Respiratory Health, Sleep Dysfunction, and Mental Health in Children and Adolescents With a Neuromuscular Disorder: A Descriptive Qualitative Study

M. Huston, A. Withers, J. Lam, Andrew Wilson, J. Downs
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Abstract

Objectives: To explore how respiratory health and sleep problems affect mental health in children and adolescents with neuromuscular disorders (NMDs).Methods: A qualitative descriptive study was carried out with content analysis of in-depth interviews conducted with children with NMDs and their parents. Data were collected during semi-structured interviews with children with NMDs and their parents. A total of 14 families were recruited (17 parents and 7 children and adolescents with NMD aged 5–17 years). Each interview was conducted with 1–3 family member(s).Results: Engagement in community activities, meaningful relationships, feeling well, and achieving independence each contributed positively to children’s mental health. Additional challenges to mental health during periods of poor respiratory and/or sleep health included: 1) challenges to behavioral regulation, 2) changes to mood, and 3) challenges to thinking. Parents and children reported nurturing and coping self-management strategies when their physical and mental health were dually challenged in addition to medical management strategies such as non-invasive ventilation (NIV).Conclusions: This study supports the notion that changes in mental health may indicate poor physical health in children with NMDs. Treating respiratory and sleep problems, such as by early NIV implementation, may improve the mental health of children with NMDs and thus support their overall wellbeing and health outcomes.
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患有神经肌肉障碍的儿童和青少年的呼吸健康、睡眠障碍和心理健康:一项描述性质的研究
目的:探讨呼吸健康和睡眠问题对神经肌肉疾病(NMDs)儿童和青少年心理健康的影响。方法:采用定性描述性研究方法,对nmd患儿及其父母进行深度访谈,并对访谈内容进行分析。通过对nmd患儿及其父母的半结构化访谈收集数据。共招募了14个家庭(17名家长和7名5-17岁的NMD儿童和青少年)。每次访谈与1-3名家庭成员进行。结果:参与社区活动、有意义的人际关系、感觉良好和实现独立对儿童的心理健康都有积极的影响。在呼吸和/或睡眠健康状况不佳期间,对心理健康的其他挑战包括:1)行为调节的挑战,2)情绪的变化,以及3)思维的挑战。当父母和孩子的身心健康受到双重挑战时,除了诸如无创通气(NIV)等医疗管理策略外,他们还报告了培养和应对自我管理策略。结论:本研究支持以下观点,即nmd患儿的心理健康变化可能表明其身体健康状况不佳。治疗呼吸和睡眠问题,如早期实施NIV,可能会改善nmd儿童的心理健康,从而支持他们的整体福祉和健康结果。
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