游戏化对支持儿童弱视治疗依从性的作用：使用焦点周边视力刺激游戏的回顾性研究

Gamification to Support Adherence to a Therapeutic Ambylopia Treatment for Children: Retrospective Study Using a Focal Ambient Visual Acuity Stimulation Game.

作者信息

Bocqué Catheline, Wang Jingyun, Rickmann Annekatrin, Julich-Haertel Henrike, Kaempf Uwe, Januschowski Kai

机构信息

Klaus Heimann Eye Research Institute, Sulzbach, Germany.

State University of New York College of Optometry, New York, NY, United States.

出版信息

JMIR Pediatr Parent. 2023 Feb 1;6:e32282. doi: 10.2196/32282.

DOI:10.2196/32282

PMID:36724007

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9932874/

Abstract

BACKGROUND

The gold standard treatment for amblyopia is patching the better eye. Improvement of visual acuity in the amblyopic eye is significantly impacted by the adherence to the patching therapy. It is known that the overall adherence is rather low.

OBJECTIVE

This retrospective study evaluated whether an updated version of attention-binding digital therapeutic games based on the principle of focal ambient visual acuity stimulation (FAVAS) would result in improved patient adherence in 4- to 16-year-old patients with amblyopia associated with anisometropia or strabismus.

METHODS

We analyzed electronically pseudonymized recorded data from patients treated with occlusion therapy and FAVAS therapeutic games. One group used an older version (2015) and the other group used a newer version (2020) that provided more attractive therapeutic games with tablet computer functionality. Objective adherence was calculated by comparing the number of minutes using the therapeutic games as monitored in the automatized logbook versus the prescribed number of minutes for using the games.

RESULTS

Children in group 2015 (n=138) spent on average 2009.3 (SD 1372.1; range 36-5556) minutes using FAVAS; children in group 2020 (n=129) spent on average 2651.2 (SD 1557.1; range 38-5672) minutes using the newer version. Group 2020 spent on average 641.9 more minutes on FAVAS than group 2015 (t=3.56, P<.001, d=0.45; 95% CI 0.69-0.20). Although patient adherence was very variable, compared to the 55.0% (SD 29.4%) in group 2015, it significantly improved up to 68.5% (SD 33.7%) in group 2020 (t=3.48, P=.001, d=0.44; 95% CI 0.68-0.19).

CONCLUSIONS

FAVAS 2020, with improved gamification aspect as well as tablet computer functionality, increased adherence significantly compared to the earlier version of FAVAS 2015, indicating that FAVAS 2020 could be an effective approach to support adherence to amblyopia treatment.

TRIAL REGISTRATION

German Clinical Trials Register (DRKS) DRKS00017633; https://drks.de/search/de/trial/DRKS00017633.

摘要

背景

弱视的金标准治疗方法是遮盖较好的眼睛。弱视眼视力的提高受到遮盖治疗依从性的显著影响。众所周知，总体依从性相当低。

目的

这项回顾性研究评估了基于焦点周边视力刺激（FAVAS）原理的更新版注意力绑定数字治疗游戏是否能提高4至16岁屈光参差或斜视相关弱视患者的治疗依从性。

方法

我们分析了接受遮盖治疗和FAVAS治疗游戏患者的电子匿名记录数据。一组使用旧版本（2015年），另一组使用新版本（2020年），新版本提供了更具吸引力的带有平板电脑功能的治疗游戏。通过比较自动日志中监测到的使用治疗游戏的分钟数与规定的游戏使用分钟数来计算客观依从性。

结果

2015组（n = 138）的儿童平均使用FAVAS的时间为2009.3（标准差1372.1；范围36 - 5556）分钟；2020组（n = 129）的儿童平均使用新版本的时间为2651.2（标准差1557.1；范围38 - 5672）分钟。2020组使用FAVAS的时间比2日15组平均多641.9分钟（t = 3.56，P <.001，d = 0.45；95%置信区间0.69 - 0.20）。尽管患者依从性差异很大，但与2015组的55.0%（标准差29.4%）相比，2020组显著提高到68.5%（标准差33.7%）（t = 3.48，P =.001，d = 0.44；95%置信区间0.68 - 0.19）。