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Preliminary Results of a Cognitive and Behavioral Intervention to Promoting the Sleep Quality of Mothers of Hospitalized Premature Infants: A Case Study.


Mothers of hospitalized premature infants have been complained sleep problems and it’s have been associated with some negative mental health outcomes such as depressive and anxiety symptoms. These changes can be perpetuated by dysfunctional beliefs about sleep, which cause increase anxiety to sleep. Cognitive-Behavioral Therapy (CBT) is effective to improve the maternal sleep quality on postpartum period. However, few studies adapted the protocols to the hospital environment.


This study aimed to evaluate the results of cognitive and behavioral intervention on sleep quality, sleep beliefs, and depressive symptoms of mothers of hospitalized preterm infants, comparing results between the control group (CG) and intervention group (IG).


After approval by Ethics Committee (CAAE:23716919.6.0000.5537), 10 mothers of preterm infants, aged 24 to 38 years, without psychiatric and neurological disorders, participated in this study. After randomization, two mothers composed the CG, which not received intervention, and eight the IG. The interventions took place for six days during the period of the Kangaroo Intermediate Care Unit (KICU) of a public maternity hospital. The Dysfunctional Sleep Beliefs and Attitudes Scale, Edinburgh Postnatal Depression Scale (EPDS), and Pittsburgh Sleep Quality Index (PSQI) were applied in three moments: before, after interventions, and at follow-up, 30 days after hospital discharge.


The medians obtained by CG in PSQI at the three moments, respectively, were 9.5, 9, and 7. In EPDS were 6.5, 4, and 1. On the Sleep Attitudes and Beliefs Scale were 4.93, 2.46, and 3.12. The medians of the IG in PSQI were 9.5, 7 and 6.5. In EPDS were 10.5, 2.5 and 1 and in Sleep Attitudes and Beliefs Scale were 6.40, 3.15, and 4.49. The data suggest that the groups, especially the IG, showed a reduction in poor sleep quality and depressive symptoms, maintained during follow-up. There was an improvement in the groups' beliefs and attitudes about sleep. Mann-Whitney test did not identify significant differences between groups' scores in Sleep Attitudes and Beliefs Scale, PSQI and EPDS: p=0,295; p=1,0; p=0,358; before, p=0,433; p=0,588; p=0,895 after interventions and p=0,893; p=1,0; p=0,675 in the follow-up.


Considering preliminary data, the results may have been influenced by the sample size, numerical difference in the CG and IG and structural conditions of hospital environment.


Sleep; Kangaroo Mother care Method; Cognitive behavioral therapy; Infant, Premature


Área Clínica


Universidade Federal do Rio Grande do Norte - Rio Grande do Norte - Brasil


Ralina Carla Lopes Martins da Silva, Larissa Maiara Fernandes de Morais, Lucas Dantas Lima, Katie Moraes de Almondes