Publicado

2023-12-29

NANDA taxonomy and insomnia evaluation scale in older people: A crosssectional study

Taxonomía NANDA y escala de evaluación del insomnio en personas mayores: un estudio transversal

Taxonomia NANDA e escala de avaliação da insônia em idosos: um estudo transversal

DOI:

https://doi.org/10.15446/av.enferm.v41n3.111620

Palabras clave:

Senior Centers, Geriatric Assessment, Sleep Wake Disorders, Cross-Sectional Studies, Sleep Quality (en)
Centros para Personas Mayores, Evaluación Geriátrica, Trastornos del Sueño-Vigilia , Estudios Transversales, Calidad del Sueño (es)
Centros Comunitários para Idosos, Avaliação Geriátrica, Transtornos do Sono-Vigília, Estudos Transversais, Qualidade do Sono (pt)

Autores/as

Objective: To identify the prevalence of indicators of the nursing diagnosis “insomnia” in older people through the Insomnia Severity Index (ISI) scale.

Materials and methods: Cross-sectional epidemiological study involving older individuals from a community center. Data analysis was conducted between July and August 2021 using the R program. Univariate analysis was adopted for sociodemographic characterization. The χ² test (Pearson’s chi-square) was employed to assess the association between the sociodemographic variables, nursing diagnosis indicators, and the ISI.

Results: A total of 90 older people (mean age = 76.8 years, SD = 7.2 years) with at least one defining characteristic were included in this study. There was a higher prevalence of the diagnostic indicators “insufficient physical endurance” (75.6%; 95% CI: 65-83%) and “average daily physical activity
is less than recommended for age and gender” (71.1%; 95% CI: 61-79%). In contrast, the diagnostic indicators “increased accidents” (6.7%; 95% CI: 3-13%) and “lifestyle incongruent with normal circadian rhythms” (2.2%; 95% CI: 92-99%) had a lower prevalence. A significant association was found between ISI, the defining characteristics (p = 0.009; < 0.001; 0.005; 0.002; 0.022; < 0.001; 0.004; < 0.001), and the related factors (p = 0.007; 0.004; < 0.001; 0.006; 0.049) of nursing diagnosis.

Conclusions: The prevailing indicators of insomnia in community-dwelling older individuals were demonstrated in our sample and their association with a validated clinical assessment survey was established. These findings may contribute to nurses’ diagnostic accuracy and their ability
to conduct effective diagnostic screening in older populations.

Objetivo: identificar la prevalencia de los indicadores del diagnóstico de enfermería “insomnio” en ancianos mediante el índice de severidad del insomnio (ISI).

Materiales y método: estudio epidemiológico transversal con ancianos de un centro comunitario. El análisis de los datos se realizó entre julio y agosto de 2021 utilizando el programa R. Se empleó el análisis univariado para la caracterización sociodemográfica. Se utilizó la prueba χ² (chi cuadrado de Pearson) para evaluar la asociación entre las variables sociodemográficas, los indicadores de diagnóstico de enfermería y el ISI.

Resultados: 90 ancianos (media = 76,8 años, DT = 7,2 años) con al menos una característica definitoria fueron incluidos en esta investigación. Se observó una mayor prevalencia de los indicadores de diagnóstico “resistencia física insuficiente” (75,6 %; IC 95 %: 65-83 %) y “actividad física diaria promedio inferior a la recomendada para la edad y el sexo” (71,1 %; IC 95 %: 61-79 %). Los indicadores diagnósticos “aumento de accidentes” (6,7 %; IC 95 %: 3-13 %) y “estilo de vida incoherente con ritmos circadianos normales” (2,2 %; IC 95 %: 92 % - 99 %) reportaron una prevalencia más baja. Se encontró una asociación significativa entre los ISI, las características definitorias (p = 0,009; < 0,001; 0,005; 0,002; 0,022; < 0,001; 0,004; < 0,001) y los factores relacionados (p = 0,007; 0,004; < 0,001; 0,006; 0,049) del diagnóstico de enfermería.

