Journal of Advanced Nursing最新文献

{"title":"Collaging Integration Procedure for Integrating Literature, Theory, and Research Data in Mixed Methods Research","authors":"Ahtisham Younas, Sergi Fàbregues, Shahzad Inayat","doi":"10.1111/jan.70187","DOIUrl":"https://doi.org/10.1111/jan.70187","url":null,"abstract":"AimsTo propose the collaging integration procedure for linking literature and theory to research data in mixed methods research (MMR) and illustrate its application in two mixed methods studies.DesignDiscussion paper/research methodology.Data SourcesThe collaging technique was used and developed based on two exploratory sequential nurse‐led mixed‐methods studies.ResultsThe collaging technique entails using multiple artefacts (data fragments, figures and textual information) within one figure. Collaging can generate relevant pre‐post linkages, create meaning and refine inferences and meta‐inferences.ConclusionThis paper offers a novel integration technique for meaningful integration of the literature review and theoretical dimensions in the integration trilogy.Implications for NursingNurse researchers can use the collaging integration procedure for effective integration for conducting rigorous mixed‐methods research. Collaging is a straightforward yet effective technique for enhancing integration in the literature review and theoretical dimensions in MMR.ImpactLinking literature review, theory and research data facilitates a more meaningful interpretation of research findings. While researchers may be able to create a more fully integrated MMR design by integrating multiple dimensions of the study, to date, most of the empirical and methodological literature on MMR has focused on integration at the design, fieldwork, analysis and interpretation dimensions, ignoring others, such as the literature review and theoretical dimensions. Collaging enables intensive analysis of the raw data and embeds the insights gained from literature and theory throughout the data analysis and presentation, thereby avoiding neglecting insights which could have been gained by back‐and‐forth comparison and integration of literature review and theoretical underpinnings.Patient or Public ContributionNo direct patient or public contribution.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"32 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse‐Led Innovations for Optimising the Quality and Safety of Care for the Older Person in Residential Aged Care: A Warrant for Action","authors":"Ramon Z. Shaban, Kate Curtis, Margaret Fry, Julie Considine, Lee‐Fay Low, Karen Watson, Brendan McCormack, Mary K. Lam, Moira Dunsmore, Yun‐Hee Jeon, Richard Iain Lindley, Jo‐Ann Dalton, Catherine Viengkham, Merrick Powell","doi":"10.1111/jan.70206","DOIUrl":"https://doi.org/10.1111/jan.70206","url":null,"abstract":"AimTo canvas the contemporary contextual forces within the Australian residential aged care sector and argue for new research and innovation. There is a pressing need to provide systematised, high‐quality and person‐centred care to our ageing populations, especially for those who rely on residential care. This paper advances a warrant for establishing a new systematic framework for assessment and management that serves as a foundation for effective person‐centred care delivery.DesignPosition paper.MethodsThis paper promulgates the current dialogue among key stakeholders of quality residential aged care in Australia, including clinicians, regulatory agencies, researchers and consumers. A desktop review gathered relevant literature spanning research, standards and guidelines regarding current and future challenges in aged care in Australia.ResultsThis position paper explores the issues of improving the quality and safety of residential aged care in Australia, including the lingering impact of COVID‐19 and incoming reforms. It calls for nurse‐led research and innovation to deliver tools to address these challenges.ConclusionThe paper proposes an appropriate holistic, evidence‐based nursing framework to optimise the quality and safety of residential aged care in Australia.Patient or Public ContributionThis study did not include patient or public involvement in its design, conduct, or reporting.