{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T18:04:21Z","timestamp":1780941861088,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["0001"],"award-info":[{"award-number":["0001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To develop and validate decision trees using conditional probabilities to identify the predictors of mortality and morbidity deterioration in trauma patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A quasi\u2010experimental longitudinal study conducted at a Level 1 Trauma Center in S\u00e3o Paulo, Brazil.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>The study analysed 201 patient records using standardised nursing documentation (NANDA International and Nursing Outcomes Classification). Decision trees were constructed using the chi\u2010squared automatic interaction detection (CHAID) algorithm and validated through K\u2010fold cross\u2010validation to ensure model reliability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Decision trees identified key predictors of survival and mobility deterioration. Patients who did not require (NOC 0414)\n                      <jats:italic>Cardiopulmonary Status<\/jats:italic>\n                      but required (NOC 0210)\n                      <jats:italic>Transfer Performance<\/jats:italic>\n                      had a 97.4% survival rate. Conversely, those requiring (NOC 0414)\n                      <jats:italic>Cardiopulmonary Status<\/jats:italic>\n                      had a 25% risk of worsening mobility, compared to 9% for those who did not.\n                      <jats:italic>K\u2010fold cross\u2010validation<\/jats:italic>\n                      confirmed the model's predictive accuracy, reinforcing the robustness of the decision tree approach (Value).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Decision trees demonstrated strong predictive capabilities for mobility outcomes and mortality risk, offering a structured, data\u2010driven framework for clinical decision\u2010making. These findings underscore the importance of early mobilisation, tailored rehabilitation interventions and assistive devices in improving patient recovery. This study is among the first to apply decision trees in this context, highlighting its novelty and potential to enhance trauma critical care practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>This study highlights the potential of decision trees, a supervised machine learning method, in nursing practice by providing clear, evidence\u2010based guidance for clinical decision\u2010making. By enabling early identification of high\u2010risk patients, decision trees facilitate timely interventions, reduce complications and support personalised rehabilitation strategies that enhance patient safety and recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>This research addresses the challenge of improving outcomes for critically ill and trauma patients with impaired mobility by identifying effective strategies for early mobilisation and rehabilitation. The integration of artificial intelligence\u2010driven decision trees strengthens evidence\u2010based nursing practice, enhances patient education and informs scalable interventions that reduce trauma\u2010related complications. These findings have implications for healthcare providers, rehabilitation specialists and policymakers seeking to optimise trauma care and improve long\u2010term patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Patients provided authorisation for the collection of their clinical data from medical records during hospitalisation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.17010","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T03:20:27Z","timestamp":1746588027000},"page":"1359-1370","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Decision Trees for Managing Impaired Physical Mobility in Multiple Trauma Patients"],"prefix":"10.1111","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7461-8143","authenticated-orcid":false,"given":"Raisa Camilo","family":"Ferreira","sequence":"first","affiliation":[{"name":"School of Nursing State University of Campinas  Campinas Brazil"},{"name":"College of Nursing University of Iowa  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9700-941X","authenticated-orcid":false,"given":"Karen","family":"Dunn\u2010Lopez","sequence":"additional","affiliation":[{"name":"College of Nursing University of Iowa  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9517-9909","authenticated-orcid":false,"given":"Sue","family":"Moorhead","sequence":"additional","affiliation":[{"name":"College of Nursing University of Iowa  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0815-9441","authenticated-orcid":false,"given":"Anna","family":"Krupp","sequence":"additional","affiliation":[{"name":"College of Nursing University of Iowa  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9288-3394","authenticated-orcid":false,"given":"Bruna Valentina","family":"Zuchatti","sequence":"additional","affiliation":[{"name":"School of Nursing State University of Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5890-991X","authenticated-orcid":false,"given":"Luciana Aparecida Costa","family":"Carvalho","sequence":"additional","affiliation":[{"name":"School of Nursing State University of Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2806-9603","authenticated-orcid":false,"given":"Micneias Tatiana de Souza Lacerda","family":"Botelho","sequence":"additional","affiliation":[{"name":"School of Nursing Universidade Federal de Mato Grosso  Sinop Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9112-752X","authenticated-orcid":false,"given":"Erika Christiane Marocco","family":"Duran","sequence":"additional","affiliation":[{"name":"School of Nursing State University of Campinas  Campinas Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,7]]},"reference":[{"key":"e_1_2_16_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010020\u201002951\u20101"},{"key":"e_1_2_16_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0280345"},{"key":"e_1_2_16_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jnu.12894"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.5555\/944919.944948"},{"key":"e_1_2_16_6_1","first-page":"11","volume-title":"PRONANDA Continuing Education Program in Nursing Based on NANDA: Cycle 7","author":"Botelho M.","year":"2019"},{"key":"e_1_2_16_7_1","volume-title":"Nursing Interventions Classification (NIC)","author":"Butcher H. 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