Assessing the Acceptability and Usability of an Interactive Serious Game in Aiding Treatment Decisions for Patients with Localized Prostate Cancer

Abstract

BackgroundMen diagnosed with localized prostate cancer face a potentially life-altering treatment decision that can be overwhelming. Enhancing patient knowledge through education can significantly reduce feelings of uncertainty while simultaneously increasing confidence in decision making. Serious games have been shown in other populations to increase health knowledge and assist with the health decision-making process. We developed an interactive serious game, Time After Time, which translates evidence-based treatment outcome data into an accessible and understandable format that men can utilize in their prostate cancer treatment decision-making process. The game specifically aims to raise men’s awareness and understanding of the impact of health-related quality of life issues associated with the major treatment options and to enrich their conversations with their health care providers.ObjectiveThis study determined the acceptability and usability of the alpha version of Time After Time, an interactive decision aid for men diagnosed with localized prostate cancer, in order to inform future iterations of the serious game.MethodsThe study employed a mixed methods approach to assess the acceptability and usability of the Time After Time serious game using qualitative focus groups and a quantitative Likert scale survey.ResultsA total of 13 men who had already completed treatment for localized prostate cancer completed the survey and participated in focus group meetings. The majority of the study participants rated Time After Time as an appropriate decision tool for localized prostate cancer and verified that it meets its goals of increasing focus on side effects and generating questions for the patient’s health care team. However, participants also expressed concerns about game usability and the diversity of information covered regarding treatment options and potential treatment outcomes.ConclusionsSerious games are a promising approach to health education and decision support for older men. Participants were receptive to the idea of a serious game as a decision aid in localized prostate cancer. However, usability issues are a major concern for this demographic, as is clarity and transparency of data sources.

A Scoping Review of Digital Gaming Research Involving Older Adults Aged 85 and Older

“…The majority of studies did not integrate the oldest old as a meaningful proportion of the sample, despite the increasing [10][11][12]14,17,[21][22][23][24][25][28][29][30][31][32][33][34][35][36][37][38][39][40]42,[44][45][46][47][48][49][50][51][52][53][54] To clarify sample proportions and enable our analysis, two authors contacted the respective authors seeking further clarification of the actual number of participants q85 years of age when necessary. Consistent with previous reviews, 2-5 this study highlights a substantial gap in the knowledge base and encourage further exploration into digital gaming use in those 85 years of age and greater.…”

“…Although an age range was described, it is possible there is a publication bias or a failure of studies to report actual age range. Some studies 24,25,35,39,40,46 only reported the age range with no mean or standard deviation; conversely, five studies 10,27,30,32,33 reported the mean age but no age range or standard deviation. Albeit the authors were able to substantiate some aspect of the participants' ages, the authors believe future studies should use clear measures to depict the exact number of participants q85 years of age and aim to have a proportionate representation of older adults in studies.…”

“…Seven 10,24,25,29,46,53,54 of the 46 articles did not report the percentage of female participants included in the study, and two articles 35,51 did not have any female participants in their sample. The remaining 37 articles all reported high percentages of female participants, thus being the majority of the gender split.…”

“…The remaining 37 articles all reported high percentages of female participants, thus being the majority of the gender split. The study setting/context varied widely across the 46 articles and was composed of retirement/independent communities 11,12,14,21,24,26,29,32,39,40,42,44,47,48,53 (n = 15), communitydwelling 13,16,19,45,46,49 (n = 6), community center 20,31,38,51,52 (n = 5), hospital/assisted living/residential/nursing home/longterm care/institutionalized 10,[15][16][17][18]25,27,28,30,33,35,37,41,43,50,54 (n = 16), not specified 23 (n = 1), or other 34,36,55 (n = 3). The majority of the studies were primarily conducted across two different living environments (hospital/assisted living/residential/nursing home/long-term care/institutionalized) or reti...…”

La realidad virtual en las intervenciones psicológicas con pacientes oncológicos

“…El uso de Internet, por ejemplo, ha posibilitado que los programas terapéuticos puedan llegar a aquellos pacientes que les resulta difícil el traslado hasta sus centros de salud, ya sea por la enfermedad, la ubicación geográfica o cualquier otra razón (1)(2)(3) . Otro ejemplo lo constituyen los denominados "juegos serios" (serious games), juegos digitales creados con propósitos que van más allá del entretenimiento, que facilitan la entrega de información médica y de herramientas de apoyo para la toma decisiones y la implicación en conductas saludables (4)(5)(6) . En los últimos años se está también comenzando a indagar acerca de la viabilidad y los beneficios asociados a la evaluación electró-nica en este tipo de pacientes, fundamentalmente mediante ordenador (7)(8)(9) , y se han generado aplicaciones móviles dirigidas a monitorizar y ayudar al manejo de la sintomatología desde casa (10)(11) , además de servir de apoyo a programas online, gracias a la posibilidad que ofrecen para registrar síntomas, recibir mensajes y acceder a módulos del programa (12) .…”