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Epilepsy is one of the most common chronic neurological diseases in children. Sleep disorders tend to increase the risk of seizures, and research has found that moderate physical activity may improve the quantity and quality of sleep in adults. However, the link between physical activity level and sleep patterns in toddlers and preschool-age children with epilepsy remains unclear.To explore the association between level of physical activity and sleep patterns in toddlers and preschool-age children with epilepsy.A cross-sectional, descriptive, correlational study was conducted. Ninety-eight children with epilepsy (1.5-6 years old) wore an actigraph for seven days. Additional data were collected using a health information datasheet, Children's Sleep Habits Questionnaire (CSHQ), and sleep diary, all of which were completed by the parents of each child.The results showed that the mean amount of time spent in moderate-to-vigorous physical activity per day was 36.00 ± 49.20 minutes and that only 23 children (23.5%) had a nighttime sleep efficiency greater than 85%. The overall CSHQ score (56.00 ± 5.69) indicated the presence of moderate to severe sleep disturbances. Multiple regression analysis showed the hours and percentage of moderate-to-vigorous physical activity to be positively associated with night sleep efficiency (β = .54, p.01; β = .51, p.01) and negatively associated with nighttime sleep hours (β = -.55, p.01; β = -.52, p.01), even after controlling for potential confounders.Based on the findings, the sleep patterns and physical activity of children with epilepsy should be regularly assessed. Furthermore, appropriately increasing the duration of moderate-to-vigorous physical activity may improve sleep efficiency and prevent reductions in the duration of night sleep.癲癇兒童日間活動與睡眠型態相關性之探討.癲癇症是兒童最常見的慢性神經系統疾病之一，睡眠障礙易使癲癇發作機會增加，成人研究顯示適度身體活動有益睡眠，但目前不清楚幼兒及學齡前癲癇兒身體活動與睡眠型態之關係。.探討幼兒期及學齡前期癲癇兒身體活動與睡眠型態之相關性。.採橫斷式描述相關性設計，共98位1.5–6歲癲癇兒連續七日佩戴活動記錄器，其父母完成癲癇兒童基本健康資料表、兒童睡眠習慣問卷（Children’s Sleep Habits Questionnaire, CSHQ）及癲癇兒童睡眠活動日誌。.癲癇兒平均每日中高度身體活動時數為36.00 ± 49.20分鐘，夜間睡眠效率85%僅23人（23.5%），CSHQ總分（56.00 ± 5.69）顯示有中至重度睡眠問題。多元迴歸分析在控制干擾因子後，中高度身體活動時數、百分比與夜間睡眠效率呈顯著正相關（β = .54, p.01; β = .51, p.01）；與夜間睡眠時數呈顯著負相關（β = -.55, p.01; β = -.52, p.01）。.依研究結果建議常規評估癲癇兒身體活動與睡眠，適度增加中高度身體活動進而提升睡眠效率及避免縮短夜間睡眠時數。.

Preterm infants face increased rates of mortality and developmental complications, which are a burden on children's parents (and caregivers), who suffer from exhaustion and situational uncertainty. This case focused on an extremely-low-birth-weight (908 gm) premature infant with initial unstable vital signs complicated by a grade 4 intraventricular hemorrhage (IVH) that led to partial brain atrophy and enlarged brain ventricles. A poor neurological outcome was expected due to the high risk of cerebral palsy and impaired cognitive abilities. Long-term healthcare for this critical infant was causing tremendous physical, emotional, and financial strains on the family. The parents suffered from worries over the poor prognosis, resulting in stress, sleep disorders, and relationship difficulties with the healthcare professionals. Considering the poor prognosis of the infant, the parents faced a medical dilemma between choosing aggressive treatment and withdrawal of treatment, which led to stress and sleep disorders. Differences between the parents and health professionals regarding disease severity perception and treatment opinions further strained their mutual relationship. To ameliorate this issue, the author implemented family-centered care (the FOCUS family intervention) to help the patient and his family. This intervention is designed to increase family involvement, foster an optimistic attitude and effective stress coping techniques, and reduce uncertainty and negative emotions. For the patient, we provided symptom-relief management to improve abnormal muscle tone and development delay. Our intervention ameliorated the negative emotions, insomnia symptoms, and imbalanced family relationships and improved the life quality of the caregivers. Furthermore, the intervention enhanced the patient's autoregulatory ability, and both physical and neurological development. This case study is expected to provide experience in critical care for premature infants with a poor prognosis and their family using a FOCUS family intervention as well as to improve the quality of healthcare delivery in intensive clinical settings.運用FOCUS家庭介入措施於四度腦室出血早產兒及其家庭之照護經驗.早產兒因為器官發育不成熟，有較高的合併症及死亡率，使其父母在充滿醫療的不確定性與無力感之中，進而對個人的身心健康及全家人的生活造成諸多負面的影響。本文個案為一位極低出生體重908公克的早產兒，一開始生命徵象不穩定，而後合併四度腦室出血，造成腦萎縮及腦室擴大，有極高的機率導致腦性麻痺及認知障礙。個案不僅未來需依賴他人照顧，亦可能造成家人沉重的身、心及經濟負擔。案父母在面對個案的不良預後，陷入放棄與積極救治的現實與倫理兩難，造成極大的壓力及睡眠問題。在醫療決策過程中，案父母與臨床醫護人員對個案病況與治療的認知不同，亦導致醫病關係緊張。筆者運用FOCUS家庭介入措施（FOCUS family intervention），提供以家庭為中心的支持性照護，在家庭方面：增進家庭參與、正向態度、有效的壓力因應方式、降低不確定感及負面評價；在個案方面：給予症狀處理，減少個案異常的肌肉張力及發展遲緩，使案父母在面對疾病的過程中改善因面對孩子疾病與預期照顧壓力的負向情緒、失眠症狀、失衡的家庭關係及生活品質，使個案能增進自我調節能力、減緩異常的神經發展。期望此照護經驗，提供臨床護理人員照顧有腦部損傷早產兒及其家庭之參考。.