护理诊断——失眠的相关因素及高危人群的文献分析

Analysis of the evidence of related factors,associated conditions and at-risk populations of the NANDA-I nursing diagnosis insomnia

目的总结有关成人失眠预测因素的文献证据,并确定其与北美护理诊断学会国际组织(NorthAmerica Nursing Diagnosis Association International,NANDA-I)护理诊断——失眠的诊断指标的一致性。方法检索Pubmed,虚拟健康图书馆和CINAHI数据库,纳入2011—2018年以英语、葡萄牙语或西班牙语发表的48篇文章。分析失眠的预测因素、NANDA-I相关因素之间的一致性。结果本研究发现的预测因素与NANDA-I相关因素具有一致性,但悲伤和白天频繁打盹除外。吸烟、咖啡因摄入,睡眠信念功能失调、肥胖和照顾者角色障碍可能是新的相关因素;慢性病可能也是新的相关因素,婚姻状况变化,经济困难、女性、年龄增长和夜班工作者可能是新的高危人群。结论与NANDA-I诊断要素相一致的失眠预测因素可为护理诊断提供证据基础。本研究发现的与失眠护理诊断相关因素没有对应关系的预测因素可考虑纳入NANDA-I分类,从而为护士和学生的临床应用提供支持。

Objectives:To summarize evidence in the literature on the predictors of insomnia in adults and to determine correspondences with diagnostic indicators of the NANDA-I diagnosis Insomnia.Methods:An integrative review performed in Pubmed,Virtual Health Library and CINAHL.Forty-eight articles published in Portuguese,English or Spanish from 2011 to 2018 were included.An analysis of correspondence between the predictors and the NANDA-I related factors and associated conditions for Insomnia was performed.Results:There was a correspondence of the predictors found in this review with NANDA-I related factors and associated conditions,except for grieving and frequent naps during the day.Smoking,caffeine intake,dysfunctional sleep beliefs,obesity and caregiver role strain are possible new related factors;chronic illness is a possible new associated condition and individuals going through changes in marital status,economically disadvantaged,female gender,increasing age and night shift worker are possible new at-risk populations.Conclusion:The predictors of insomnia that had a correspondence with the NANDA-I elements can support the evidence base of the nursing diagnosis.The predictors found without a correspondence with the diagnosis can be considered for inclusion in the NANDA-I classification,thereby supporting the clinical reasoning of nurses and students.