Survival mode: Mothers’ perceptions of implementing physician’s recommendations for paediatric sleep-care

Paediatric sleep problems are pervasive and affect optimal development. Although evidence-based treatments are available, clinical experience suggests that they are not effectively translated into practice. The experience of the clinicians at the Sleep-/Wake Behaviour Clinic at Sunny Hill Children’s Health Centre (BC Children’s Hospital) suggested that well-validated treatment protocols were not translating into clinical successes with their patients. A preliminary study in Kamloops showed that families were not implementing physicians’ recommendations for sleep-care, which raised questions about was preventing them from doing so. Therefore, the purpose of this study was to understand a) mother’s experience managing their child’s sleep problem in the context of the BC healthcare system and family; and, b) describe the meanings they make from these experiences, and in turn, how these inform mothers’ reactions to physician’s sleep-care recommendations. Mothers seeking sleep-care support from the Kamloops Paediatric Sleep Clinic were interviewed about their experiences implementing recommendations and the barriers they faced. Through an iterative process of theoretical sampling, memoing, and on-going review of the literature, I constructed a theoretical process model of mothers’ experience managing their child’s sleep problem entitled “Surival Mode.” This nascent theory was validated through negative case analysis, flip-flop techniques and member-checking, until I was satisfied that it “fit” and was a “useful” model from the participants’ perspective. Understanding the meaning of sleep problems for mothers, and the factors underlying adherence with sleep recommendations, may help increase intervention success and, inform policy/program development.