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The use of digitally enabled technology is considered a promising platform to prevent morbidity and enhance youth mental health as youth are growing up in the digital world and accessing the Internet at increasingly younger age. This scoping review will identify, describe and categorise the models, frameworks and strategies that have been used to study the implementation of digital mental health interventions targeted at youth aged 15–34 years.
We will conduct a scoping review following the Arksey-O’Malley five-stage scoping review method and the Scoping Review Methods Manual by the Joanna Briggs Institute. Implementation methods will be operationalised according to pre-established aims: (1) process models that describe or guide the implementation process; (2) evaluation frameworks evaluating or measuring the success of implementation; and (3) implementation strategies used in isolation or combination in implementation research and practice. Primary research studies in all languages will be identified in CINAHL, Cochrane Central Register of Controlled Trials, Embase, ERIC, Education Research Complete, MEDLINE and APA PsycINFO on 6 January 2025. Two reviewers will calibrate screening criteria and the data charting form and will independently screen records and abstract data. We will use the Evidence Standards Framework for Digital Health Technologies by the National Institute for Health and Care Excellence to classify digital interventions based on functions, and a pre-established working taxonomy to synthesise conceptually distinct implementation outcomes. Convergent integrated data synthesis will be performed.
Ethical approval is not applicable as this scoping review will be conducted only on data presented in the published literature. Findings will be published and directly infused into our multidisciplinary team of academic researchers, youth partners, health professionals and knowledge users (healthcare and non-governmental organisation decision makers) to co-design and pilot test a digital psychoeducational health intervention to engage, educate and empower youth to be informed stewards of their mental health.
To assess the incidence of delirium and its predictors among adult patients admitted to the intensive care units of comprehensive specialised hospitals in the Amhara region of northwest Ethiopia from 18 October 2024 to 20 February 2025.
A multicentre prospective observational study was conducted.
Four comprehensive specialised hospitals in the Amhara region of northwest Ethiopia, from 18 October 2024 to 20 February 2025.
A total of 351 patients were included in the final analysis during the study period.
The primary outcome measure of this study was the incidence of delirium. Additionally, the study investigated the factors associated with delirium incidence among adult patients admitted to intensive care units.
The incidence of delirium among adult patients in intensive care units was 42.17% (95% CI: 37.08 to 47.42). Pain (adjusted HR (AHR) = 4.74; 95% CI: 2.38 to 9.44), mechanical ventilation (AHR = 2.96; 95% CI: 1.56 to 5.63), age 65 years or older (AHR = 2.18; 95% CI: 1.48 to 3.21) and agitation (Richmond Agitation-Sedation Scale (RASS) ≥1) (AHR = 3.26; 95% CI: 2.09 to 5.09) were statistically significant factors associated with delirium.
In the present study, more than one-third of patients developed delirium. Pain, mechanical ventilation, age 65 or older and agitation (RASS≥1) were significantly associated with delirium occurrence. To reduce the incidence of delirium, the current study recommends treating or preventing pain and agitation. Additionally, special attention should be given to patients receiving mechanical ventilation and those aged 65 or older during care.
To ascertain the current evidence about the support, education and learning needs of experienced registered nurses who are transitioning their work to intensive care nursing as a new context.
A scoping review was conducted using established frameworks from JBI, Arksey and O'Malley.
A search was conducted in CINHAL and MEDLINE (April 2023). Two researchers independently screened the records, extracted and cross-checked the data. The results were consolidated narratively in answer to the review questions. The PRISMA-ScR checklist was used to guide reporting.
Eight articles (seven research, one evaluation) were included. The data were widely heterogenous. Evidence pays more attention to education experiences and needs during transition than to mechanisms used informally to engender socialisation of experienced registered nurses into the intensive care team. Key education strategies include orientation, skill and knowledge development, self-directed learning, preceptorship and mentorship, situated clinical nurse education and expertise sharing from the wider intensive care team. Four papers related to the COVID-19 pandemic reported education related to patient surges; three papers described team or buddy nursing as an educational strategy. Several articles reported that learning needs and experiences evolve as transition occurs, and intensive care is a specialised learning environment where required skills and knowledge are domain specific. Reality shock can be encountered, education needs can be influenced by prior experience and social connection with and support from the team can make a difference.
This review has identified the current state of evidence regarding the support education and learning needs of experienced registered nurses who are transitioning to work in intensive care. The evidence is limited and very heterogeneous. Findings highlight several areas of evidence paucity and some basis for further research. Given the importance of this group to the intensive care workforce, it will be imperative to invest in future research.
Attending to the specific learning and support needs of experienced registered nurses who are making transitions to work in intensive care may impact their experiences of transition shock and quality of learning and may make some differences to recruitment and retention of staff.
By consolidating the evidence, this scoping review highlights important support, education and learning needs of experienced nurses who are transitioning to intensive care. Insight arising from the review will assist experienced nurses, and those working in education and management, as they seek to engage with and support registered nurses who are making transitions to this context of work. There are genuine gaps in research evidence which will require the investment of nursing researchers internationally.
Preferred Reporting Items for Systematic Reviews and Meta-Analyse extension for Scoping Reviews (PRISMA-ScR).
No patient or public contribution.
by Seowoo Kim, Laura M. Perry, Brenna Mossman, Addison Dunn, Michael Hoerger
Patients with chronic and serious illnesses experience significant quality of life concerns. More research is needed to understand the impact of financial burden on patients with COPD, heart failure, and kidney failure. Patients with COPD, heart failure, or kidney failure completed a cross-sectional online survey using validated measures of financial burden (general financial strain as well as financial toxicity attributable to treatment), physical quality of life (symptom burden and perceived health), and emotional quality of life (anxiety, depression, and suicidal ideation). ANCOVA was used to examine whether financial strain and financial toxicity were associated with physical and emotional quality of life, while accounting for key covariates. Among 225 participants with COPD (n = 137), heart failure (n = 48), or kidney failure (n = 40), 62.2% reported general financial strain, with 34.7% experiencing financial toxicity attributable to treatments. Additionally, 68.9% rated their health as fair or poor, experiencing significant symptom burden including fatigue, dyspnea, and chest pain. Participants also reported clinically relevant levels of anxiety (55.1%), depression (52.0%), and suicidal ideation (21.8%). In the total sample, financial strain was associated with worse physical and emotional quality of life on all measures (all Ps
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