Conclusiones: los indicadores prevalentes de insomnio en ancianos que viven en comunidades fueron evidenciados en nuestra muestra, estableciendo además su asociación con una encuesta de evaluación clínica validada. Estos resultados pueden contribuir a una mayor precisión en los diagnósticos de enfermería y a fortalecer la capacidad de realizar un cribado diagnóstico asertivo en la población anciana.

Objetivo: identificar a prevalência dos indicadores do diagnóstico de enfermagem “insônia” em idosos por meio do índice de gravidade da insônia (IGI).

Materiais e método: estudo epidemiológico do tipo transversal com idosos frequentadores de um centro de convivência. A análise dos dados foi realizada entre julho e agosto de 2021 no programa R. Para a caracterização sociodemográfica, foi adotada a análise univariada. Foi aplicado o teste χ² (qui-quadrado de Pearson) para avaliar a associação entre as variáveis sociodemográficas, os índices do diagnóstico de enfermagem e o IGI.

Resultado: 90 participantes foram incluídos (média = 76,8 anos, DP = 7,2 anos) e apresentaram ao menos uma característica definidora. Houve maior prevalência dos
índices diagnósticos “resistência física insuficiente” (75,6%; IC 95%: 65-83%) e “média de atividade física diária inferior à recomendada para idade e sexo” (71,1%; IC 95%: 61-79%). Em contrapartida, os índices diagnósticos “Aumento de acidentes” (6,7%; IC 95%: 3-13%) e “Estilo de vida incoerente com ritmos circadianos normais” (2,2%; IC 95%: 92-99%) obtiveram menor prevalência. Houve associação significativa entre a IGI, as características definidoras (p = 0,009; < 0,001; 0,005; 0,002; 0,022; < 0,001; 0,004; < 0,001) e os fatores relacionados (p = 0,007; 0,004; < 0,001; 0,006; 0,049) do diagnóstico de enfermagem.

Conclusões: foram evidenciados os indicadores prevalentes de insônia em idosos não institucionalizados em nossa amostra, e sua associação foi feita com instrumento de avaliação clínica validado. Tais resultados poderão contribuir para maior acurácia nos diagnósticos de enfermagem e fortalecer a capacidade de triagem diagnóstica assertiva na população idosa.

Referencias

(1) Casagrande M; Forte G; Favieri F; Corbo I. Sleep quality and aging: A systematic review on healthy older people, mild cognitive impairment and Alzheimer’s disease. IJERPH. 2022;19(14):8457. http://doi.org/10.3390/ijerph19148457 DOI: https://doi.org/10.3390/ijerph19148457

(2) Gorgoni M; De Gennaro L. Sleep in the aging brain. Brain Sci. 2021;12;11(2):229. http://doi.org/10.3390/brainsci11020229 DOI: https://doi.org/10.3390/brainsci11020229

(3) Mendonça FMR; Mendonça GPRR; Souza LC; Galvão LP; Paiva HS; Périco CAM et al. Benzodiazepines and sleep architecture: A systematic review. CNS Neurol Disord Drug Targets. 2023;22(2):172-179. http://doi.org/10.2174/1871527320666210618103344 DOI: https://doi.org/10.2174/1871527320666210618103344

(4) Thangaleela S; Sivamaruthi BS; Kesika P; Mariappan S; Rashmi S; Choeisoongnern T et al. Neurological insights into sleep disorders in Parkinson’s disease. Brain Sci. 2023;14;13(8):1202. http://doi.org/10.3390/brainsci13081202 DOI: https://doi.org/10.3390/brainsci13081202

(5) Brewster GS; Riegel B; Gehrman PR. Insomnia in the older adult. Sleep Med Clin. 2022;17(2):233-239. http://doi.org/10.1016/j.jsmc.2022.03.004 DOI: https://doi.org/10.1016/j.jsmc.2022.03.004

