Kato Pamela M, Cole Steve W, Bradlyn Andrew S, Pollock Brad H
Department of Pediatrics, Stanford Hospital, Stanford, California, USA.
Pediatrics. 2008 Aug;122(2):e305-17. doi: 10.1542/peds.2007-3134.
Suboptimal adherence to self-administered medications is a common problem. The purpose of this study was to determine the effectiveness of a video-game intervention for improving adherence and other behavioral outcomes for adolescents and young adults with malignancies including acute leukemia, lymphoma, and soft-tissue sarcoma.
A randomized trial with baseline and 1- and 3-month assessments was conducted from 2004 to 2005 at 34 medical centers in the United States, Canada, and Australia. A total of 375 male and female patients who were 13 to 29 years old, had an initial or relapse diagnosis of a malignancy, and currently undergoing treatment and expected to continue treatment for at least 4 months from baseline assessment were randomly assigned to the intervention or control group. The intervention was a video game that addressed issues of cancer treatment and care for teenagers and young adults. Outcome measures included adherence, self-efficacy, knowledge, control, stress, and quality of life. For patients who were prescribed prophylactic antibiotics, adherence to trimethoprim-sulfamethoxazole was tracked by electronic pill-monitoring devices (n = 200). Adherence to 6-mercaptopurine was assessed through serum metabolite assays (n = 54).
Adherence to trimethoprim-sulfamethoxazole and 6-mercaptopurine was greater in the intervention group. Self-efficacy and knowledge also increased in the intervention group compared with the control group. The intervention did not affect self-report measures of adherence, stress, control, or quality of life.
The video-game intervention significantly improved treatment adherence and indicators of cancer-related self-efficacy and knowledge in adolescents and young adults who were undergoing cancer therapy. The findings support current efforts to develop effective video-game interventions for education and training in health care.
自我给药的依从性欠佳是一个常见问题。本研究的目的是确定一款电子游戏干预措施对改善患有恶性肿瘤（包括急性白血病、淋巴瘤和软组织肉瘤）的青少年和青年成人的依从性及其他行为结果的有效性。
2004年至2005年，在美国、加拿大和澳大利亚的34个医疗中心进行了一项包含基线评估以及1个月和3个月评估的随机试验。共有375名年龄在13至29岁之间、初次诊断或复发诊断为恶性肿瘤、目前正在接受治疗且预计从基线评估起至少持续治疗4个月的男性和女性患者被随机分配到干预组或对照组。干预措施是一款针对青少年和青年成人的癌症治疗与护理问题的电子游戏。结果指标包括依从性、自我效能感、知识、掌控感、压力和生活质量。对于开具了预防性抗生素的患者，通过电子药丸监测设备追踪其对复方新诺明的依从性（n = 200）。通过血清代谢物检测评估对6-巯基嘌呤的依从性（n = 54）。
干预组对复方新诺明和6-巯基嘌呤的依从性更高。与对照组相比，干预组的自我效能感和知识也有所增加。该干预措施未影响依从性、压力、掌控感或生活质量的自我报告指标。
电子游戏干预显著提高了正在接受癌症治疗的青少年和青年成人的治疗依从性以及与癌症相关的自我效能感和知识指标。这些发现支持了当前为医疗保健教育和培训开发有效电子游戏干预措施的努力。
