Radhakrishnan Kavita, Toprac Paul, O'Hair Matt, Bias Randolph, Kim Miyong T, Bradley Paul, Mackert Michael
1 School of Nursing, University of Texas-Austin , Austin, Texas.
2 Simulation and Game Applications Laboratory, University of Texas-Austin , Austin, Texas.
Games Health J. 2016 Dec;5(6):366-374. doi: 10.1089/g4h.2016.0038. Epub 2016 Oct 24.
To develop and test the prototype of a serious digital game for improving community-dwelling older adults' heart failure (HF) knowledge and self-management behaviors. The serious game innovatively incorporates evidence-based HF guidelines with contemporary game technology.
The study included three phases: development of the game prototype, its usability assessment, and evaluation of the game's functionality. Usability testing included researchers' usability assessment, followed by research personnel's observations of participants playing the game, and participants' completion of a usability survey. Next, in a pretest-post-test design, validated instruments-the Atlanta Heart Failure Knowledge Test and the Self Care for Heart Failure Index-were used to measure improvement in HF self-management knowledge and behaviors related to HF self-maintenance, self-management, and self-efficacy, respectively. A postgame survey assessed participants' perceptions of the game.
During usability testing, with seven participants, 100%, 100%, and 86% found the game easy to play, enjoyable, and helpful for learning about HF, respectively. In the subsequent functionality testing, with 19 participants, 89% found the game interesting, enjoyable, and easy to play. Playing the game resulted in a significant improvement in HF self-management knowledge, a nonsignificant improvement in self-reported behaviors related to HF self-maintenance, and no difference in HF self-efficacy scores. Participants with lower education level and age preferred games to any other medium for receiving information.
It is feasible to develop a serious digital game that community-dwelling older adults with HF find both satisfying and acceptable and that can improve their self-management knowledge.
开发并测试一款严肃数字游戏的原型，以提高社区居住老年人的心力衰竭（HF）知识和自我管理行为。这款严肃游戏创新性地将基于证据的HF指南与当代游戏技术相结合。
该研究包括三个阶段：游戏原型的开发、可用性评估以及游戏功能评估。可用性测试包括研究人员的可用性评估，随后研究人员观察参与者玩游戏的情况，以及参与者完成一份可用性调查问卷。接下来，在前测-后测设计中，使用经过验证的工具——亚特兰大心力衰竭知识测试和心力衰竭自我护理指数——分别测量HF自我管理知识的改善情况以及与HF自我维护、自我管理和自我效能相关的行为改善情况。游戏后调查评估了参与者对游戏的看法。
在可用性测试中，7名参与者中有100%、100%和86%的人分别认为游戏易于游玩、有趣且有助于了解HF。在随后的功能测试中，19名参与者中有89%的人认为游戏有趣、好玩且易于游玩。玩游戏导致HF自我管理知识有显著改善，与HF自我维护相关的自我报告行为有不显著的改善，且HF自我效能得分没有差异。教育水平较低和年龄较大的参与者比起其他任何信息接收媒介更喜欢游戏。
开发一款社区居住的老年HF患者认为既令人满意又可接受且能提高其自我管理知识的严肃数字游戏是可行的。
