application of the instrument with sociodemographic, perinatal, and neonatal variables; application of the pre-test: Knowledge, Attitude, and Practice (KAP) survey: individual reading of the educational booklet by participants. 2) Application of the post-test via telephone call: KAP survey. Results: Most were mothers of preterm children (82%). The intervention increased parents' knowledge, attitude, and practice scores on all instrument items, highlighting changes in sleep timing and location. The length of hospital stay and time spent in the unit showed higher averages in terms of parents' knowledge. Knowledge and practice, before and after the CAP survey, showed statistically significant values (p<0.05). Conclusion: The use of the educational booklet promoted the acquisition of knowledge, attitudes, and practices among parents, as evidenced by the increase in scores after its implementation.
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References
1. Henrique NCP, Hilário JSM, Louzada FM, Scorzafave LGDS, Santos DD, Mello DF. Child sleep habits and maternal perception throughout the child’s first year of life. J. Hum. Growth Dev. (Online). 2022; 32 ( 3 ): 321-30. Doi:10.36311/jhgd.v32.13095
2.Dias DS, Silva DTN, Sena JM, Teixeira RS, Figueiredo MCA. A hora do sono. Revista Ibero-Americana de Humanidades, Ciências e Educação . 2022; 8( 10 ): 4190-7. Doi: 10.51891/rease.v8i10.7405
3.Sabagh K, Ghaljaei F. The interventional effect of quiet time protocol on the sleep status of premature neonates admitted to the NICU. Iranian J. Neonatol. (Online). 2024; 15( 2 ): 53-62. DOI:10.22038/IJN.2023.73016.2414
4.Romeo RR, Leonard JA, Grotzinger HM, Robinson ST, Takada ME, Mackey AP, et al. Neuroplasticity associated with changes in conversational turn-taking following a family-based intervention. Dev. Cogn. Neurosci. 2021; 49: 100967. Doi:10.1016/j.dcn.2021.100967
5.Stewart LM, Sellmaier C, Brannan AM, Brennan EM. Supporting sleep and health of employed parents with typical and exceptional care demands. J. Soc. Serv. Res. 2022; 48( 2 ): 259-72. Doi:10.1080/01488376.2021.2024935
6. Lélis ALPA, Cardoso MVLML, Hall WA. Sleep disorders in children with cerebral palsy: an integrative review. Sleep Med. Rev. 2016; 30: 63-71. Doi:10.1016/j.smrv.2015.11.008
7. Lélis ALPA, Cipriano MAB, Cardoso MVLML, Lima FET, Araújo T. Influence of the family context on sleep disorders in children. Rev. Rene. 2014; 15( 2 ): 343-53. Doi:10.15253/2175-6783.2014000200020
8. Moon RY, Carlin RF, Hand I. Sleep-related infant deaths: updated 2022 recommendations for reducing infant deaths in the sleep environment. Pediatrics. 2022; 150( 1 ): e2022057990. Doi:10.1542/peds.2022-057990
9. Andrade C, Menon V, Ameen S, Praharaj SK. Designing and conducting knowledge, attitude, and practice surveys in psychiatry: practical guidance. Indian. J. Psychol. Med. 2020; 42( 5 ): 478-81. Doi:10.1177/0253717620946111
10. Ribeiro VM, Vóvio CL, Moura MP. Letramento no Brasil: alguns resultados do indicador nacional de alfabetismo funcional. Educ Soc. 2002; 23( 81 ): 49-70. Doi:10.1590/S0101-73302002008100004
11. Monde M. The KAP survey model: knowledge, attitude and practices [Internet]. Medicins du Monde. 2011 [cited 2025 Oct 27]. Available from: https://www.medecinsdumonde.org/en/publication/the-kap-survey-model-knowledge-attitude-and-practices/
12. Ribeiro ALT, Araújo ÉF de, Pinho IVOS de, Melo MC, Martins RGG, Lara CCQ. Avaliação de tecnologia educativa para crianças com diabetes: estudo metodológico. Esc. Anna Nery. 2021; 25( 5 ): e20200282. Doi:10.1590/2177-9465-EAN-2020-0282
13. Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010; 23: 340:c332. Doi:10.1136/bmj.c332
14. Goodstein MH, Stewart DL, Keels EL, Moon RY. Transition to a safe home sleep environment for the NICU patient. Pediatrics. 2021; 148( 1 ): e2021052046. Doi: 10.1542/peds.2021-052045