(6) Ganidagli S; Ozturk E; Ozturk ZA. Risk factors of poor sleep quality in older adults: An analysis based on comprehensive geriatric assessment. Curr Med Res Opin. 2023;39(5):701-706. http://doi.org/10.1080/03007995.2023.2192124 DOI: https://doi.org/10.1080/03007995.2023.2192124

(7) Pazan F; Wehling M. Polypharmacy in older adults: A narrative review of definitions, epidemiology and consequences. Eur Geriatr Med. 2021;12:443-452. http://doi.org/10.1007/s41999-021-00479-3 DOI: https://doi.org/10.1007/s41999-021-00479-3

(8) Benca RM; Teodorescu M. Sleep physiology and disorders in aging and dementia. In: Dekosky ST; Asthana S (Eds.). Handbook of Clin Neurol. Vol 167. Elsevier; 2019. p. 477-493. https://doi.org/10.1016/B978-0-12-804766-8.00026-1 DOI: https://doi.org/10.1016/B978-0-12-804766-8.00026-1

(9) Bollu PC; Kaur H. Sleep Medicine: Insomnia and Sleep. Mo Med. 2019;116(1):68-75. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390785/

(10) Riemann D; Krone LB; Wulff K; Nissen C. Sleep, insomnia, and depression. Neuropsychopharmacol. Rep. 2020;45:74-89. http://doi.org/10.1038/s41386-019-0411-y DOI: https://doi.org/10.1038/s41386-019-0411-y

(11) United Nations. Policy Brief: COVID-19 and the Need for Action on Mental Health. United States (USA ); 2020. https://bit.ly/3SVV7K6

(12) Álvarez Muñoz FJ; Rubio-Aparicio M; Gurillo Muñoz P; García Herrero AM; Sánchez-Meca J; Navarro-Mateu F. Suicide and dementia: Systematic review and meta-analysis. Rev Psiquiatr Salud Ment. 2020;13(4):213-227. http://doi.org/10.1016/j.rpsm.2020.04.012 DOI: https://doi.org/10.1016/j.rpsmen.2020.04.006

(13) Steiner ABQ; Jacinto AF; Citero VA. Older adults with dementia: Knowledge and attitudes of physicians in health units. Rev Saúde Pública. 2020;(54):137. https://www.scielo.br/j/rsp/a/kk6zY3QFFNvqymBmJ5KQ8fC/?lang=en DOI: https://doi.org/10.11606/s1518-8787.2020054002451

(14) Borges CR; Poyares D; Piovezan R; Nitrini R; Brucki S. Alzheimer’s disease and sleep disturbances: A review. Arq Neuro-Psiquiatr. 2019;77(11):815-824. https://doi.org/10.1590/0004-282X20190149 DOI: https://doi.org/10.1590/0004-282x20190149

(15) Herdman TH; Kamitsuru S; Lopes CT. NANDA International, Inc. Nursing diagnoses: Definitions and classification, 2020-2023. 12th ed. New York: Thieme; 2021.

(16) Alnawwar MA; Alraddadi MI; Algethmi RA; Salem GA; Salem MA; Alharbi AA. The effect of physical activity on sleep quality and sleep disorder: A systematic review. Cureus. 2023;15(8):e43595. https://doi.org/10.7759/cureus.43595 DOI: https://doi.org/10.7759/cureus.43595

(17) Cardoso RB; Souza PA; Caldas CP; Bitencourt GR. Diagnósticos de enfermagem em idosos hospitalizados à luz da teoria do conforto de Kolcaba. Rev. Enferm. Ref. 2020;5(4):e20066. http://doi.org/10.12707/RV20066 DOI: https://doi.org/10.12707/RV20066

