The study aimed to explore nurses' use of social media for networking, cooperation, and learning purposes. This cross-sectional study collected data from 158 nurses using an online questionnaire, primarily distributed through open social media for Sigma nurses across 19 European countries in 2023. Over half of the respondents were Sigma nursing members [n=105 (66.4%)]. PhD or a second academic degree was held by 58.2% (n=92) of the respondents. The questionnaire examined (1) background characteristics; (2) social media platforms' use; (3) usage of social media for learning; and (4) networking. WhatsApp, Facebook, and Instagram were the most frequently used social media platforms. While most nurses did not perceive social media as a tool for learning, a significant portion reported using it for receiving, discussing, and posting knowledge, indicating a contradiction in perceptions of learning through social media. Social media was primarily used to stay updated on research, news, and webinars. Barriers to utilizing social media for learning addressed a lack of time, concerns over privacy, user skills, information overload, content reliability, and platform complexity. Social media can enhance learning and networking opportunities for nurses, but platforms must be selected and content tailored to meet their educational needs. Further research is necessary for generalizability, given the limited sample size and representativeness, and to optimize social media strategies for knowledge dissemination. This study adds to the literature by presenting indicative descriptive perspectives of predominantly highly educated nurses in the European region on social media use for professional networking, collaboration, and learning.

ABSTRACTObjectiveNo studies have yet evaluated whether light therapy or negative ion therapy can be used as maintenance treatment after acute treatment with antidepressants in patients with major depressive disorder. To address the importance of this question, we surveyed participants with depression to determine their knowledge and attitudes about light therapy and negative ion therapy, and their willingness to participate in a randomized clinical trial with these therapies substituting for antidepressants for maintenance treatment.MethodsParticipants with a self-reported diagnosis of depression were recruited by email, newsletters, and social media to complete an online survey with questions about awareness and effectiveness of light therapy and negative ion therapy for depression. Vignettes describing the use of these therapies for maintenance treatment were presented with follow up questions about the ease of use and reasons for wanting (and not wanting) to use the therapies instead of antidepressants. Another vignette described a randomized study with these therapies followed by questions on whether participants would likely volunteer for the study. Chi-square tests were used to examine differences in responses between therapies.ResultsA total of 221 participants completed the survey. Most of them were aware of both therapies, but more participants had heard of light therapy (95% compared to 62% for negative ion therapy, p<0.0001), had used light therapy (28% versus 16%, p<0.003), and regarded light therapy as effective (54% versus 37%, p<0.001). Both therapies were considered easy to use. The majority of participants (78%) thought that it was important to find non-medication therapies for maintenance treatment, and 77% responded that they would likely volunteer for a randomized study to determine efficacy of the two therapies for maintenance treatment.ConclusionPeople with depression are generally aware of light therapy and negative ion therapy and believe they would be good therapies to substitute for antidepressants in maintenance treatment. These findings support the importance and feasibility for a randomized relapse prevention trial with light therapy and negative ion therapy in patients with depression.

Introduction Global ageing is increasing. Most older people live independently but at times require nursing care as they age. This care is provided in a variety of settings including acute, primary, community and residential care services. In such instances, it is important that older people feel comfortable and listened to, and it is imperative that student nurses are educated to competently care for and nurse older people in collaborative partnerships. Intergenerational initiatives promote shared learning and help break down barriers among different age cohorts. An online intergenerational caf & eacute; was developed to provide a learning opportunity for older people and student nurses to meet as equals and connect socially in a protected place and time. This paper reports on older people's views of their participation in an online intergenerational caf & eacute;. Methods Ethical approval was granted for this survey design research. Older people living in the community (n = 49) participated in online intergenerational caf & eacute;s with student nurses. Following the online caf & eacute;, participants were invited to voluntarily participate in the study through completion of an anonymous online survey. Consent was indicated through the return of the survey questionnaire. All agreed to complete the survey. Likert scale quantitative data was analysed using descriptive statistical analysis (SPSS, version 21). Responses to the open-ended questions were thematically analysed. Findings The cafes supported intergenerational learning, and participants felt comfortable participating. Participants discovered some but not all key points of interest about students. In many ways, they were quite similar to students. Participants felt students would be respectful, empathetic and advocate for them in a care situation. Many agreed that the caf & eacute;s were well organised, but some would have liked more clarity on the discussion topics. Conclusions This caf & eacute; initiative has merit as it helped reduce barriers and facilitated intergenerational learning. Implications for Practice Participation in Intergenerational caf & eacute;s can help reduce barriers by faciliating understanding and mutual respect . They can provide a forum for discussion on nursing care expectations.

