{"title":"Revisiting the Delphi technique - Research thinking and practice: A discussion paper","authors":"Felicity Hasson, Sinead Keeney, Hugh McKenna","doi":"10.1016/j.ijnurstu.2025.105119","DOIUrl":"10.1016/j.ijnurstu.2025.105119","url":null,"abstract":"<div><div>The Delphi technique is a research methodology which has traditionally been used to gain consensus among experts on complex issues characterised by uncertainty. Pioneered by the Rand Corporation in the 1950s for military applications, it has since been widely adopted across various fields, including nursing, health and social sciences and information systems on an array of multifaceted real-world issues. However, since its inception, the Delphi technique has undergone substantial methodological development and its use has now gone beyond its initial rationale.</div><div>In the last two decades there has been a growing body of work illustrating an increasing methodological diversity of the method. While such diversity presents possibilities, it also challenges traditional application and methodological rigour. In an attempt to preserve the integrity of the method, generic and discipline specific guidelines have emerged providing general principles and standards.</div><div>The aim of this paper is to present a much-needed critical reflection on the current application of the Delphi technique and its methodological development and to build on our paper from 2001 (Keeney et al., 2001). While the development of the Delphi method and its evolution are well recognised and reported in the literature, some controversies surrounding the approach remain and it is timely to revisit the method with a critical eye.</div><div>Ultimately, the Delphi technique's flexibility is its significant strength, enabling the exploration of novel lines of inquiry, but it also presents a challenge. Striking the right balance between flexibility and rigour can lead to more meaningful insights and actionable outcomes from a Delphi study. Yet to achieve this, some level of consensus may need to be reached on the Delphi technique itself. In recognition of its 60th birthday, it is an opportune time to re-examine its key aspects and methodological advances and reflect on ‘when is a Delphi not a Delphi?’</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"168 ","pages":"Article 105119"},"PeriodicalIF":7.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on Sharma et al. (2025) 'Energy conservation education intervention for people with end-stage kidney disease receiving hemodialysis (EVEREST): A two-arm parallel-group study'.","authors":"Juan Ye,Kun Huang","doi":"10.1016/j.ijnurstu.2025.105120","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2025.105120","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"141 1","pages":"105120"},"PeriodicalIF":8.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Romain Collet , Charlotte Groenewoud , Raymond Ostelo , Juul van Grootel , Marike van der Leeden , Marike van der Schaaf , Suzanne Wiertsema , Edwin Geleijn , Mel Major , Judith Bosmans , Johanna van Dongen
{"title":"Cost-effectiveness of multidisciplinary transitional care interventions: A systematic review and meta-analysis","authors":"Romain Collet , Charlotte Groenewoud , Raymond Ostelo , Juul van Grootel , Marike van der Leeden , Marike van der Schaaf , Suzanne Wiertsema , Edwin Geleijn , Mel Major , Judith Bosmans , Johanna van Dongen","doi":"10.1016/j.ijnurstu.2025.105103","DOIUrl":"10.1016/j.ijnurstu.2025.105103","url":null,"abstract":"<div><h3>Background</h3><div>Multidisciplinary transitional care interventions promote care coordination after hospital discharge and address (older) patients' complex care needs related to their physical, nutritional, and/or psychosocial status.</div></div><div><h3>Objective</h3><div>This review aimed to identify, critically appraise, and synthesize evidence on the cost-effectiveness of multidisciplinary transitional care interventions compared to usual care.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Setting(s)</h3><div>Hospitals and primary care.</div></div><div><h3>Participants</h3><div>Adult patients admitted to a hospital, regardless of their condition, and discharged home.</div></div><div><h3>Methods</h3><div>Medline, Embase, CINAHL, and CENTRAL were searched for randomized controlled trials assessing multidisciplinary transitional care interventions' cost-effectiveness compared to usual care and reporting quality of life or quality-adjusted life years (QALY) from inception to July 2024. Findings were stratified by economic perspective and follow-up duration. Evidence certainty was assessed using Grading of Recommendations Assessment, Development, and Evaluation. The primary outcome was the incremental net monetary benefit (expressed as mean difference). Cost-effectiveness acceptability curves depicted probabilities of cost-effectiveness at various willingness-to-pay thresholds.</div></div><div><h3>Results</h3><div>Thirteen trials, containing 4114 patients, were included. From a healthcare perspective over 12 months, there was “low” certainty that multidisciplinary transitional care interventions reduced healthcare costs (MD, €-3452; 95 % CI, −<!