Tung Jeanne, Grunow John E, Jacobs Noel
*Division of Pediatric Gastroenterology, Mayo Clinic, Rochester, MN †Division of Pediatric Gastroenterology ‡Department of Pediatrics, Oklahoma University Health Sciences Center, Oklahoma City.
J Pediatr Gastroenterol Nutr. 2015 Sep;61(3):292-6. doi: 10.1097/MPG.0000000000000788.
Data suggest physicians poorly assess disease-specific literacy and transition readiness in pediatric patients with inflammatory bowel disease (IBD). We piloted an electronic, interactive iPad quiz game that could be used in a clinical setting, with the aims of measuring IBD-related knowledge, and concomitant mood and quality of life (QOL) in a pediatric population.
Two pediatric IBD clinics developed and tested 2 versions of "Emma." Patients between 10 and 18 years of age played Emma during an office visit. Each patient answered 12 randomly selected disease-related questions and 4 mood-related questions.
Sites 1 and 2 tested Emma v1 between May and August 2013. Emma v2 was tested from November 2013 to January 2014 and from September 2013 to January 2014. A total of 56 patients played Emma v1, whereas 60 played Emma v2. In Emma v2, 73.1% of questions were answered correctly. Patients recognized signs of IBD (88%), causes of diarrhea in addition to IBD (79.4%), and could define lactose intolerance (95.8%), but fewer patients understood serological testing used for disease monitoring (68%) or knew that magnetic resonance enterography did not involve radiation (22.9%). Patients tended to report good functioning in the areas of energy, mood, anxiety, and school-related QOL. Patients with Crohn disease, however, reported higher stress levels compared with patients with ulcerative colitis; older patients reported lower energy levels, and postsurgical patients reported lower QOL.
The Emma iPad game has the potential to evaluate gaps in IBD knowledge, assess emotional functioning, and increase patient engagement as a transition tool in the clinical setting.
数据显示，医生对患有炎症性肠病（IBD）的儿科患者的疾病特异性知识水平及过渡准备情况评估不佳。我们试用了一款可在临床环境中使用的电子交互式iPad问答游戏，旨在测量儿科人群中与IBD相关的知识以及伴随的情绪和生活质量（QOL）。
两家儿科IBD诊所开发并测试了两个版本的“艾玛”游戏。10至18岁的患者在门诊就诊时玩艾玛游戏。每位患者回答12个随机抽取的与疾病相关的问题和4个与情绪相关的问题。
站点1和站点2在2013年5月至8月期间测试了艾玛v1。艾玛v2在2013年11月至2014年1月以及2013年9月至2014年1月进行了测试。共有56名患者玩了艾玛v1，而60名患者玩了艾玛v2。在艾玛v2中，73.1%的问题回答正确。患者能识别IBD的症状（88%）、除IBD外腹泻的原因（79.4%），并能定义乳糖不耐受（95.8%），但较少患者理解用于疾病监测的血清学检测（68%），或知道磁共振小肠造影不涉及辐射（22.9%）。患者倾向于报告在精力、情绪、焦虑和与学校相关的生活质量方面功能良好。然而，克罗恩病患者报告的压力水平高于溃疡性结肠炎患者；年龄较大的患者报告精力水平较低，术后患者报告生活质量较低。
艾玛iPad游戏有潜力评估IBD知识方面的差距，评估情绪功能，并作为临床环境中的一种过渡工具提高患者参与度。