BACKGROUND:Delirium is frequently unrecognised, and healthcare professionals lack knowledge and confidence in recognition and management of the condition. Increased delirium education within pre-registration healthcare profession curricula may help to address this. A modified Delphi approach was utilised to develop a set of education priorities associated with delirium education for healthcare profession students. METHODS:An initial list of 72 education priorities were identified from a literature review, stakeholder focus groups, and a review of available clinical guidelines. Priorities were grouped into eight domains 'assessment and diagnosis', 'aetiology and risk factors', 'pathophysiology', 'treatment of delirium', 'prevention', 'delirium and dementia', 'impact on people with delirium, informal caregivers and family' and 'health promotion and public education'. Academic experts and healthcare professionals were invited to rank each priority and each domain across two rounds. Round one consisted of a survey including the list of 72 potential education priorities which participants were asked to rank from one (not a priority) to five (essential priority). Items which did not reach consensus criteria following round one were re-distributed as round two of the survey and participants were asked to repeat this exercise for the shorter list of items. Additionally, in round two, participants were asked to rank the eight domains from most important to least important. RESULTS:Eighty participants completed round one of the Delphi survey and 55 (68.75%) also completed round two. Following round one, 41 priorities were considered highly relevant and therefore met the criteria to be included in the final set of education priorities. An additional four items reached these criteria following round two and so the final set consists of 45 items. Priorities related to prevention, diagnosis, and treatment were consistently ranked highly whereas priorities related to pathophysiology and health promotion were consistently ranked lowest. DISCUSSION:This Delphi study identified areas of education viewed as the highest priorities for healthcare profession students' delirium education, drawn from a range of academics and healthcare professionals. The final set may help to inform the development of delirium education reflecting these priorities.

Background Worldwide, the COVID-19 pandemic contributed to further gaps in mental health care, particularly in low- and middle-income countries such as Vietnam, where care is inaccessible for 90% of those who need it. There has subsequently been a considerable increase in the use of digital mental health interventions such as smartphone apps. Presently, the evidence for such interventions is limited, especially in cases in which the interventions have been adapted from evidence-based in-person formats. Implementation science aims to promote the incorporation of scientific findings into practice. A key determinant of implementation success is an intervention’s usability. Hurdles to usability include an intervention being too confusing or time-intensive to use. Facilitators include incorporating a greater number of engagement features and integrating human support. Objective The aim of this implementation science feasibility study was to describe the challenges and mitigation strategies used in the development, usability testing, and implementation of a digital depression intervention (VMood smartphone app) developed in Vietnam. VMood was adapted from an evidence-based in-person intervention originally developed in Canada that is grounded in principles of cognitive behavioral therapy with supportive coaching by a lay health or social services worker. The research team is currently testing the effectiveness and cost-effectiveness of VMood in a randomized controlled trial across 8 provinces in Vietnam informed by the results of this feasibility assessment. Methods This mixed methods feasibility study was organized using an implementation outcome framework focused on acceptability, adoption, appropriateness, and feasibility. This study involved three data collection components: (1) usability testing (interviews and focus groups with app user and provider participants who tested VMood in 1 Vietnamese province), (2) app metrics (from the early phase of the randomized controlled trial in the same province but from different municipalities), and (3) discourse data (notes from various team meetings, communications, and reports on VMood’s development and implementation). Qualitative data were analyzed using thematic content analysis. App use data were analyzed using basic descriptive statistics. Results The findings of the 3 data components showed that there were seven main challenges: (1) challenges with recruitment and uptake of the app, (2) challenges with use and engagement, (3) screening challenges, (4) digital divide, (5) limitations to digital applications for mental health, (6) technological challenges, and (7) funding and policy constraints. Various solutions to help mitigate the challenges were used by the team. Conclusions The findings contribute important evidence on the challenges to the development and feasibility assessment of a digital depression app adapted from an in-person intervention in Vietnam. The findings have applicability for others looking to develop and implement digital interventions in similar contexts, serving as a unique opportunity to share the lessons learned regarding the development and testing process.