--> <!-->8816 to 1912) while there was no difference in QALYs (MD, 0.00; 95 % CI, −<!--> <!-->0.03 to 0.04) compared to usual care. The probability of cost-effectiveness over 12 months was 90 % at a willingness-to-pay of €0/QALY, decreasing slightly to 84 % at higher willingness-to-pay thresholds (“moderate” certainty). Over six months, cost-effectiveness probabilities ranged from 43 % at €0/QALY to 87 % at €100,000/QALY, exceeding 80 % at a willingness to pay of €50,000/QALY (“low” to “moderate” certainty). From a societal perspective, the probabilities of cost-effectiveness were lower, primarily due to a limited number of studies with conflicting results.</div></div><div><h3>Conclusions</h3><div>Multidisciplinary transitional care interventions demonstrate potential for cost-effectiveness. However, the “low” evidence certainty of most comparisons underscores the need for further research to explore the cost-effectiveness of different types of multidisciplinary transitional care interventions across patient populations and country income levels to identify the most cost-effective strategies.</div></div><div><h3>Registration</h3><div>The review protocol was registered on PROSPERO, CRD42023421423.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"168 ","pages":"Article 105103"},"PeriodicalIF":7.5,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on Wang et al. (2024) ‘Comparative effectiveness of delirium recognition with and without a clinical decision assessment system on outcomes of hospitalized older adults: Cluster randomized controlled trial’","authors":"Xi Zhang, Ping Li","doi":"10.1016/j.ijnurstu.2025.105109","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2025.105109","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"111 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Authors' response to “Comment on Wang et al. (2024) ‘Comparative effectiveness of delirium recognition with and without a clinical decision assessment system on outcomes of hospitalized older adults: Cluster randomized controlled trial.’”","authors":"Jiamin Wang, Ying Wu, Yongjun Huang, Fangyu Yang","doi":"10.1016/j.ijnurstu.2025.105108","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2025.105108","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"40 45 1","pages":""},"PeriodicalIF":8.1,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yun Young Choi , Bomi Hong , Sun Young Rha , Sungkun Cho , Hye Sun Lee , Jiyeon Lee
{"title":"The effect of nurse-led enhanced supportive care as an early primary palliative care approach for patients with advanced cancer: A randomized controlled trial","authors":"Yun Young Choi , Bomi Hong , Sun Young Rha , Sungkun Cho , Hye Sun Lee , Jiyeon Lee","doi":"10.1016/j.ijnurstu.2025.105102","DOIUrl":"10.1016/j.ijnurstu.2025.105102","url":null,"abstract":"<div><h3>Background</h3><div>Nurses play an important role in providing palliative care. However, few studies have evaluated the effectiveness of nurse-led primary palliative care.</div></div><div><h3>Objective</h3><div>To evaluate the effect of nurse-led enhanced supportive care as an early primary palliative care approach for advanced cancer patients.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Setting(s)</h3><div>This study was conducted at Yonsei Cancer Center in Seoul, Korea.</div></div><div><h3>Participants</h3><div>Advanced cancer patients initiating palliative chemotherapy (N = 258) and their family caregivers (N = 120) were enrolled and completed 3-month (n = 182 patients, n = 79 caregivers) and 6-month (n = 141 patients, n = 60 caregivers) follow-up assessments.</div></div><div><h3>Methods</h3><div>Participants were randomly assigned to the intervention or control group (1:1). The intervention group received nurse-led enhanced supportive care, which included symptom management and coping enhancement counseling before each chemotherapy cycle (baseline to 3 months) and was delivered by trained nurses. The control group received symptom monitoring. Family caregivers only participated in the evaluation. The primary outcomes were quality of life (EORTC-QLQ C30), symptoms (ESAS), and coping (Brief COPE) at 3 months. The secondary outcomes were quality of life, symptoms, and coping at 6 months. Self-efficacy for coping with cancer (CBI-3.0 K), and depression among cancer patients and family caregivers (HADS-D) at 3 and 6 months were also evaluated. The data were analyzed using linear mixed models.</div></div><div><h3>Results</h3><div>The intervention group reported beneficial effects in the following outcomes: 1) Quality of life [role functioning domain at 3 months (1.01 ± 2.34 vs. −<!--> <!-->8.37 ± 2.07; <em>p</em> = .003 [−<!--> <!-->15.57, −<!--> <!-->3.18]; adjusted <em>p</em> = .044), 2) coping [active coping at 3 months (0.27 ± 0.16 vs. −<!--> <!-->0.34 ± 0.14; <em>p</em> = .006 [−<!--> <!-->1.04, −<!--> <!-->0.18]; adjusted <em>p</em> = .044), and self-distraction (0.22 ± 0.17 vs. −<!--> <!-->0.42 ± 0.15; <em>p</em> = .004 [−<!--> <!-->1.08, −<!--> <!-->0.20]; adjusted <em>p</em> = .044) at 3 months]; 3) self-efficacy in coping with cancer [maintaining activity and independence at 3 months (1.45 ± 0.47 vs. −<!