What Are The Relationships Among Cumulative Trauma, Posttraumatic Stress Disorder, Sleep Quality, And Perinatal Outcomes In African American Women?

WHAT ARE THE RELATIONSHIPS AMONG CUMULATIVE TRAUMA, POSTTRAUMATIC STRESS DISORDER, SLEEP QUALITY, AND PERINATAL OUTCOMES IN AFRICAN-AMERICAN WOMEN? NANCY J. HAUFF, MSN, RN May 2015 Advisor: Judith Fry-McComish, PhD, RN, FAAN, IMH-IV, E Major: Nursing Degree: Doctor of Philosophy Trauma, primarily in the form of intimate partner violence and automobile accidents, accounts for 6-8% of all pregnancy complications. Much less is known about cumulative trauma (CT) exposure especially in African-American women. Women exposed to several types of trauma including childhood abuse, discrimination, or witnessed family violence may develop symptoms of posttraumatic stress or have difficulty sleeping. The purpose of this study was to examine the relationships among cumulative trauma, posttraumatic stress, sleep, and perinatal outcomes. A sample of 150 essentially healthy African-American women who had given birth were recruited at Hutzel Women\u27s Hospital and St. John Providence Hospital Southfield, and asked to complete the Cumulative Trauma Scale, Community Safety Questionnaire, Conflict Tactics Scale, Clinician-administered PTSD Scale, Pittsburgh Sleep Quality Index, Edinburgh Depression Inventory, and Demographic Data Form. The prenatal and hospital medical records were reviewed for multiple maternal and neonatal outcomes. Regression analysis was used to determine if relationships between the variables exist, and the strength of those relationships. The findings of this study showed: 1) African- American women experience traumatic events. 2) cumulative trauma is associated with PTSD, depression, poor sleep quality, and neonatal outcomes; 3) nursing must go beyond the assessment of intimate partner violence, report active trauma, and record findings in the medical record; and 4) more research is needed to better understand mothers\u27 use of over the counter and other medications to help them sleep. The relevance to maternal child health is that a better understanding of cumulative trauma exposure, PTSD, poor sleep, and the risk for poor perinatal outcomes among African-American women can lead to earlier identification and the development of nursing interventions