BACKGROUND:Few studies have examined the association between community solidarity and health-related behaviors. This study investigates solidarity in navigating challenges during the COVID-19 pandemic. METHODS:We used cross-sectional data from a multi-national survey of 1,346 respondents to examine (1) factors relating to feelings of solidarity, and (2) associations between solidarity and public health preventive behaviors. RESULTS:More than half (53.1%) of participants expressed feelings of solidarity; they were more likely to be aged 30 years or over, employed full-time, and residing in Eastern economies. We found a statistically significant association between positive feelings of solidarity and three of five COVID-19 prevention behaviors (social distancing, skipping an event, and masking in public). Those who reported previous influenza vaccination were also more likely to adopt these behaviors. DISCUSSION:The findings underscore the potential of fostering community solidarity to enhance prosocial actions amid widespread emergencies.

Background: Within the context of global ageing, older people will require health care during times in their later lives. As most nurses will care for older people across a variety of care settings, it is crucial that older people and nurses can work together in partnership. In preparation for this, it is important to develop intergenerational learning innovations for student nurses and older people. An online intergenerational discussion cafe' was developed to provide an opportunity for older people and student nurses to meet and get to know each other. Objectives: 1) Evaluate the effectiveness of an intergenerational discussion cafe' as a way of facilitating intergenerational learning, 2) Elicit participants' views on whether intergenerational learning had occurred. Design: Ethically approved survey research.Settings: Tertiary education institution. Participants: Third year student nurses (n = 50) across three BSc Nursing pre-registration degree programmes enrolled on a shared community care module. Methods: Post-cafe', student nurses were invited via email to voluntarily participate in the research and to complete an anonymous online survey. Questionnaire return implied consent. Fifty student nurses (n = 50) participated in the post cafe' survey. Descriptive statistical analysis of Likert scale quantitative data and thematic analysis of open-ended questions was undertaken.Results: Participants reported that the intergenerational cafe's were well organised, worked well and strongly agreed that the cafe's were helpful in facilitating student nurses and older people to connect socially and share views.Results also showed that participants felt they got to know a lot about older people and that they were in many ways quite similar to older people.Conclusions: This study provides valuable information on the use of intergenerational cafe's as a means of facilitating intergenerational learning. Findings indicate that it was a positive learning experience for participants.

Abstract Background The global burden of mental illness is substantial, with depression impacting close to 300 million people worldwide. This has been exacerbated within the context of the COVID-19 pandemic. Yet, in many low- and middle-income countries including Vietnam, there is a substantial treatment gap, with many requiring mental health care unable to access it. Task-shifting is an evidence-based approach that seeks to address this gap by utilizing non-specialist providers to provide care. While there is a large body of literature exploring task-shifting, there is little that explores the client experience. This paper describes the facilitators and barriers impacting the client experience of a task-shifting supported self-management (SSM) intervention for depression in Vietnam. SSM involves a client workbook and supportive coaching by non-specialist providers. Methods This paper is situated within a randomized controlled trial that demonstrated the effectiveness of the SSM intervention in adult populations across eight provinces in Vietnam. Semi-structured interviews were conducted with a convenience sample of clients (recipients of the intervention) with depression caseness as measured by the Self-Report Questionnaire-20 depression screening measure, and providers (non-specialist “social collaborators”) to explore SSM’s acceptability and factors influencing participation and adherence. This paper presents the qualitative findings from an analysis of the interviews, focusing on the client perspective. Qualitative descriptive methods and thematic analysis were used. Results Forty-five clients were interviewed. Sub-themes reported for the facilitators and benefits for the client experience of the SSM intervention were client-provider relationship building and family and community connections. Sub-themes reported for the barriers were clients’ responsibilities, clients’ health conditions, and consequences of stigma. Conclusions Due to challenges with sustaining and scaling up the in-person SSM intervention in Vietnam, the research team has pivoted to delivering the SSM intervention digitally through a smartphone-based app adapted from SSM, with direction from the Government of Vietnam. Findings from this study suggest that while digital interventions may support accessibility and convenience, they may neglect the critical human contact component of mental health care. Ultimately, a model that combines digital delivery with some form of human contact by a support person may be important.