15. Anacleto LA, Alves VH, Rodrigues DP, Vieira BDG, Pereira AV, Almeida VLM. Hospital discharge management of premature newborns: nurses’ knowledge. Rev. pesqui.: cuid. fundam. online. 2021; 13: 634-9. Doi:10.9789/2175-5361.rpcfo.v13.9359
16. Araujo EB, Reis DBC, Rocha AD, Machado ABS. Hospitalization and discharge of the neonate in the neonatal care unit: identification of parents' doubts. Rev. Enferm. Atual In Derme. 2022; 96( 39 ): e-021265. Doi: 10.31011/reaid-2022-v.96-n.39-art.1405
17. Risanger LI, Kofoed PE, Noergaard B, Vahlkvist S. Parents’ perception of staff support in a father-friendly neonatal intensive care unit. Children (Basel). 2023; 10( 4 ): 673. Doi:10.3390/children10040673
18. Meng L, Lingling Z, Haihong Z, Xiaobai Z, Dandan H, Shaoyan W. Readiness for hospital discharge and its correlation with the quality of discharge teaching among the parents of premature infants in NICU. Appl. Bionics. Biomech. 2022: 4924021. Doi: https://doi.org/10.1155/2022/4924021
19. Hua W, Yuwen W, Simoni JM, Yan J, Jiang L. Parental readiness for hospital discharge as a mediator between quality of discharge teaching and parental self-efficacy in parents of preterm infants. J Clin Nurs. 2020; 29( 19-20 ): 3754-63. Doi:10.1111/jocn.15405
20.Zakaria R, Sutan R. What’s mom needs for their preemie after NICU discharge? A scoping review. Malays. J. Med. Health Sci.[Internet]. 2021[cited 2025 Oct 27]; 17( 4 ): 399-409. Available from: https://medic.upm.edu.my/upload/dokumen/2021100810123752_MJMHS_0539.pdf
21.Francisco ASPG, Graciosa MD, Pacheco SCS, Sonza A, Sanada LS. Does premature birth affect Brazilian parents’ practices related to infant positioning? Rev. Paul. Pediatr. 2024; 42: e2022163. Doi:10.1590/1984-0462/2024/42/2022163
22. Sacks AM, Fitzgerald J, Boerste LA. Improving safe infant sleep compliance through implementation of a safe sleep bundle. Adv Neonatal Care. 2023; 23( 1 ): 4-9. Doi:10.1097/ANC.0000000000000992
23. Kellams A, Hauck FR, Moon RY, Kerr SM, Heeren T, Corwin MJ, et al. Factors associated with choice of infant sleep location. Pediatrics. 2020; 145( 3 ): e20191523. Doi:10.1542/peds.2019-1523
24.Shatz A, Joseph L, Korn L. Infants’ sleep: Israeli parents’ knowledge, attitudes and practices. Children (Basel). 2021; 8( 9 ): 803. Doi:10.3390/children8090803
2.Dias DS, Silva DTN, Sena JM, Teixeira RS, Figueiredo MCA. A hora do sono. Revista Ibero-Americana de Humanidades, Ciências e Educação . 2022; 8( 10 ): 4190-7. Doi: 10.51891/rease.v8i10.7405
3.Sabagh K, Ghaljaei F. The interventional effect of quiet time protocol on the sleep status of premature neonates admitted to the NICU. Iranian J. Neonatol. (Online). 2024; 15( 2 ): 53-62. DOI:10.22038/IJN.2023.73016.2414
4.Romeo RR, Leonard JA, Grotzinger HM, Robinson ST, Takada ME, Mackey AP, et al. Neuroplasticity associated with changes in conversational turn-taking following a family-based intervention. Dev. Cogn. Neurosci. 2021; 49: 100967. Doi:10.1016/j.dcn.2021.100967
5.Stewart LM, Sellmaier C, Brannan AM, Brennan EM. Supporting sleep and health of employed parents with typical and exceptional care demands. J. Soc. Serv. Res. 2022; 48( 2 ): 259-72. Doi:10.1080/01488376.2021.2024935
6. Lélis ALPA, Cardoso MVLML, Hall WA. Sleep disorders in children with cerebral palsy: an integrative review. Sleep Med. Rev. 2016; 30: 63-71. Doi:10.1016/j.smrv.2015.11.008
7. Lélis ALPA, Cipriano MAB, Cardoso MVLML, Lima FET, Araújo T. Influence of the family context on sleep disorders in children. Rev. Rene. 2014; 15( 2 ): 343-53. Doi:10.15253/2175-6783.2014000200020
8. Moon RY, Carlin RF, Hand I. Sleep-related infant deaths: updated 2022 recommendations for reducing infant deaths in the sleep environment. Pediatrics. 2022; 150( 1 ): e2022057990. Doi:10.1542/peds.2022-057990
