Analysis of the evidence of related factors, associated conditions and at-risk populations of the NANDA-I nursing diagnosis insomnia.
Lidia Santiago Guandalini, Eduarda Ferreira da Silva, Juliana de Lima Lopes and 3 others
PMID 33195760WHAT IT FOUND
Most NANDA-I insomnia risk factors are supported by evidence, but frequent naps and grieving are not.
The review proposes adding smoking, caffeine, obesity, dysfunctional beliefs, and caregiver strain as new nursing-related factors for insomnia assessment.
Key findings
01All current NANDA-I related factors and associated conditions for insomnia were supported by the literature except for frequent naps and grieving.
02The review identified five possible new related factors amenable to nursing intervention: smoking, caffeine intake, dysfunctional sleep beliefs, obesity, and caregiver role strain.
03Most included studies were cross-sectional, limiting the ability to establish causal relationships between the identified predictors and insomnia.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most included studies were cross-sectional, which prevents establishing cause-and-effect relationships between the predictors and insomnia. The search strategy may have missed studies using different terminology for specific risk factors, potentially explaining the lack of evidence for 'frequent naps' and 'grieving'. There was wide variation in the instruments used to assess insomnia across the included studies, which may affect the comparability of the results.
Declared interests
The study was funded by the Brazilian National Council for Scientific and Technological Development (CNPq). No other conflicts of interest were declared.
The easy way to misread this
Do not treat the proposed new related factors (such as smoking or obesity) as established causes of insomnia. This review identifies associations from mostly cross-sectional studies; it does not prove that changing these factors will resolve insomnia, nor does it test nursing interventions for them.