Objective: Measurement-based care (MBC) is an emerging, objective, and systematic evidence-based practice for monitoring symptom severity and treatment efficacy to assist clinicians in developing individualized treatment strategies for patients with major depressive disorder (MDD). This study aimed to identify the barriers and facilitators of enhanced MBC (eMBC) in the outpatient setting to clarify the eMBC utilization dilemma. Methods: Between September 2022 and June 2023, we collected the opinions of healthcare providers, adult and adolescent patients, and family members of adolescent patients via online surveys. Specifically, we surveyed their acceptance and perspectives on MBC and eMBC primarily through custom-designed Likert scales developed for this study. Results: We received responses from 270 adult patients, 144 adolescent patients, 109 family members, and 355 healthcare providers. The results showed that 85.3% of patients and family members were willing to use the eMBC intervention. However, adolescent patients responded significantly differently from the other two groups, with lower acceptance and confidence. Among healthcare providers, while only 69.9% used MBC in practice, 94% believed standardized scales would be effective in treatment, and 91.8% were willing to try eMBC. Additionally, we received 277 remarks regarding eMBC from patients and families. Conclusion: In general, both clinicians and patients looked forward to using eMBC and recognized the potential benefits. However, they still had many concerns about privacy, professionalism, and time consumption. Responses from adolescent patients appeared more conservative and lacked confidence in eMBC. Further implementations are required to explore how eMBC can be operationalized in the outpatient setting to help different patients.

The COVID-19 pandemic had an unprecedented impact on global mental health and well-being, including across the Asia-Pacific. Efforts to mitigate virus spread led to far-reaching disruption in the delivery of health and social services. In response, there was a rapid shift to the use of digital mental health (DMH) approaches. Though these technologies helped to improve access to care for many, there was also substantial risk of access barriers leading to increased inequities in access to mental health care, particularly among at-risk and equity-deserving populations. The objective of this study was to conduct a needs assessment and identify priorities related to equitable DMH access among at-risk and equity-deserving populations in the Asia Pacific region during the first year of the COVID-19 pandemic. The study consisted of a modified Delphi consensus methodology including two rounds of online surveys and online consultations with stakeholders from across the region. Study participants included policy makers, clinicians and service providers, and people with lived experience of mental health conditions. Results demonstrate that vulnerabilities to negative mental health impacts and access barriers were compounded during the pandemic. Access barriers included a lack of linguistically and culturally appropriate DMH options, low mental health literacy and poor access to technological infrastructure and devices, low levels of awareness and trust of DMH options, and lack of policies and guidelines to support effective and equitable delivery of DMH. Recommendations to improve equitable access include ensuring that diverse people with lived experience are engaged in research, co-design and policy development, the development and implementation of evidence-based and equity-informed guidelines and frameworks, clear communication about DMH evidence and availability, and the integration of DMH into broader health systems. Study results can inform the development and implementation of equitable DMH as its use becomes more widespread across health systems.

Purpose:To validate the efficacy of enhanced measurement-based care against standard measurement-based care in patients with major depressive disorder. Patients and Methods:In this pilot study of an ongoing multicenter cluster randomized controlled trails, 160 patients diagnosed with major depressive disorder were enrolled from 2 mental health centers, with a plan to include 12 centers in total. One hundred patients engaged in a six-month evaluation using a technology-enhanced measurement-based care tool, including assessments of clinical symptoms, side effects, and functionality at baseline, two months, four months and six months. Simultaneously, the remaining 60 patients underwent standard paper-based measurement-based care, utilizing the same set of scales over the same six-month period, with assessments at the same time points. Results:Patients utilizing the enhanced measurement-based care tool demonstrated a significantly higher reduction rate in PHQ-9 scores compared to those using standard paper-based measurement-based care during the two-month follow-up. Additionally, a notable positive correlation was observed between the frequency of enhanced measurement-based care tool usage and the quality of life during the two-month follow-up. Conclusion:Enhanced measurement-based care has the effect of reducing depressive symptoms. Our study emphasized that using enhanced measurement-based care via smartphones is a feasible tool for patients with major depressive disorder. Our future study, including results from additional research centers, may further validate the effectiveness of enhanced measurement-based care.

