Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Lois Chandler Howland, DrPH, MSN, RN, Chairperson; Nancy Jallo, PhD, FNP-BC, WHNP-BC; Kathy Shadle James, DNSC, MSN, RN


Guided imagery, mental health, motherhood, Neonatal Intensive Care Unit, nursing, Preterm infants, sleep quality, women


Background: Mothers who have given birth to preterm infants are at an increased risk for impaired sleep. Evidence based interventions are needed to assist mothers in improving their sleep quality as few are available. Purpose: Guided by the transactional framework of Lazarus and Folkman (1984), the purpose of this study was to: describe maternal and infant factors which influence sleep quality, examine the relationships between depression, anxiety, stress, social support, to sleep quality, and describe the influence of a R-GI intervention on sleep quality among a sample of mothers whose preterm babies were admitted to NICU. Methods: This prospective, descriptive, secondary data analysis study which used repeated-measures (N = 20) (mother-infant dyads) was conducted over 8-weeks. The intervention consisted of the use of a CD which contained three tracks structured to influence outcomes. Maternal study measures collected at baseline (pre-enrollment), week four (time 2), and week eight (time 3) included: The Perceived Stress Scale (PSS), The State-Trait Anxiety Inventory (STAI) State Scale only, The Duke UNC – Functional Social Support Scale (FSSQ), The Center for Epidemiologic Studies Depression Scale (CES-D), and The Pittsburg Sleep Quality Index (PSQI). Infant measures included The Neonatal Medical Index (NMI) collected at time 3. Findings: The findings suggested that anxiety, depression, stress, and lower income are related to poor sleep quality, and that social support and increased age are related to better sleep quality. The participants reported that the intervention of R-GI assisted them in falling asleep and reduced stress. With cumulative R-GI use, sleep quality improved. The findings from this study may be used to inform future intervention studies designed to benefit the health outcomes of mothers of hospitalized preterm infants. Conclusion: This study was important in providing an investigation into factors which influence sleep quality in a sample of mothers whose preterm babies were admitted to NICU. Continued research is needed with a larger population to better understand interventions and factors which influence sleep quality in this population.

Document Type

Dissertation: Open Access



Included in

Nursing Commons