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"66 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Descriptive Qualitative Study of Patient and Carer Perspectives on the Acceptability of Transcatheter Aortic Valve Implantation","authors":"Nicola Straiton, Robyn Gallagher, Janice Gullick","doi":"10.1111/jan.70180","DOIUrl":"https://doi.org/10.1111/jan.70180","url":null,"abstract":"AimTo provide a structured analysis of the acceptability of transcatheter aortic valve implantation to support clinical conversations, decision making and recovery for older adults with aortic stenosis and their carers.BackgroundWhile transcatheter aortic valve implantation is an effective treatment for heart valve disease, its acceptability to patients and caregivers remains unclear. Understanding the acceptability of clinical procedures is key for influencing patient engagement in self‐care and guiding the information and support patients and carers need.DesignA descriptive, qualitative study used deductive content analysis, guided by Sekhon's Theoretical Framework of Acceptability.MethodsParticipants included 18 aortic stenosis patients (mean age 84.2 ± 4.1 years) and 8 carers from three Australian metropolitan hospitals (2018–2020). Semi‐structured interviews were conducted 4–6 months post–TAVI and transcribed verbatim. Analysis used Sekhon's Theoretical Framework of Acceptability across three temporal zones, with deductive coding examining affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness and self‐efficacy.ResultsParticipants described high prospective, concurrent and retrospective acceptability of transcatheter aortic valve implantation. Perceived prospective acceptability framed the procedure as lifesaving. Peri‐operatively, participants found the procedure simple, low‐risk and minimally disruptive, ensuring high concurrent acceptability. Post‐procedure, patient participants described a slow but gradual return to normal, growing confidence and a reengagement with their valued pastimes. The absence of structured rehabilitation advice led to self‐designed recoveries and uncertainty about safe limits.ConclusionTranscatheter aortic valve implantation was perceived as a highly acceptable intervention that helped this group of mostly older adults achieve their personal goals.Relevance to Clinical PracticeDespite the minimally invasive nature of transcatheter aortic valve replacement, optimising recovery and rehabilitation requires a holistic approach that addresses both clinical needs and patient goals.Patient and Public ContributionNone in the conceptualisation or design.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"179 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Healthcare Experiences and Preferences of LGBT+ People: An Online Asynchronous Focus Group Study","authors":"John P. Gilmore, David J. Field","doi":"10.1111/jan.70210","DOIUrl":"https://doi.org/10.1111/jan.70210","url":null,"abstract":"AimTo explore experiences of LGBT+ individuals in accessing and receiving healthcare in Ireland, and to identify opportunities for more inclusive and equitable healthcare delivery.DesignA descriptive qualitative study using asynchronous online focus groups.MethodsAsynchronous online focus groups were conducted using the MURAL collaborative platform over a three‐week period in 2023. Participants (<jats:italic>n</jats:italic> = 43) self‐selected into one of three focus groups based on gender and sexual identity. Data were analysed using reflexive thematic analysis to generate key themes.ResultsFour themes were identified: (1) Culturally aware healthcare professionals; (2) Access and information; (3) Specialist versus universal services; and (4) Mental health support. Participants reported frequent experiences of misgendering, heteronormative assumptions, and provider inexperience. Geographic inequities, unclear referral pathways, and a lack of centralised, inclusive information were also key barriers. While specialist services were valued, participants advocated for a dual approach that integrates LGBT+ competence into all healthcare settings.ConclusionDespite legal and social progress, LGBT+ individuals in Ireland continue to encounter significant barriers to equitable healthcare. The findings highlight a need for improved cultural competence, better access to inclusive services, and systemic reform.Implications for the Profession and/or Patient CareHealthcare providers must receive comprehensive training in LGBT+ health to ensure respectful, appropriate, and inclusive care. Enhanced visibility of inclusive providers and improved service pathways are needed to address current inequities, particularly in mental health and gender‐affirming care.ImpactThis study identifies key gaps in provider competence, service accessibility, and mental health provision. Findings will inform healthcare education, policy development, and service design to improve experiences and outcomes for LGBT+ individuals in both urban and rural contexts.Reporting MethodThis study adhered to the Standards for Reporting Qualitative Research (SRQR).Patient or Public ContributionNo patient or public contribution was involved.