Background Evidence-based mental health policies are key to supporting the expansion of community-based mental health care and are increasingly being developed in low and middle-income countries (LMICs). Despite this, research on the process of mental health policy development in LMICs is limited. Engagement between researchers and policy makers via an integrated Knowledge Translation (iKT) approach can help to facilitate the process of evidence-based policy making. This paper provides a descriptive case study of a decade-long policy and research collaboration between partners in Vietnam, Canada and Australia to advance mental health policy for community-based depression care in Vietnam. Methods This descriptive case study draws on qualitative data including team meeting minutes, a focus group discussion with research team leaders, and key informant interviews with two Vietnamese policy makers. Our analysis draws on Murphy et al.’s (2021) findings and recommendations related to stakeholder engagement in global mental health research. Results Consistent with Murphy et al.’s findings, facilitating factors across three thematic categories were identified. Related to ‘the importance of understanding context’, engagement between researchers and policy partners from the formative research stage provided a foundation for engagement that aligned with local priorities. The COVID-19 pandemic acted as a catalyst to further advance the prioritization of mental heath by the Government of Vietnam. ‘The nature of engagement’ is also important, with findings demonstrating that long-term policy engagement was facilitated by continuous funding mechanisms that have enabled trust-building and allowed the research team to respond to local priorities over time. ‘Communication and dissemination’ are also crucial, with the research team supporting mental health awareness-raising among policy makers and the community, including via capacity building initiatives. Conclusions This case study identifies factors influencing policy engagement for mental health system strengthening in an LMIC setting. Sustained engagement with policy leaders helps to ensure alignment with local priorities, thus facilitating uptake and scale-up. Funding agencies can play a crucial role in supporting mental health system development through longer term funding mechanisms. Increased research related to the policy engagement process in global mental health will further support policy development and improvement in mental health care in LMICs.

Background: Previous studies have shown that patients with non-communicable diseases (NCDs) had a higher risk of coronavirus disease 2019 (COVID-19). This study aimed to evaluate the associated factors and global impact of the presence of NCDs on COVID-19 related experience, behaviours, and mental health outcomes.

Background Digital interventions, such as smartphone apps, have emerged as a promising way to better meet growing population mental health needs. The evidence for many of these digital interventions is currently limited, especially in the context of those adapted from in-person formats. Our team developed a digital depression intervention (VMood) in Vietnam. VMood, adapted from an evidence-based in-person intervention (SSM) developed in Canada, uses cognitive behaviour therapy (CBT) principles with remote coaching by non-specialist providers. Fidelity-adaptation is a major tension in implementation science. Fidelity is the degree an intervention is delivered as intended. Conversely, adaptations are sometimes made to address specific contexts. This paper aims to identify key elements of fidelity-adaptation – the degree VMood is consistent with the theoretical aspects of the SSM intervention and practical aspects of implementing digitally in the Vietnamese setting. Methods This study uses Dimensions from Dane and Schneider’s Implementation Fidelity Evaluation Framework: adherence (D1), quality (D2), participant responsiveness (D3), and program differentiation (D4). Discourse data from team meetings explored elements that must remain intact (D1) and those requiring adaptation to fit the digital modus and local cultural context (D4). Non-specialist providers with SSM knowledge and app users from Vietnam tested VMood. Experts familiar with CBT from Vietnam and Canada provided theoretical feedback. Interviews or focus groups were conducted with all participants to gain insights into (D1-4). All qualitative data were analyzed using thematic content analysis. Results Key findings were: Adherence (D1): participants agreed that VMood captures the important theoretical content from SSM, with the same content being delivered in a different format and Program Differentiation (D4): participants presented a variety of adaptation suggestions unique for the digital format to strengthen VMood’s acceptability, including keeping the app simple by reducing the amount of text; incorporating more dynamic content (e.g., animations, videos) to increase engagement; and including more culturally appropriate scenarios. Conclusions The updated VMood intervention is currently being implemented in a randomized controlled trial across eight provinces in Vietnam. With the global increase in digital health services adapted from in-person delivery, understanding how to balance fidelity with necessary adaptations is important both theoretically and practically.

