Table 4. Themes and Key Findings from VDs and older adults: Challenges.

Themes	Key findings
Challenges for the Intervention Program	Training
	• Lack of demonstration of the real treatment process, which is considered more powerful than the use of simulated patients and role-play
	• Lack of step-by-step guides for interventions for specific problems of depressive older adults
Challenges for doctors	• Time constraints and busy workloads
	• Anxiety and loss of confidence
	• Poor adherence to the protocol
	• Feeling incompetent in implementing the intervention
Challenges due to the elders’ family	• The presence of others (spouse, sons or daughter)
Challenges for the elders	• Those who are in good condition have no time to receive intervention because they have to work
	• Suffering from serious problems (physical, financial, et al.), which lead them to believe the intervention will be ineffective