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BackgroundPsychological distress among taxi drivers is 5 times higher than that in the general population, and more than half of all drivers have experienced 3 or more potentially traumatic events in their lifetime. Nevertheless, help-seeking for mental health problems in this male-dominated, predominately immigrant workforce is low. Mobile technologies have the potential to increase mental health awareness, teach self-help skills, and encourage help-seeking in this hard-to-reach population. ObjectiveThis study aimed to assess the feasibility, acceptability, and potential efficacy of Driving to Health, a mobile phone–friendly mental health website app designed for people working as taxi drivers. MethodsDrivers (n=46) were recruited from the Melbourne Airport Taxi Holding Yard to participate in a single-arm trial. Self-reported, paper-based assessments were completed at baseline and at 1 month. Feasibility was measured by completion rates, representativeness of study participants, and levels of use. Acceptability was assessed by measuring users’ perception of the quality of the app and anticipated levels of future use. The efficacy of Driving to Health to increase awareness, self-help behaviors, and intentions to seek help was assessed using the user version of the Mobile App Rating Scale (uMARS) and the General Help-Seeking Questionnaire (GHSQ). Psychological symptoms were measured using the short form of the Depression, Anxiety, and Stress Scale (DASS-21). Data were analyzed using complete case analysis. ResultsIn total, 42 participants comprising drivers from 10 different countries of origin, and 14 different languages, completed pre- and poststudy measures (42/46, 91% completion rate). Just under half (45%) of all users used the app more than once with an average visit of 4 min 8 seconds. Responding to the uMARS, 62% (26/42) of the participants said that they would recommend the app to many people. Nearly all (40/42, 95%) participants said that Driving to Health increased awareness of their own mental health; 86% (36/42) said that it increased their mental health knowledge; and 76% (32/42) said that it increased their self-help behaviors. Increases in help-seeking intentions on the GHSQ were not significant, and increases on all 3 scales of DASS-21 were not reliable or meaningful. ConclusionsThis study suggests that Driving to Health is an acceptable and feasible electronic health intervention for a hard-to-reach population. Our findings also suggest that Driving to Health results in increases in mental health awareness, behaviors, and willingness to seek help.

BackgroundAround the world, depression is both under- and overtreated. The diamond clinical prediction tool was developed to assist with appropriate treatment allocation by estimating the 3-month prognosis among people with current depressive symptoms. Delivering clinical prediction tools in a way that will enhance their uptake in routine clinical practice remains challenging; however, mobile apps show promise in this respect. To increase the likelihood that an app-delivered clinical prediction tool can be successfully incorporated into clinical practice, it is important to involve end users in the app design process. ObjectiveThe aim of the study was to maximize patient engagement in an app designed to improve treatment allocation for depression. MethodsAn iterative, user-centered design process was employed. Qualitative data were collected via 2 focus groups with a community sample (n=17) and 7 semistructured interviews with people with depressive symptoms. The results of the focus groups and interviews were used by the computer engineering team to modify subsequent protoypes of the app. ResultsIterative development resulted in 3 prototypes and a final app. The areas requiring the most substantial changes following end-user input were related to the iconography used and the way that feedback was provided. In particular, communicating risk of future depressive symptoms proved difficult; these messages were consistently misinterpreted and negatively viewed and were ultimately removed. All participants felt positively about seeing their results summarized after completion of the clinical prediction tool, but there was a need for a personalized treatment recommendation made in conjunction with a consultation with a health professional. ConclusionsUser-centered design led to valuable improvements in the content and design of an app designed to improve allocation of and engagement in depression treatment. Iterative design allowed us to develop a tool that allows users to feel hope, engage in self-reflection, and motivate them to treatment. The tool is currently being evaluated in a randomized controlled trial.

Nursing programs across North America are typically significantly oversubscribed, resulting in inflated admitting averages thus making it an unattainable profession for many qualified students. This article proposes a lottery-based admissions process, whereby students who meet established selected criteria for entry would be selected at random until all seats are filled. This would allow all qualified applicants equal chance of admission, and may address issues related to equity, diversity, and inclusion, and may lessen some of the significant burden on prospective applicants.