Abstract Background Competence in delirium care begins with pre-registration education for health care professionals. Although a common complication for hospitalised patients, delirium is avoidable and reversible. Delirium requires early recognition in person-centred care. Students need to learn how to identify and effectively care for ‘at risk’ patients. Aim To identify and examine literature on how pre-registration health care professional students are prepared to recognise, assess, and deliver interventions to prevent delirium in practice, using digital/web based educational interventions. Method Mixed methods systematic review with narrative synthesis. A protocol was registered with PROSPERO. The review questions and search strategy were guided by the Population, Phenomena of Interest, Context (PICo) framework. The PRISMA framework guided the screening, data extraction and analysis. Database searches (MEDLINE, Web of Science, Embase, CINAHL, Cochrane Central Register of Controlled Trials, PsycINFO & Scopus) were undertaken in April 2023 for publications from 2012 to 2023. Covidence software [30] was used to extract and manage the data. Quality appraisal was guided by the Crowe Critical Appraisal Tool (CCAT) [31]. Findings Ten papers were included: mixed methods (2), qualitative (1) and quantitative (7). Medical students were the most studied group (n = 5), followed by student nurses (n = 4) and mixed nursing and medical students (n = 1). Length of learning experience varied from 12 min virtual reality (VR) to a two-week ‘geriatrics’ elective. Learning was enhanced by player autonomy, engagement, safety, applicability, choices, multiple perspectives and moral reasoning opportunities. Discussion Digital programmes should be visually appealing, interactive with opportunities for practice and timely appropriate feedback.

Background e-Health tools using validated questionnaires to assess outcomes may facilitate measurement-based care for psychiatric disorders. MoodFX was created as a free online symptom tracker to support patients for outcome measurement in their depression treatment. We conducted a pilot randomized evaluation to examine its usability, and clinical utility. Methods Patients presenting with a major depressive episode (within a major depressive or bipolar disorder) were randomly assigned to receive either MoodFX or a health information website as the intervention and control condition, respectively, with follow-up assessment surveys conducted online at baseline, 8 weeks and 6 months. The primary usability outcomes included the percentage of patients with self-reported use of MoodFX 3 or more times during follow up (indicating minimally adequate usage) and usability measures based on the System Usability Scale (SUS). Secondary clinical outcomes included the Quick Inventory of Depressive Symptomatology, Self-Rated (QIDS-SR) and Patient Health Questionnaire (PHQ-9). Results Forty-nine participants were randomized (24 to MoodFX and 25 to the control condition). Of the 23 participants randomized to MoodFX who completed the user survey, 18 (78%) used MoodFX 3 or more times over the 6 months of the study. The mean SUS score of 72.7 (65th–69th percentile) represents good usability. Compared to the control group, the MoodFX group had significantly better improvement on QIDS-SR and PHQ-9 scores, with large effect sizes and higher response rates at 6 months. There were no differences between conditions on other secondary outcomes such as functioning and quality of life. Conclusion MoodFX demonstrated good usability and was associated with reduction in depressive symptoms. This pilot study supports the use of digital tools in depression treatment.

Context: Calls to collect patients’ race/ethnicity (RE) data as a measure to promote equitable health care among vulnerable patient groups are increasing. The COVID-19 pandemic has highlighted how a public health crisis disproportionately affects racialized patient groups. However, less is known about the uptake of RE data collection in the context of mental health care services. Methodology: A qualitative case study used surveys with mental health patients (n = 47) and providers (n = 12), a retrospective chart review, and a focus group to explore healthcare providers’ and patients’ perspectives on collecting RE data in Canada. Results: The patient survey data and focus groups show that patients avoid providing identifying information due to perceived stigma and discrimination and a lack of trust. Providers did not feel comfortable asking patients about RE, leading to chart review data where RE information was not systematically collected. Conclusions: The uptake and implementation of RE data collection in mental health care contexts require increased training and support, systematic implementation, and further evaluation and measurement of how the collection of RE data will be used to mitigate systemic racism and improve mental health outcomes.

BackgroundInterprofessional education is crucial for healthcare students to develop collaborative skills and provide effective patient care. However, opportunities for interprofessional learning are often limited in healthcare curricula. The present study aimed to engage students from different health professions in co-designing an educational resource on delirium recognition and management through an interprofessional lens and explore their experiences of this process.MethodsTwo co-design workshops were conducted with students from medicine, nursing, pharmacy, and occupational therapy programmes at two universities across the island of Ireland. Focus groups were held following these workshops to explore students' experiences of the co-design process. The workshops involved a range of activities, including theme generation, scenario development, resource creation (podcasts, simulations), and focus group discussions. Data from focus groups were analysed thematically.ResultsA total of 19 students participated across the two workshops. Three themes were identified: (1) Relationship development, where students identified the benefits of co-creating the resource and valued the flexibility, collaboration, and social aspects of the co-design approach; (2) Interprofessional collaboration, which challenged students' assumptions about other disciplines, fostered teamwork and communication, and highlighted the need for early and continuous interprofessional learning; (3) Professional growth, with students reporting increased confidence in managing delirium, working with other professions, and engaging in novel experiences like podcasting and simulation.ConclusionsThe co-design process facilitated interprofessional collaboration, peer learning, and personal growth among healthcare students. Students appreciated the opportunity to co-create an educational resource while developing interprofessional skills. The study demonstrates the potential of co-design as a methodology for enhancing interprofessional education and promoting effective teamwork in healthcare.