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"32 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's Experiences of Care and Support Following Postpartum Psychosis: A Meta‐Ethnography","authors":"Vimbai Carr, Gill Thomson, Victoria Moran, Gill Strachan","doi":"10.1111/jan.70195","DOIUrl":"https://doi.org/10.1111/jan.70195","url":null,"abstract":"BackgroundPostpartum psychosis is a psychiatric emergency that occurs following childbirth. Women are often cared for in general psychiatric units or in psychiatric Mother and Baby units. Postpartum psychosis is associated with a significant risk of relapse. There is a need to explore how women perceive care to understand what works well or needs further improvement.AimsThis review aimed to explore women's experiences of care and support for postpartum psychosis.DesignA systematic review using meta‐ethnographic methods was conducted.Data SourcesComprehensive searches were conducted between 4 March 2024 and 4 March 2025 on five databases (CINAHL, EMBASE, MEDLINE, PsycINFO and Web of Science). Backward and forward chain searching was also undertaken.Review MethodsCritical appraisal was conducted following screening. Reciprocal and refutational translation were used to form the synthesis, and a line of argument was developed. The eMERGe reporting guidelines were used.ResultsFifteen studies were included within this synthesis. All the studies were conducted in high income countries and included 235 women. Three main themes were developed. ‘Navigating the unknown’ explored women's perceptions of postpartum psychosis as a less well‐known condition, and their informational needs. ‘The double‐edged sword of care’ found that there were helpful elements of formal mental health care, but that accessing care was sometimes traumatic, stigmatising and conflicting to women's identities. ‘Seeking consolation and recovery’ explored women's need for psychological support and experiences of peer support.ConclusionThe findings of this review highlighted women's needs in respect to informational support, medication support, psychological support and in‐patient care settings. Mother and baby units were strongly preferred by women.ImpactThe findings highlighted a need for specialised care for postpartum psychosis.Patient or Public ContributionThere were no patient or public contributions.Trial RegistrationProspero (CRD42024515712)","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"52 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Communication to Enhance Adolescent Depression Recovery-Intervention Development Protocol.","authors":"Lalit Dzifa Kodzo,Mengjia Wang,Stephen Kpekura,Akriti Baral Kafle,Fath Ur Rahman,Imtiaz Alam,Ruixing Zhang","doi":"10.1111/jan.70202","DOIUrl":"https://doi.org/10.1111/jan.70202","url":null,"abstract":"AIMTo develop a structured intervention aimed at enhancing family communication to reduce relapse in adolescents with depression.DESIGNThis study follows a multi-stage process guided by the Intervention Mapping procedure with the Medical Research Council framework, assessing the layers of complexity. Its design comprises four interrelated stages to construct a family communication intervention, culminating in a pilot randomised controlled trial.METHODSThe program has four stages: (1) Identifying family interaction gaps through literature review and expert input; (2) Investigating communication needs of depressed adolescents and their families via a mixed methods study to develop a model intervention; (3) Refining the intervention with focus groups and expert e-Delphi; and (4) Finalising the intervention based on pilot randomised controlled trial outcomes. The research will be conducted in Greater Accra, Ghana.RESULTSThe process will result in a family communication intervention tailored to the needs of adolescents with depression and their families. It will be pilot tested, and the results will inform a nationwide efficacy trial.CONCLUSIONThis research integrates qualitative and quantitative data to inform the development of an evidence-based family communication intervention. The program will carefully examine data integration and contextual challenges encountered during its implementation.IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CAREThe intervention has the potential to enhance family communication, thus playing a crucial role in adolescent depression recovery by reducing relapse rates. Healthcare professionals will benefit from a structured, evidence-based communication tool that can be used in clinical settings.IMPACTThe study focuses on improving communication between families of adolescents with depression, aiming to develop a family communication package for clinical and community use. This intervention may enhance recovery outcomes and reduce relapse risk for adolescents.REPORTING METHODThis study adhered to the GUIDED guideline for reporting intervention development studies.PATIENT OR PUBLIC CONTRIBUTIONNo Patient or Public Contribution.