(18) Nogueira ILA; Tinôco JDS; Fernandes MIDCD; Delgado MF; Lisboa IND; Lopes MVO et al. The diagnostic accuracy of delayed development in adolescents. Int J Nurs Knowl. 2021;32(3):150-156. https://doi.org/10.1111/2047-3095.12304 DOI: https://doi.org/10.1111/2047-3095.12304

(19) Eckerblad J; Klompstra L; Heinola L; Rojlén S; Waldréus N. What frail, older patients talk about when they talk about self-care-a qualitative study in heart failure care. BMC geriatrics, 2023;23(1):818-826. https://doi.org/10.1186/s12877-023-04538-1 DOI: https://doi.org/10.1186/s12877-023-04538-1

(20) Madeira E; Machado JR; Alfradique P; Macedo EC; Carvalho CM; Koike RY. Quality of life in elderly residents of a community center. Rev Pesqui. 2022;14:e-11865. https://doi.org/10.9789/2175-5361.rpcfo.v14.11865 DOI: https://doi.org/10.9789/2175-5361.rpcfo.v14.11865

(21) Instituto Brasileiro de Geografia e Estatística (IBGE). Censo Brasileiro de 2022. Rio de Janeiro: IBGE; 2023. https://www.ibge.gov.br/

(22) Loureiro CV; de Oliveira CR; Silva EJGS; de Oliveira GL; da Paz MT; de Oliveira MCS et al. Brasil chegou a vez das Anas, Terezas e Dalvas: Reflexões sobre racismo junto às idosas do Programa Renascer – HUGG. Ra. e Rum. 2021;9(1):94-105. https://seer.unirio.br/raizeserumos/article/view/11019 DOI: https://doi.org/10.9789/2317-7705.2021.v9.i1.94-105

(23) Pashmdarfard M; Azad A. Assessment tools to evaluate activities of daily living (ADL) and instrumental activities of daily living (IADL) in older adults: A systematic review. Med J Islam Repub Iran. 2020;34:33. https://doi.org/10.34171/mjiri.34.33 DOI: https://doi.org/10.47176/mjiri.34.33

(24) Moghadas T; Kesbakhi MS. Factors influencing implementation of nursing process by nursing students: A qualitative study. J Med Edu. 2020;19(4):e110810. https://doi.org/10.5812/jme.110810 DOI: https://doi.org/10.5812/jme.110810

(25) Wells SY; Dietch JR; Edner BJ; Glassman LH; Thorp SR; Morland LA et al. The development of a brief version of the Insomnia Severity Index (ISI-3) in older adult veterans with posttraumatic stress disorder. Behav Sleep Med. 2021;19(3):352-362. https://doi.org/10.1080/15402002.2020.1760278 DOI: https://doi.org/10.1080/15402002.2020.1760278

(26) Castro LS. Adaptação e validação do índice de gravidade de insônia (IGI): Caracterização populacional, valores normativos e aspectos associados. São Paulo: Universidade Federal de São Paulo; 2011. https://repositorio.unifesp.br/handle/11600/23193

(27) Jodrá P; Jiménez-Gamero MD. A quantile regression model for bounded responses based on the exponential-geometric distribution. Revstat. 2020;18(4):415-436. https://doi.org/10.57805/revstat.v18i4.309

(28) República Federativa do Brasil. Ministério da Saúde. Conselho Nacional de Saúde. Resolução n.° 466 de 12 de dezembro de 2012. https://conselho.saude.gov.br/resolucoes/2012/Reso466.pdf

(29) República Federativa do Brasil. Ministério da Saúde. Conselho Nacional de Saúde. Resolução n° 510 de 07 de abril de 2016. https://conselho.saude.gov.br/resolucoes/2016/Reso510.pdf

(30) Alves AN; Coura AS; França ISX; Magalhães IMO; Rocha MA; Araújo RS. Acesso de primeiro contato na atenção primária: uma avaliação pela população masculina. Rev. bras. epidemiol. 2020;23:e200072. https://doi.org/10.1590/1980-549720200072 DOI: https://doi.org/10.1590/1980-549720200072

