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Title: Sleep hygiene education and children with developmental disabilities
Author: Sutton, Julie
ISNI:       0000 0004 9358 3881
Awarding Body: Bangor University
Current Institution: Bangor University
Date of Award: 2017
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Sleep hygiene education (SHE) is a first-line treatment for behavioural sleep problems that affect up to 80% of children with developmental disabilities (DD). SHE involves advising parents on behaviours which promote quality sleep in children; however, it is an inadequately conceptualised intervention currently supported by theories based on popular wisdom. Professionals who support families of children with DD and sleep problems have routinely implemented SHE for years without explicit explanation of what the intervention is supposed to achieve. For these families, severe and enduring sleep problems are a daily reality, placing increased impetus on the need for evidence based and transparent SHE interventions. This is also reflected in the current prudent healthcare agenda in the UK, which obliges professionals to only deliver care which is relevant to individual need. The aim of this thesis is therefore to develop a systematic understanding about what SHE does, how it is delivered and how it is supposed to work to improve sleep. Through a hybrid of deductive and inductive approaches, an evidence based SHE tool and nuanced programme theory is developed, which helps communicate the essentials of SHE. Firstly, a scoping review investigates what is known about SHE and findings inform the design of an inductive programme theory development phase underpinned by a participatory methodology. This incorporates an exploratory study examining the perceptions of parents and professionals about SHE through qualitative interviewing. Stakeholders then deliberate emerging themes in a co-design study and cumulative findings are synthesised to develop the main outputs of this thesis: a SHE tool underpinned by a programme theory. An abstraction to mid-range change theories demonstrates how the programme theory presents plausible solutions to sleep problems and the original contribution of an explicit understanding of the nature of the complexity embedded in a SHE intervention for children with DD is presented. The findings indicate how the legitimation of sleep problems is a foundation on which SHE implementation should be based. It also demonstrates a greater understanding of the nature of customisation, knowledge exchange, health expectation and impact of rationing and gaming on implementation success. Implications for policy and practice include a more explicit understanding of what SHE is and how best to deliver it and for research, a theory-driven framework for evaluating SHE.
Supervisor: Huws, Jacqueline Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Sleep ; sleep hygiene education ; children ; developmental disabilities