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"46 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Recontextualisation Theory to Understand Learning Across Multiple Sites in Simulation‐Based Nurse Education","authors":"Helen T. Allan, Mike O'Driscoll","doi":"10.1111/jan.70163","DOIUrl":"https://doi.org/10.1111/jan.70163","url":null,"abstract":"AimThe aim of this discussion paper is to explore whether recontextualisation theory deepens our understanding of learning across multiple sites when introducing simulation‐based education (SBE) into nurse education.BackgroundThe requirement for students to learn in clinical placements remains an aspiration as well as a regulatory requirement internationally. Yet, the increasing complexity of healthcare and the numbers of vacancies in the healthcare workforce globally have led to poor learning environments. In the context of faster internet speeds, rapid development in virtual technologies, affordability of hardware, and the move to online educational provision after the COVID‐19 pandemic, SBE has emerged as a key teaching method in health professional preparation programmes globally.DesignCritical discussion paper.MethodsThis discussion paper is based on current literature on SBE and recontextualisation theory.FindingsEvaluations of SBE often show positive outcomes for learning in nurse education. Weaknesses and gaps in the evidence on SBE, such as the scarcity of control groups or longitudinal studies, have been identified. Using recontextualization theory, we argue that SBE may also increase the theory‐practice split for students across multiple sites of learning.ConclusionsThe introduction of SBE offers supplementary positive learning opportunities to those in clinical practice while at the same time creating multiple sites of learning which are not always aligned. More needs to be done to teach from a curriculum which relies on students being motivated and able to learn across multiple sites of learning.Implications for the Profession and Patient CareTo support student nurses in UG professional preparation programmes which rely on SBE as well as clinical practice and universities, shared values between nurse educators and clinical nurses need to be enacted collaboratively. This could be achieved by reframing how students and nurses learn and rework knowledge across sites of learning.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"28 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144928042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological Haemodynamic Management in the Intensive Care Unit: The Evolution of the Nurse's Role Over 50 Years","authors":"Adrianna Lorraine Watson","doi":"10.1111/jan.70185","DOIUrl":"https://doi.org/10.1111/jan.70185","url":null,"abstract":"AimTo examine the evolution of intensive care nurses’ roles in pharmacological haemodynamic management from 1975 to 2025 and to explore projected responsibilities through 2075.DesignA scholarly commentary.MethodsA critical synthesis of literature, historical accounts and clinical guidelines spanning 1975–2025, focussing on nursing practice, technology, workforce dynamics and patient safety in critical care pharmacology.Data SourcesCINAHL, PubMed, EBSCO, Embase, Cochrane, Google Scholar and major pharmacological guideline repositories were searched for sources between 1975 and 2025, including clinical trials, systematic reviews, position papers and qualitative studies.ResultsNurses have progressed from unstandardised vasoactive medication titration to advanced, protocol‐driven multimodal vasopressor strategies. Milestones include the early catecholamine era, nurse‐led sepsis protocols and contemporary adoption of peripheral vasopressor practices supported by technology. Looking ahead, intensive care nurses will increasingly supervise technologically driven titration, manage multimodal regimens, address drug shortages and sustain resilience amid workforce pressures.ConclusionOver the past five decades, nurses have transformed vasopressor management and remain essential in bridging innovation with ethical, patient‐centred care. The next 50 years will require advanced decision‐making, technological fluency and improved support for the nursing workforce.Implications for the Profession and/or Patient CareInvestment in simulation‐based education, workforce supports and ethical frameworks is vital to prepare nurses for expanding responsibilities and ensure patient safety.ImpactProblem addressedHistorical variability and future challenges in nursing roles for vasopressor management.Main findingsNurses have driven safety and innovation and will face increasing technological, ethical and workforce demands.ImpactRelevant to critical care nurses, nurse educators, nurse leaders and policy‐makers worldwide shaping the future of critical care practice.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"23 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144928044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family Communication to Enhance Adolescent Depression Recovery-Intervention Development Protocol.","authors":"Lalit Dzifa Kodzo, Mengjia Wang, Stephen Kpekura, Akriti Baral Kafle, Fath Ur Rahman, Imtiaz Alam, Ruixing Zhang","doi":"10.1111/jan.70202","DOIUrl":"https://doi.org/10.1111/jan.70202","url":null,"abstract":"<p><strong>Aim: </strong>To develop a structured intervention aimed at enhancing family communication to reduce relapse in adolescents with depression.