--> <!-->0.31 ± 0.42; <em>p</em> = .006 [−<!--> <!-->2.99, −<!--> <!-->0.52]; adjusted <em>p</em> = .044)]. The intervention was not effective in reducing symptoms and depression of patients or depression of caregivers (adjusted <em>p</em> > .05).</div></div><div><h3>Conclusions</h3><div>Nurse-led enhanced supportive care as an early primary palliative care approach has demonstrated effectiveness in improving the role functioning domain of quality of life, use of coping strategies, and self-efficacy in maintaining activity and independence among advanced cancer patients. Nurse-led early ","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"168 ","pages":"Article 105102"},"PeriodicalIF":7.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Authors' response to \"Comment on Zhang et al. (2025) 'Effectiveness of exercise-based interventions in preventing cancer therapy-related cardiac dysfunction in patients with breast cancer: A systematic review and network meta-analysis'\".","authors":"Dandan Zhang, Hexiao Ding, Ruisi Ma, Ting Liu","doi":"10.1016/j.ijnurstu.2025.105107","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2025.105107","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":" ","pages":"105107"},"PeriodicalIF":7.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valerie Danesh , Anthony D. McDonald , Kellia J. Hansmann , Leanne M. Boehm , Han Su , Tammy L. Eaton , Kelly M. Toth , Alejandro C. Arroliga , Brittany D. Work , Joanne McPeake
{"title":"Driving behavior and driving outcomes after acute and critical illness: A systematic review","authors":"Valerie Danesh , Anthony D. McDonald , Kellia J. Hansmann , Leanne M. Boehm , Han Su , Tammy L. Eaton , Kelly M. Toth , Alejandro C. Arroliga , Brittany D. Work , Joanne McPeake","doi":"10.1016/j.ijnurstu.2025.105105","DOIUrl":"10.1016/j.ijnurstu.2025.105105","url":null,"abstract":"<div><h3>Background</h3><div>Adults recovering from hospitalization for acute or critical illnesses often face new or worsening physical and cognitive impairments, which can impact their driving abilities and safety. The purpose of this review is to synthesize evidence on driving behaviors and outcomes in the six months following hospitalization for acute or critical illness to guide patient care, provider recommendations, and future research.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted on PubMed, CINAHL, PsycINFO, and Cochrane databases from 1997 to October 20, 2023 with forward and backward searches.</div><div>Primary empirical research involving vehicle drivers was included. Studies were excluded if they involved fewer than five participants, or if they focused on acute medical conditions with established driving rehabilitation programs. Two reviewers screened abstracts and full texts, resolving discrepancies through discussion.</div></div><div><h3>Results</h3><div>Nineteen studies met the inclusion criteria. Driving behavior and safety data from these studies were derived from simulators (n = 10), self-reports (n = 8) and administrative/regulatory datasets (n = 1). Simulation studies primarily focused on post-surgical populations, and brake reaction times. Self-report studies highlighted driving suspension, cessation, and perceived safety issues. The heterogeneity of study designs and populations limited formal meta-analyses.</div></div><div><h3>Discussion</h3><div>The evidence on driving safety and behavior post-hospitalization is heterogeneous and sparse, with some studies indicating no significant change in collision rates and others showing increased risks. Consequently, clinicians face challenges in recommendations on return to driving. There is a need for robust study designs and naturalistic driving studies to examine the specific impacts of hospitalization on driving safety and to develop evidence-based guidelines to address discharge planning to answer questions of “when should I return to driving?”</div></div><div><h3>Registration</h3><div>PROSPERO identifier CRD42023464876.</div></div>","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"168 ","pages":"Article 105105"},"PeriodicalIF":7.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on Zhang et al. (2025) 'Effectiveness of exercise-based interventions in preventing cancer therapy-related cardiac dysfunction in patients with breast cancer: A systematic review and network meta-analysis'.","authors":"Da Qian,Haotian Su,Xuli Meng","doi":"10.1016/j.ijnurstu.2025.105106","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2025.105106","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"19 1","pages":"105106"},"PeriodicalIF":8.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"'They never listen' - Normalised deviance in nursing and midwifery staffing.","authors":"Stuart Tuckwood,Peter Griffiths","doi":"10.1016/j.ijnurstu.2025.105110","DOIUrl":"https://doi.org/10.1016/j.ijnurstu.2025.105110","url":null,"abstract":"","PeriodicalId":50299,"journal":{"name":"International Journal of Nursing Studies","volume":"19 1","pages":"105110"},"PeriodicalIF":8.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}