This paper reviews the literature on sleep problems in pre-school children, aiming to raise awareness of the current knowledge in this field. The article begins with a discussion of the prevalence of sleep problems in young children. Disorders of initiating and maintaining sleep are by far the most common type of sleep problem in this age group, and are therefore the focus of this review. The effects of sleep disturbance are examined, focusing on how parents often feel desperate and in need of support outside the family. The causes of sleep problems are considered and the complexity in identifying causal factors is highlighted. The article continues with an exploration of the treatment of sleep problems, suggesting that much of the advice given to parents is contradictory. The literature demonstrates that the use of medication is common, but it appears that this method of treatment is of limited benefit. It seems that behaviour modification or a psychodynamic approach may be much more successful, and the use of self-help manuals/booklets has been shown to be useful by some authors. Finally, preventative strategies are discussed highlighting the need for further research in this area.

In the pre-school years sleep problems are one of the most common subjects on which parents seek advice from health professionals. In the majority of cases a sleepless child causes significant stress within the family, and if parents do not obtain sufficient sleep this can have a detrimental effect on their physical and emotional well-being. In a small number of cases a child who wakes frequently and will not settle back to sleep may be at risk of physical abuse. In recent years it has been suggested that it may be possible to prevent sleep problems developing by providing parents with advice in the post-natal period. Parents have stated that they find this type of intervention helpful, however, there has been no attempt to establish whether a preventive approach is effective. The aim of this research was to evaluate the efficacy of health education in reducing the incidence of sleep problems. Adopting an experimental approach, participants were randomly allocated to a control group or an intervention group. Parental knowledge of sleep and settling behaviour was manipulated when the children in the intervention group were 3 months old. The sleeping behaviour of the infants in both groups was compared 6 months later, when the children were 9 months old. Data was collected from 86 families in the intervention group and 83 families in the control group. A comprehensive analysis of the sleeping behaviour demonstrated that a significantly smaller percentage of babies in the intervention group had settling and night-waking difficulties than in the control group.

Since the 1960s there has been an awareness of a 'care-gap' when patients are transferred between hospital and home. In the United Kingdom, attempts to improve continuity of care have included the development of the role of the hospital/community liaison nurse. The liaison role has evolved in different ways and no systematic evaluation has occurred. This paper reports the findings of an exploratory study into the structure and process of the liaison role. It is suggested that the role is effective in enhancing continuity of care, but that modifications accompanied by educational and organizational changes would improve current practice.

The morale of nurses is a phenomenon often open to public comment without substantiated evidence. This study objectively explored the morale of nurses in a large district general hospital preparing for transition to National Health (NHS) Trust status. Information was sought using a 72-item questionnaire. The investigation was firmly centred around a structured theory which construes morale in terms of nine dimensions. The notion of morale being a construct synthesized of nine dimensions adds to the uniqueness of the study. Other studies fail to differentiate between the dynamic morale construct and the more complacent attitudes of job satisfaction.

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