An ecological-transactional analysis of children’s sleep problems following the Christchurch and Kaikoura earthquakes : a qualitative study in the context of clinical reasoning.
Following a natural disaster, children are prone to various reactions and maladaptive responses as a result of exposure to a highly stressful and potentially traumatic event. Children’s responses can range from an acute stress response to post-traumatic-stress disorder or may fall somewhere in between. While responses to highly stressful events vary, a common finding is that children will develop sleep problems. This was found following the Christchurch September 2010 and February 2011 earthquakes. The purpose of this study was to investigate the context and phenomenology of the sleep problems of a small number of children experiencing these and the 2016 Kaikoura earthquakes, including possible mechanisms of effect. Participants were four families, including four mothers, one father and four children. The design of this study was unique. Interview data was subjected to a content analysis, extracted themes were organised according to an ecological-transactional framework and then the factors were subject to an analysis, based on the principles of clinical reasoning, in order to identify possible mechanisms of effect. Parents reported 16 different sleep problems across children, as well as other behaviours possibly indicative of post-traumatic stress response. In total, 34 themes and 26 interactions were extracted in relation to factors identified across participants about the children’s sleep and the families’ earthquake experiences. This demonstrated how complex it is to explore the development of sleep problems in the context of disaster. Key factors identified by parents that likely played a key role in the development and perpetuation of sleep problems included earthquake related anxiety, parental mental health and conflict, the child’s emotional and behavioural problems and other negative life events following the earthquakes. The clinical implications of the analysis included being aware that such families, may not have had access to specialized support around their children’s sleep. This was much needed due to the strain such problems place on the family, especially in a post-disaster community such as Christchurch.