Turkiye Klinikleri Journal of Pediatrics

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Evlilik Doyumu, Maternal Depresyon, Bağlanma ve Erken Çocukluk Dönemi Uyku Sorunları: Tanımlayıcı Araştırma
Marital Satisfaction, Maternal Depression, Attachment and Early Childhood Sleep Problems: A Descriptive Study
Hatice Ezgi BARIŞa,c, Büşra SELVİb, Canan TUNAb, Tutku Nil ARASb, Gül İlayda SARARb, Mert KANTARCIb, Perran BORANc
aMarmara Üniversitesi Sağlık Bilimleri Enstitüsü, Sosyal Pediatri ABD, İstanbul, Türkiye
bMarmara Üniversitesi Tıp Fakültesi, İstanbul, Türkiye
cMarmara Üniversitesi Tıp Fakültesi, Sosyal Pediatri BD, İstanbul, Türkiye
Turkiye Klinikleri J Pediatr. 2022;31(2):113-20
doi: 10.5336/pediatr.2021-86634
Article Language: TR
Full Text
ÖZET
 Amaç: Evlilik ilişkisi, erken çocukluk dönemi uyku sorunları olan bir çocuğun bakımında özellikle önemli olabilir. Amacımız, annenin evlilikten aldığı doyumun, erken çocukluk dönemi uyku sorunları üzerine etkisini incelemektir. Gereç ve Yöntemler: Çocuk Sağlığı İzlem Polikliniğimizden takipli 3-12 ay arası bebeklerin anneleri, anne ve bebek uykusu ile ilgili soruları içeren Kısa Bebek Uyku Anketi'nden türetilen sorularla değerlendirildi. Annenin evlilik doyumu, Evlilik Yaşamı Ölçeği (EYÖ) ile; annenin depresif semptomları Edinburgh Doğum Sonrası Depresyon Ölçeği (EDSDÖ) ile; anne-bebek bağlanması ise Doğum Sonrası Bağlanma Ölçeği (DSBÖ) ile değerlendirildi. Bulgular: Yüz dört anne-bebek ikilisinde, bebeklerde uyku sorunu sıklığı %39,4 olarak bildirildi. Uyku sorunu olan ve olmayan bebeklerin annelerinin EYÖ puanları arasında fark saptanmadı. Anne EYÖ puanı ile bebeklerin gece uyanma sayıları negatif korelasyon gösterdi (rs: - 0,27, p=0,005). Babaların %18,3'ü anne-bebek ikilisinden farklı odada uyumaktaydı. Babanın farklı odada uyuduğu ailelerde, annelerin EYÖ puanı daha düşük saptandı (p=0,008). Evlilik yaşam doyumu daha yüksek olan annelerde, depresif semptom puanlaması düşmekte (p<0,001) ve daha iyi anne-bebek bağlanması gözlenmekteydi (p=0,04). On altı annede EDSDÖ'ye göre depresyon taraması pozitif saptandı. Bebeklerinde uyku sorunu olan annelerin ortanca EDSDÖ puanı, diğer annelerden yüksek saptanırken (p=0,022); uyku sorunu olan ve olmayan bebeklerin annelerinin DSBÖ puanları arasında anlamlı farklılık izlenmedi. Sonuç: Bebeğin geceleri sık uyanması, annenin evlilik doyumunun azalmasıyla ilişkili iken babanın aynı odada yatması, daha iyi evlilik doyumu ile ilişkili saptanmıştır. Erken bebeklik döneminde uyku sorunları, annenin depresif semptomlarıyla ilişkili bulunmuştur. Klinik uygulamalarda, annenin ruhsal iyilik hâli ve annebebek bağlaması ile ilişkili olduğu gösterilen evlilik doyumuna ve eşler arası yakın ilişkinin sürdürülmesine odaklanmak erken çocukluk dönemi uyku sorunlarının yönetiminin bir parçası olması önerilmektedir.

Anahtar Kelimeler: Çocuk; uyku sorunu; maternal depresyon; evlilik doyumu; bağlanma
ABSTRACT
 Objective: The marital relationship may be particularly important for dealing with early childhood sleep problems. Our primary aim was to examine the impact of maternal marital satisfaction on early childhood sleep problems. Material and Methods: Mothers, whose infants aged 3-12 months and followed up in our well child clinic, were evaluated with questions derived from the Brief Infant Sleep Questionnaire containing questions about mother and baby sleep. Mother's marital satisfaction, mother's depressive symptoms and mother-infant bonding were assessed by the Marital Life Scale (MLS), Edinburgh Postpartum Depression Scale (EPDS) and Postpartum Bonding Questionnaire (PBQ), respectively. Results: Of the 104 mother-infant dyad, 39.4% infants had sleep problems. There were no significant differences in MLS scores of mothers of infants with and without sleep problems. MLS scores were negatively correlated with the infants' night awakenings (rs: -0.27, p=0.005). Approximately 18.3% of fathers were sleeping in another room. Lower maternal MLS scores were observed in those compared to the fathers who sleep in the same room with their partners (p=0.008). Mothers with higher marital satisfaction had lower depressive symptom scores (p<0.001) and better mother-infant relationship (p=0.04). Sixteen mothers were screened positive for depression according to EPDS. Mothers of infants with sleep problems had higher EPDS scores (p=0.022), whereas no significant difference was observed in PBQ scores. Conclusion: Frequent infant night awakenings were associated with decreased maternal marital satisfaction while bed sharing with partners were related to improved marital satisfaction. Early childhood sleep problems were found to be associated with maternal depressive symptoms. In clinical practice, clinicians should focus on marital satisfaction and maintenance of intimate partner relationship in the management of early childhood sleep problems.

Keywords: Child; sleep problem; maternal depression; marital satisfaction; bonding
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