</p><p><strong>Design: </strong>This study follows a multi-stage process guided by the Intervention Mapping procedure with the Medical Research Council framework, assessing the layers of complexity. Its design comprises four interrelated stages to construct a family communication intervention, culminating in a pilot randomised controlled trial.</p><p><strong>Methods: </strong>The program has four stages: (1) Identifying family interaction gaps through literature review and expert input; (2) Investigating communication needs of depressed adolescents and their families via a mixed methods study to develop a model intervention; (3) Refining the intervention with focus groups and expert e-Delphi; and (4) Finalising the intervention based on pilot randomised controlled trial outcomes. The research will be conducted in Greater Accra, Ghana.</p><p><strong>Results: </strong>The process will result in a family communication intervention tailored to the needs of adolescents with depression and their families. It will be pilot tested, and the results will inform a nationwide efficacy trial.</p><p><strong>Conclusion: </strong>This research integrates qualitative and quantitative data to inform the development of an evidence-based family communication intervention. The program will carefully examine data integration and contextual challenges encountered during its implementation.</p><p><strong>Implications for the profession and/or patient care: </strong>The intervention has the potential to enhance family communication, thus playing a crucial role in adolescent depression recovery by reducing relapse rates. Healthcare professionals will benefit from a structured, evidence-based communication tool that can be used in clinical settings.</p><p><strong>Impact: </strong>The study focuses on improving communication between families of adolescents with depression, aiming to develop a family communication package for clinical and community use. This intervention may enhance recovery outcomes and reduce relapse risk for adolescents.</p><p><strong>Reporting method: </strong>This study adhered to the GUIDED guideline for reporting intervention development studies.</p><p><strong>Patient or public contribution: </strong>No Patient or Public Contribution.</p>","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Machine Learning‐Based Risk Prediction Model for Delirium in Older Inpatients: A Prospective Cohort Study","authors":"Xu‐Hua Zhou, Di‐Fei Duan, Meng Zhang, Shuang Liu, Jing Lv, Yi Wang, Lin Chen, Ying‐Jun Zhang, Bo Gu, Qian Chen","doi":"10.1111/jan.70154","DOIUrl":"https://doi.org/10.1111/jan.70154","url":null,"abstract":"AimsTo develop and validate a machine learning‐based risk prediction model for delirium in older inpatients.DesignA prospective cohort study.MethodsA prospective cohort study was conducted. Eighteen clinical features were prospectively collected from electronic medical records during hospitalisation to inform the model. Four machine learning algorithms were employed to develop and validate risk prediction models. The performance of all models in the training and test sets was evaluated using a combination of the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, Brier score, and other metrics before selecting the best model for SHAP interpretation.ResultsA total of 973 older inpatient data were utilised for model construction and validation. The AUC of four machine learning models in the training and test sets ranged from 0.869 to 0.992; the accuracy ranged from 0.931 to 0.962; and the sensitivity ranged from 0.564 to 0.997. Compared to other models, the Random Forest model exhibited the best overall performance with an AUC of 0.908 (95% CI, 0.848, 0.968), an accuracy of 0.935, a sensitivity of 0.992, and a Brier score of 0.053.ConclusionThe machine learning model we developed and validated for predicting delirium in older inpatients demonstrated excellent predictive performance. This model has the potential to assist healthcare professionals in early diagnosis and support informed clinical decision‐making.ImpactBy identifying patients at risk of delirium early, healthcare professionals can implement preventive measures and timely interventions, potentially reducing the incidence and severity of delirium. The model's ability to support informed clinical decision‐making can lead to more personalised and effective care strategies, ultimately benefiting both patients and healthcare providers.Reporting MethodThis study was reported in accordance with the TRIPOD statement.Patient or Public ContributionNo patient or public contribution.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"122 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144928043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}