Doctoral Dissertations

Date of Award

5-2020

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Nursing

Major Professor

Sadie P. Hutson

Committee Members

Katherine Newnam, Hilary Fouts, Joel Anderson

Abstract

Caregiver-infant bed-sharing has become increasingly controversial in western industrialized countries over the past few decades. In these countries, public health authorities recommend against all infant bed-sharing since some infants die while sharing a bed with their caregiver. However, anthropologists have shown that caregivers and infants likely shared sleep surfaces for thousands of years, producing an infant who has evolved to expect close human contact during sleep. In many countries, infant-caregiver bed-sharing is practiced widely without increases in infant death rates or recommendations against the practice. It is important to examine bed-sharing in various contexts to fully understand the problem. Before this project, there was no data available on infant-caregiver bed-sharing in Southern-Central Appalachia. This manuscript is divided into three parts, each with a focus on infant bed-sharing which builds toward the results of an original study of caregiver-infant experiences of bed-sharing in Southern-Central Appalachia. In part I, I present a multidisciplinary theory integration on infant-caregiver bed-sharing to show that investigators and practitioners must look at this problem through multiple lenses. Part II consists of a systematic qualitative meta-synthesis on infant-caregiving experiences in which we found that caregivers describe the experience of bed-sharing with their infants in terms of responsiveness, approval, and practicality. In part III, I discuss the results of a narrative analysis of caregiver-infant bed-sharing experiences in Southern-Central Appalachia. This manuscript provides a wholistic overview of the infant-bed-sharing problem today with implications for nursing practice, research, and policy. This is a complex issue with wide-reaching implications for infant safety, development, and caregiver decision-making.

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