Lukey Alexandra, Mackay Martha, Hasan Khalad, Rush Kathy L
School of Population and Public Health, University of British Columbia, Vancouver, Canada.
School of Nursing, University of British Columbia, Vancouver, Canada.
Games Health J. 2023 Oct;12(5):385-396. doi: 10.1089/g4h.2022.0132. Epub 2023 Aug 14.
Self-care is essential to improving heart failure patient outcomes. However, the knowledge and behaviours necessary for self-care decision making, such as symptom perception and management, are complex and require patient education. The objective of this study was to test the feasibility, acceptability, and potential effectiveness of a web-based, gamified heart failure patient education solution, Heart Self-Care Patient Education (HeartSCaPE), that used narrative and virtual reward gamification techniques. This mixed-methods study used a pre-post-test design with an embedded explanatory qualitative phase. Patients completed the Self-Care of Heart Failure Index, that measured self-care behaviour change and the Dutch Heart Failure Knowledge Scale, used to measure heart failure knowledge. Usability measures of HeartSCaPE were tracked using Google Analytics and the System Usability Scale. Nineteen patients completed the study, with a subset of six participating in semi-structured interviews. We found increases in HF knowledge despite high baseline knowledge scores. Post-intervention self-reported HF self-care behaviours (), as measured by the Self-Care of Heart Failure Index, were also improved. Knowledge and self-care scores were not correlated. Participants also scored HeartSCaPE as highly usable. In interviews, participants described valuing the opportunity to practice self-care decision-making. There were mixed opinions regarding the use of virtual rewards. We found that a gamified web-based solution that uses narrative and reward-based gamification techniques has the potential to improve HF patient knowledge and self-care. Further research is needed to confirm the study's clinical benefits and address technology literacy inequities.
自我护理对于改善心力衰竭患者的预后至关重要。然而，自我护理决策所需的知识和行为，如症状感知和管理，非常复杂，需要对患者进行教育。本研究的目的是测试一种基于网络的、游戏化的心力衰竭患者教育解决方案——心脏自我护理患者教育（HeartSCaPE）的可行性、可接受性和潜在效果，该方案采用了叙事和虚拟奖励游戏化技术。这项混合方法研究采用了前后测试设计，并嵌入了解释性定性阶段。患者完成了心力衰竭自我护理指数，该指数用于衡量自我护理行为的变化，以及荷兰心力衰竭知识量表，用于衡量心力衰竭知识。使用谷歌分析和系统可用性量表跟踪HeartSCaPE的可用性指标。19名患者完成了研究，其中6名患者参与了半结构化访谈。尽管基线知识得分较高，我们仍发现心力衰竭知识有所增加。通过心力衰竭自我护理指数测量，干预后自我报告的心力衰竭自我护理行为也有所改善。知识和自我护理得分没有相关性。参与者也对HeartSCaPE的可用性给予了高度评价。在访谈中，参与者表示重视实践自我护理决策的机会。对于虚拟奖励的使用存在不同意见。我们发现，一种使用叙事和基于奖励的游戏化技术的基于网络的游戏化解决方案有可能提高心力衰竭患者的知识水平和自我护理能力。需要进一步的研究来证实该研究的临床益处，并解决技术素养不平等问题。