(31) Ramos CV; Fronteira I; Silva ZM; Holanda AMC; Paz SMRS; Pereira TG et al. Tendência temporal e diferenças regionais na mortalidade materna no estado do Piauí, 2006-2021. Cad. Estud. Soc. 2022;37(1):1-19. https://doi.org/10.33148/CESv37n1(2022)2106 DOI: https://doi.org/10.33148/CESv37n1(2022)2106

(32) República Federativa do Brasil. Ministério da Economia, Secretaria Especial de Previdência e Trabalho. Previdência complementar para mulheres: Guia para mulheres que querem cuidar do seu futuro. Brasília: Ministério da Economia; 2021. https://bit.ly/49wq5xR

(33) Lee SB; Oh JH; Park JH; Choi SP; Wee JH. Differences in youngestold, middle-old, and oldest-old patients who visit the emergency department. Clin Exp Emerg Med. 2018;5(4):249-255. https://doi.org/10.15441/ceem.17.261 DOI: https://doi.org/10.15441/ceem.17.261

(34) Chung E; Lee SH; Lee HJ; Kim YH. Comparative study of young-old and old-old people using functional evaluation, gait characteristics, and cardiopulmonary metabolic energy consumption. BMC Geriatr. 2023;23:400. https://doi.org/10.1186/s12877-023-04088-6 DOI: https://doi.org/10.1186/s12877-023-04088-6

(35) Tavares DM dos S; Oliveira NGN; Santos LLS; Marchiori GF; Souza LA; Rodrigues FR. Condições de saúde de mulheres e homens idosos com idade avançada: estudo longitudinal. Rev. enferm. UERJ. 2021;29(1):e57581. http://doi.org/10.12957/reuerj.2021.57581 DOI: https://doi.org/10.12957/reuerj.2021.57581

(36) Organisation for Economic Co-operation and Development (OECD). Demography - fertility rates - OECD data. Paris: OECD; 2023. https://data.oecd.org/pop/fertility-rates.htm

(37) Higgins SSS; Luna APH; Santos RO; Rabelo AMP; Soalheiro M; Ferreira VC. A study on social contact rates relevant for the spread of infectious diseases in a Brazilian slum. Rev. bras. estud. popul. 2023;40:e0241. https://doi.org/10.20947/S0102-3098a0241 DOI: https://doi.org/10.20947/S0102-3098a0241

(38) Fundação Perseu Abramo (FPA). Idosos no Brasil: Vivências, Desafios e Expectativas na Terceira Idade. Publicações Perseu Abramo. Brasil; 2020. https://bit.ly/49xahLg

(39) Romero DE; Muzy J; Damacena GN; Souza NA; Almeida WS; Szwarcwald CL et al. Older adults in the context of the COVID-19 pandemic in Brazil: Effects on health, income and work. Cad. Saúde Pública. 2021;37(3):e00216620. https://doi.org/10.1590/0102-311X00216620 DOI: https://doi.org/10.1590/0102-311x00216620

(40) Cruz AG; Lopes MCF da G; Reis LFPC dos; Parola VS de O. Prevalência e caracterização de acidentes domésticos e lazer de idosos em contexto comunitário: Estudo observacional transversal. Rev. Enf. Ref. 2022;6(1):1-8. https://revistas.rcaap.pt/referencia/article/view/28689 DOI: https://doi.org/10.12707/RV21119

(41) Guandalini LS; da Silva EF; Lopes J de L; Santos VB; Lopes CT; de Barros ALBL. Analysis of the evidence of related factors, associated conditions and at-risk populations of the NANDA-I nursing diagnosis insomnia. Int. J. Nurs. Sci. 2020;7(4):466-476. https://doi.org/10.1016/j.ijnss.2020.09.003 DOI: https://doi.org/10.1016/j.ijnss.2020.09.003