9. Andrade C, Menon V, Ameen S, Praharaj SK. Designing and conducting knowledge, attitude, and practice surveys in psychiatry: practical guidance. Indian. J. Psychol. Med. 2020; 42( 5 ): 478-81. Doi:10.1177/0253717620946111
10. Ribeiro VM, Vóvio CL, Moura MP. Letramento no Brasil: alguns resultados do indicador nacional de alfabetismo funcional. Educ Soc. 2002; 23( 81 ): 49-70. Doi:10.1590/S0101-73302002008100004
11. Monde M. The KAP survey model: knowledge, attitude and practices [Internet]. Medicins du Monde. 2011 [cited 2025 Oct 27]. Available from: https://www.medecinsdumonde.org/en/publication/the-kap-survey-model-knowledge-attitude-and-practices/
12. Ribeiro ALT, Araújo ÉF de, Pinho IVOS de, Melo MC, Martins RGG, Lara CCQ. Avaliação de tecnologia educativa para crianças com diabetes: estudo metodológico. Esc. Anna Nery. 2021; 25( 5 ): e20200282. Doi:10.1590/2177-9465-EAN-2020-0282
13. Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010; 23: 340:c332. Doi:10.1136/bmj.c332
14. Goodstein MH, Stewart DL, Keels EL, Moon RY. Transition to a safe home sleep environment for the NICU patient. Pediatrics. 2021; 148( 1 ): e2021052046. Doi: 10.1542/peds.2021-052045
15. Anacleto LA, Alves VH, Rodrigues DP, Vieira BDG, Pereira AV, Almeida VLM. Hospital discharge management of premature newborns: nurses’ knowledge. Rev. pesqui.: cuid. fundam. online. 2021; 13: 634-9. Doi:10.9789/2175-5361.rpcfo.v13.9359
16. Araujo EB, Reis DBC, Rocha AD, Machado ABS. Hospitalization and discharge of the neonate in the neonatal care unit: identification of parents' doubts. Rev. Enferm. Atual In Derme. 2022; 96( 39 ): e-021265. Doi: 10.31011/reaid-2022-v.96-n.39-art.1405
17. Risanger LI, Kofoed PE, Noergaard B, Vahlkvist S. Parents’ perception of staff support in a father-friendly neonatal intensive care unit. Children (Basel). 2023; 10( 4 ): 673. Doi:10.3390/children10040673
18. Meng L, Lingling Z, Haihong Z, Xiaobai Z, Dandan H, Shaoyan W. Readiness for hospital discharge and its correlation with the quality of discharge teaching among the parents of premature infants in NICU. Appl. Bionics. Biomech. 2022: 4924021. Doi: https://doi.org/10.1155/2022/4924021
19. Hua W, Yuwen W, Simoni JM, Yan J, Jiang L. Parental readiness for hospital discharge as a mediator between quality of discharge teaching and parental self-efficacy in parents of preterm infants. J Clin Nurs. 2020; 29( 19-20 ): 3754-63. Doi:10.1111/jocn.15405
20.Zakaria R, Sutan R. What’s mom needs for their preemie after NICU discharge? A scoping review. Malays. J. Med. Health Sci.[Internet]. 2021[cited 2025 Oct 27]; 17( 4 ): 399-409. Available from: https://medic.upm.edu.my/upload/dokumen/2021100810123752_MJMHS_0539.pdf
21.Francisco ASPG, Graciosa MD, Pacheco SCS, Sonza A, Sanada LS. Does premature birth affect Brazilian parents’ practices related to infant positioning? Rev. Paul. Pediatr. 2024; 42: e2022163. Doi:10.1590/1984-0462/2024/42/2022163
22. Sacks AM, Fitzgerald J, Boerste LA. Improving safe infant sleep compliance through implementation of a safe sleep bundle. Adv Neonatal Care. 2023; 23( 1 ): 4-9. Doi:10.1097/ANC.0000000000000992
23. Kellams A, Hauck FR, Moon RY, Kerr SM, Heeren T, Corwin MJ, et al. Factors associated with choice of infant sleep location. Pediatrics. 2020; 145( 3 ): e20191523. Doi:10.1542/peds.2019-1523
24.Shatz A, Joseph L, Korn L. Infants’ sleep: Israeli parents’ knowledge, attitudes and practices. Children (Basel). 2021; 8( 9 ): 803. Doi:10.3390/children8090803
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2025-12-12
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Parents’ knowledge, attitudes, and practices regarding sleep in babies discharged from the neonatal unit. (2025). Ciência, Cuidado E Saúde, 24(1). https://doi.org/10.4025/ciencuidsaude.v24i1.76864