Australia's Medicare is at a mid‐life reflection point. This is not a moment for existential dread or rash actions. Instead, it is a time for age‐related improvement. Middle‐aged Medicare would benefit from policy that reflects the benefits of subtractive change to reduce its complexity. In addition, policies prioritising the use of data science to enact technologically innovative approaches would improve overall flexibility. Finally, policy can play an important role in strengthening connections between health profession cadres, incentivising them to work together at the top of scope. With education, practice, and policy collaborating, we can enable Medicare's wellbeing for years to come. [ABSTRACT FROM AUTHOR]

Over half of all new cancer cases in Alberta are diagnosed among people aged 65+ years, a group that encompasses vast variation. Patient-reported experience measures are routinely collected within Cancer Care Alberta; however, the specific consideration of the needs and concerns of older Albertans with cancer is lacking. In 2021, 2204 adults who had received treatment at a cancer centre in Alberta completed the Ambulatory Oncology Patient Satisfaction Survey (AOPSS). In this study, we explored the age differences in satisfaction across six dimensions of person-centred care and in the proportions of unmet needs across eight types of issues, with specific attention to older adults. Using three age groups (18–39, 40–64, 65+), only the physical comfort dimension showed significantly lower satisfaction among those aged 65+ years. Using five age groups (18–39, 40–64, 65–74, 75–84, 85+), significantly lower levels of satisfaction were found related to 'physical comfort' for those aged 65–74 and 75–84, 'coordination and continuity of care' for those aged 75–84 and 85+, and 'information, communication, and education' for those aged 85+. Therefore, grouping together all older adults aged 65+ years obscured lower levels of satisfaction with some dimensions of person-centred care among those aged 75–84 and 85+ years. Unmet needs generally increased with age for all types of issues, with significant differences across age groups for emotional, financial, social/family, and sexual health issues. The lower levels of satisfaction and higher proportions of unmet needs call for tailored interventions to promote optimal care experiences and outcomes among older adults receiving cancer care in Alberta and their families. [ABSTRACT FROM AUTHOR]

Introduction: The organ donation and transplantation (ODT) system in Canada is complex and can be challenging for individuals to navigate. We thus aimed to illuminate the experiences of individuals on transplant journeys using a patient‐oriented convergent parallel mixed‐methods approach. Methods: We captured data on adult patients, living donors, and caregivers on transplant journeys across Canada through an online survey (n = 935) and focus groups (n = 21). The survey was comprised of 48 questions about the individuals' experiences with the living donation and transplantation system, which were analyzed descriptively. Qualitative data were analyzed using an inductive conventional content analysis approach. Results: Most participants were female (70.1%), English speaking (92.6%) and White (87.8%). Participants' experiences were represented across six key themes: holistic person‐centred care, accountable care, collective impact, navigating uncertainty, connection and advocacy. Quantitative and qualitative data were integrated to identify five opportunities to improve the organ donation and transplantation system in Canada: enhancing mental health support, establishing formal peer support programmes, improving continuity of care, improving knowledge acquisition, and expanding resources and support. Conclusion: It is imperative that the ODT system commits to asking, listening, and learning from individuals on transplant journeys and to provide them opportunities to help improve it. [ABSTRACT FROM AUTHOR]

The Primary Care Audit, Teaching and Research Open Network (Patron) is an Australian database of de-identified electronic medical records from primary care patients. It includes over 3.5 million patients from 129 primary care practices in Victoria and Queensland. The database contains a wide range of de-identified data, including reason for visit, clinical observations, diagnosis, medications, and referrals. The data can be used by government, educational institutions, researchers, and industry with approved applications. The database aims to inform research, policy questions, and medical training. However, it acknowledges limitations, such as the concentration of data in Victoria and the underrepresentation of First Nations Australians. Access to the data requires approval from the Data Governance Committee and an ethics committee. [Extracted from the article]