(42) Kim I; Ahn J. The effect of changes in physical self-concept through participation in exercise on changes in self-esteem and mental wellbeing. Int. J. Environ. Res. Public Health. 2021;18(10):5224. http://doi.org/10.3390/ijerph18105224 DOI: https://doi.org/10.3390/ijerph18105224

(43) Sejbuk M; Mirończuk-Chodakowska I; Witkowska AM. Sleep quality: A narrative review on nutrition, stimulants, and physical activity as important factors. Nutrients. 2022;14(9):1912. https://doi.org/10.3390/nu14091912 DOI: https://doi.org/10.3390/nu14091912

(44) Endeshaw YW; Yoo W. Organized social activity, physical exercise, and the risk of insomnia symptoms among community-dwelling older adults. J Aging Health. 2019;31(6):989-1001. https://doi.org/10.1177/0898264317747705 DOI: https://doi.org/10.1177/0898264317747705

(45) Meyer N; Harvey AG; Lockley SW; Dijk DJ. Circadian rhythms and disorders of the timing of sleep. Lancet. 2022;400(10357):1061-1078. https://doi.org/10.1016/S0140-6736(22)00877-7 DOI: https://doi.org/10.1016/S0140-6736(22)00877-7

(46) Zhang D; Li S. Family members’ abuse of older adults, psychological well-being, and sleep quality among older women and men in China. J appl gerontol. 2024;43(2):205-214. https://doi.org/10.1177/07334648231203835 DOI: https://doi.org/10.1177/07334648231203835

(47) Wu F; Sheng Y. Social support network, social support, selfefficacy, health-promoting behavior and healthy aging among older adults: A pathway analysis. Arch Gerontol Geriatr. 2019;85:103934. https://doi.org/10.1016/j.archger.2019.103934 DOI: https://doi.org/10.1016/j.archger.2019.103934

(48) Donizzetti AR. Ageism in an aging society: The role of knowledge, anxiety about aging, and stereotypes in young people and adults. Int J Environ Res Public Health. 2019;16(8):1329. https://doi.org/10.3390/ijerph16081329 DOI: https://doi.org/10.3390/ijerph16081329

(49) Wichniak A; Bieńkowski P; Dąbrowski R; Mastalerz-Migas A; Rymaszewska J. Treatment of insomnia in older adults. Recommendations of the Polish Sleep Research Society, Polish Society of Family Medicine and the Polish Psychiatric Association. Psychiatr pol. 2023;57(3):495-516. https://doi.org/10.12740/PP/OnlineFirst/161597 DOI: https://doi.org/10.12740/PP/OnlineFirst/161597

(50) González-Martín AM; Aibar-Almazán A; Rivas-Campo Y; Marín-Gutiérrez A; Castellote-Caballero Y. Effects of mindfulness-based cognitive therapy on older adults with sleep disorders: A systematic review and meta-analysis. Front. public health. 2023;11:1242868. https://doi.org/10.3389/fpubh.2023.1242868 DOI: https://doi.org/10.3389/fpubh.2023.1242868

(51) Yuan K; Zheng YB; Wang YJ; Sun YK; Gong YM; Huang YT et al. A systematic review and meta-analysis on prevalence of and risk factors associated with depression, anxiety and insomnia in infectious diseases, including COVID-19: A call to action. Mol Psychiatry. 2022;27:3214-3222. https://doi.org/10.1038/s41380-022-01638-z DOI: https://doi.org/10.1038/s41380-022-01638-z

(52) Curtis K; Fry M; Shaban RZ; Considine J. Translating research findings to clinical nursing practice. J Clin Nurs, 2017;26(5-6):862-872. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5396371/ DOI: https://doi.org/10.1111/jocn.13586