Worldwide, the COVID-19 pandemic has contributed to further gaps in mental health care, particularly in low- and middle-income countries such as Vietnam, where care is inaccessible for 83% of those who need it. In response, there has been an explosion of digital mental health interventions, such a s smartphone apps. Presently, the evidence for such interventions is limited, especially where they have been adapted from evidence-based in-person formats. Implementation science aims to promote the uptake of scientific findings into practice. A key determinant of implementation success is an intervention’s usability. Hurdles to usability include an intervention being too confusing or time-intensive to use. Facilitators include incorporating a greater number of engagement features and integrating human support. The aim of this implementation science feasibility study is to describe the challenges and mitigation strategies used in the development, usability testing, and implementation of a digital depression intervention (VMood smartphone app) developed in Vietnam. VMood was adapted from an evidence-based in-person intervention originally developed in Canada that is grounded in principles of Cognitive Behavioural Therapy, with supportive coaching by a nonspecialist provider. The research team is currently testing the effectiveness and cost-effectiveness of VMood in a randomized controlled trial (RCT) across eight provinces in Vietnam, informed by results from this feasibility study. This mixed methods feasibility study was informed by Proctor et al.,’s Implementation Outcomes Framework, focusing on acceptability, adoption, appropriateness, and feasibility. This study involved three data collection components: 1) usability testing (interviews and focus groups with app user and provider participants who tested VMood in one Vietnamese province; 2) app metrics (from the early phase of the RCT in the same province but from different municipalities); and 3) discourse data (notes from various team meetings, communications, and reports on VMood’s development and implementation). Qualitative data were analyzed using thematic content analysis. App usage data were analyzed using basis descriptive statistics. Findings from the three data components showed there were seven main challenges that fell within Proctor et al.,’s Framework: 1) challenges with recruitment and uptake of the app; 2) challenges with utilization and engagement; 3) screening challenges; 4) digital divide; 5) limitations to digital applications for mental health; 6) technological challenges; and 7) funding and policy constraints. Various solutions to help mitigate the challenges were utilized by the team. Adjustments based on recommendations critical to VMood’s usability and implementation were made to the VMood intervention that is currently being tested in the RCT. Findings from this study have applicability for others looking to develop and implement similar digital interventions. The larger RCT is registered at ClinicialTrials.gov, identifier [NCT05783531].

BackgroundDelirium is a complex neuropsychiatric syndrome characterised by an acute state of confusion, with a substantial impact on medical inpatients. Despite its growing recognition as a global healthcare concern, delirium remains underdiagnosed, partly due to a lack of awareness among healthcare professionals. The aim of this study was to explore how healthcare professional students experience caring for individuals experiencing delirium, the influence of their current pre-registration healthcare education, and importance of interprofessional teamwork in their role.MethodsThis qualitative study used a focus group approach to collect data from 40 healthcare professional students, including nursing, pharmacy, and medical students, across two universities in Ireland. The focus groups explored participants' experiences of caring for people with delirium, their delirium education, and their collaboration with interdisciplinary teams. The data were analysed using a reflexive thematic analysis approach.ResultsFollowing thematic analysis, three themes are reported. The first is "The Upside Down," revealing student perceptions of caring for people with delirium who are facing distressing situations. The second team reported is, "Teamwork Makes the Dream Work," emphasising the critical role of interprofessional collaboration in delirium management and patient outcomes. Finally, the theme of "A Little Is Not Enough," highlighted students' critiques of current delirium education in their pre-registration training. Collectively, these themes illuminate challenges in delirium care, advocate for teamwork in healthcare settings, and call for improvements in educational preparation for future healthcare professionals.ConclusionsThis study contributes to the existing literature by providing insights into the perspectives of healthcare professional students on delirium care. The findings also highlight the challenging nature of caring for individuals with delirium and the need for improved delirium education and interdisciplinary collaboration.