What is Known on the Subject: Research has shown effectiveness of nonpharmacological interventions in improving or maintaining cognition, mood, functioning, self‐efficacy and quality of life for persons with mild‐to‐moderate dementia (PWDs).These interventions are critical during the earlier stages of dementia. However, Canadian and international literature report underutilization of and difficulty accessing the interventions. What this Paper Adds to Existing Knowledge: To our knowledge, this is the first review that explored factors influencing seniors' utilization of nonpharmacological interventions in the earlier stages of dementia. This review contributed to the discovery of unique factors such as PWDs' beliefs, fears, perceptions, and acceptability of nonpharmacological interventions and environmental influences on intervention provision.PWDs' intervention uptake may appear as a matter of personal choices related to individuals' knowledge, beliefs and perceptions. However, the analysis of the research evidence suggests that PWDs' choices are shaped by environmental factors such as formal and informal caregiver support, acceptability and accessibility of nonpharmacological interventions, dementia care workforce, community's attitudes towards dementia and funding. The complex interplay among factors highlights the importance of targeting health promotion strategies at both individuals and their environments. What are the Implications for Practice: The review findings feature opportunities for healthcare practitioners, including mental health nurses, in advocating for PWDs' evidence‐informed decision‐making and access to desired nonpharmacological treatments. Involvement of patients and families in care‐planning through ongoing assessment of health and learning needs, as well as enablers and barriers to using interventions, continuing information provision, and personalized referrals to appropriate services can promote PWDs' rights to healthcare. Introduction: Despite the significance of nonpharmacological interventions in optimal management of mild‐to‐moderate dementia, it remains unclear in the literature how persons with mild‐to‐moderate dementia (PWDs) view, understand and access nonpharmacological interventions. Aim: The purpose of this review was to explore the extent and nature of evidence concerning factors that influence the use of nonpharmacological interventions for community‐dwelling seniors with mild‐to‐moderate dementia. Method: An integrative review was undertaken following Toronto and Remington (A step‐by‐step guide to conducting an integrative review, 2020)'s instruction which expanded Torraco (Human Resource Development Review, 2016, 15, 404)'s and Whittemore and Knafl (Journal of Advanced Nursing, 2005, 52, 546)'s guidance. Results: The review of 16 studies suggests that PWDs' use of nonpharmacological interventions is shaped by a complex interplay of various personal, interpersonal, organizational, community and political influences. Discussion: The findings highlight the complex, interrelated relationships among multiple factors and subsequent limitations of behaviour‐oriented health promotion strategies. To assist PWDs in making healthier choices, health promotion strategies need to direct attention to both individuals' behaviours and environmental conditions impacting the behaviours. Implications for Practice: The findings of this review can inform multidisciplinary health practitioners' (including mental health nurses) practice with seniors living with mild‐to‐moderate dementia. We recommend actionable ways in which they can empower patients and their families in dementia management. [ABSTRACT FROM AUTHOR]

Aim: To explore undergraduate nursing students' understanding of fundamental care and identify educational leadership opportunities to deepen students' understanding of fundamental care concepts. Design: Sequential‐explanatory mixed methods study. Methods: We conducted a cross sectional survey (n = 202) and focus groups (n = 24) to explore undergraduate nursing students' ability to identify fundamental care needs. All data were collected between November 2020 and April 2021. Survey data were analysed using descriptive and inferential statistics and focus group data were thematically analysed. Results: Year One students scored significantly lower in their ability to identify fundamental care needs compared with students in other years, even after controlling for route, gender and age. Post‐degree students scored significantly higher than direct entry or transfer students. Students ≤19 years of age had significantly lower scores compared with students ≥25 years of age. Our focus group findings highlighted that students were often unable to define fundamental care, but they identified learning about various components of fundamental care in a variety of ways. While students understood that fundamental care was required in all settings, they were challenged in providing this care in acute and virtual settings. Students shared several suggestions to support fundamental care skills development across the curriculum. Conclusions: There is a need for a clear definition and description of the fundamentals of care that is used consistently by faculty, students and curriculum documents. It is important to encourage and support educators to share real‐world nursing stories, offer students time to share their personal experiences, develop creative learning opportunities and foster student reflection to deepen students' understanding of the fundamentals of care. Impact Educators need support to meaningfully incorporate fundamentals of care learning opportunities across multiple care settings. Educational leaders can use these findings to develop or adapt their curricula to support fundamental care skill development. [ABSTRACT FROM AUTHOR]