(53) Luckhardt EM; Gunnels MS; Chlan LL. Assessing discomfort in critically ill patients: A narrative review of the literature. Crit Care Nurse. 2022;42(4):47-54. https://doi.org/10.4037/ccn2022280 DOI: https://doi.org/10.4037/ccn2022280

Cómo citar

VANCOUVER

1.
Souza Szpalher A, Barreto Cardoso R, Weiss C, Alfradique de Souza P. NANDA taxonomy and insomnia evaluation scale in older people: A crosssectional study. Av. enferm. [Internet]. 12 de octubre de 2023 [citado 14 de julio de 2024];41(3). Disponible en: https://revistas.unal.edu.co/index.php/avenferm/article/view/111620

ACM

[1]
Souza Szpalher, A., Barreto Cardoso, R., Weiss, C. y Alfradique de Souza, P. 2023. NANDA taxonomy and insomnia evaluation scale in older people: A crosssectional study. Avances en Enfermería. 41, 3 (oct. 2023). DOI:https://doi.org/10.15446/av.enferm.v41n3.111620.

ACS

(1)
Souza Szpalher, A.; Barreto Cardoso, R.; Weiss, C.; Alfradique de Souza, P. NANDA taxonomy and insomnia evaluation scale in older people: A crosssectional study. Av. enferm. 2023, 41.

APA

Souza Szpalher, A., Barreto Cardoso, R., Weiss, C. y Alfradique de Souza, P. (2023). NANDA taxonomy and insomnia evaluation scale in older people: A crosssectional study. Avances en Enfermería, 41(3). https://doi.org/10.15446/av.enferm.v41n3.111620

ABNT

SOUZA SZPALHER, A.; BARRETO CARDOSO, R.; WEISS, C.; ALFRADIQUE DE SOUZA, P. NANDA taxonomy and insomnia evaluation scale in older people: A crosssectional study. Avances en Enfermería, [S. l.], v. 41, n. 3, 2023. DOI: 10.15446/av.enferm.v41n3.111620. Disponível em: https://revistas.unal.edu.co/index.php/avenferm/article/view/111620. Acesso em: 14 jul. 2024.

Chicago

Souza Szpalher, Adriana, Rosane Barreto Cardoso, Carleara Weiss, y Priscilla Alfradique de Souza. 2023. «NANDA taxonomy and insomnia evaluation scale in older people: A crosssectional study». Avances En Enfermería 41 (3). https://doi.org/10.15446/av.enferm.v41n3.111620.

Harvard

Souza Szpalher, A., Barreto Cardoso, R., Weiss, C. y Alfradique de Souza, P. (2023) «NANDA taxonomy and insomnia evaluation scale in older people: A crosssectional study», Avances en Enfermería, 41(3). doi: 10.15446/av.enferm.v41n3.111620.

IEEE

[1]
A. Souza Szpalher, R. Barreto Cardoso, C. Weiss, y P. Alfradique de Souza, «NANDA taxonomy and insomnia evaluation scale in older people: A crosssectional study», Av. enferm., vol. 41, n.º 3, oct. 2023.

MLA

Souza Szpalher, A., R. Barreto Cardoso, C. Weiss, y P. Alfradique de Souza. «NANDA taxonomy and insomnia evaluation scale in older people: A crosssectional study». Avances en Enfermería, vol. 41, n.º 3, octubre de 2023, doi:10.15446/av.enferm.v41n3.111620.

Turabian

Souza Szpalher, Adriana, Rosane Barreto Cardoso, Carleara Weiss, y Priscilla Alfradique de Souza. «NANDA taxonomy and insomnia evaluation scale in older people: A crosssectional study». Avances en Enfermería 41, no. 3 (octubre 12, 2023). Accedido julio 14, 2024. https://revistas.unal.edu.co/index.php/avenferm/article/view/111620.

Descargar cita

CrossRef Cited-by

CrossRef citations0

Dimensions

PlumX

Visitas a la página del resumen del artículo

185

Descargas

Los datos de descargas todavía no están disponibles.