Development, Usability, and Efficacy of a Serious Game to Help Patients Learn About Pain Management After Surgery: An Evaluation Study

Abstract

BackgroundPostoperative pain is a persistent problem after surgery and can delay recovery and develop into chronic pain. Better patient education has been proposed to improve pain management of patients. Serious games have not been previously developed to help patients to learn how to manage their postoperative pain.ObjectiveThe aim of this study was to describe the development of a computer-based game for surgical patients to learn about postoperative pain management and to evaluate the usability, user experience, and efficacy of the game.MethodsA computer game was developed by an interdisciplinary team following a structured approach. The usability, user experience, and efficacy of the game were evaluated using self-reported questionnaires (AttrakDiff2, Postoperative Pain Management Game Survey, Patient Knowledge About Postoperative Pain Management questionnaire), semi-structured interviews, and direct observation in one session with 20 participants recruited from the general public via Facebook (mean age 48 [SD 14]; 11 women). Adjusted Barriers Questionnaire II and 3 questions on health literacy were used to collect background information.ResultsTheories of self-care and adult learning, evidence for the educational needs of patients about pain management, and principles of gamification were used to develop the computer game. Ease of use and usefulness received a median score between 2.00 (IQR 1.00) and 5.00 (IQR 2.00) (possible scores 0-5; IQR, interquartile range), and ease of use was further confirmed by observation. Participants expressed satisfaction with this novel method of learning, despite some technological challenges. The attributes of the game, measured with AttrakDiff2, received a median score above 0 in all dimensions; highest for attraction (median 1.43, IQR 0.93) followed by pragmatic quality (median 1.31, IQR 1.04), hedonic quality interaction (median 1.00, IQR 1.04), and hedonic quality stimulation (median 0.57, IQR 0.68). Knowledge of pain medication and pain management strategies improved after playing the game (P=.001).ConclusionsA computer game can be an efficient method of learning about pain management; it has the potential to improve knowledge and is appreciated by users. To assess the game’s usability and efficacy in the context of preparation for surgery, an evaluation with a larger sample, including surgical patients and older people, is required.

A Systematic Literature Review of the Design Approach and Usability Evaluation of the Pain Management Mobile Applications

“…For clarity of discussion, we first divide pain types into two categories, i.e., acute and chronic pain. It was found that 25 publications presented apps for pain management that were relevant to chronic pain, and two research papers proposed solutions for acute pain management [22,23]. Under the chronic pain condition, three apps were for general chronic pain type [16,24,25], and 22 apps were for disease/regional-specific pain type.…”

“…Nine publications (33% of the studies) [16,22,23,28,30,37,40,41,45] mentioned that the potential users had an average to high technology literacy level for mobile devices, while three publications (11% of studies) [27,31,44] showed that the proposed app was designed for patients with low or no technology literacy. One app was designed for patients that can have any technology literacy level [46].…”

“…Nine or 33% of the publications [22][23][24][25]27,35,37,39,48] were only based on record keeping for the pain summaries (intensity, duration, and location), while 18 or 65% of the solutions also gathered data for the associated symptoms of pain such as fatigue, nausea, vomiting, oral problems, breathlessness or sleep quality, etc.…”

Game Learning Analytics for Educators

“…If that is the case, as between both measures the only intervention is the game, it can be concluded that the increase in that characteristic is due to the game effect, and therefore the game is formally validated. There are plenty of examples in literature that use this approach to validate serious games including, for instance: a game for children with autism to learn emotions [10], a game for patients to manage pain after surgery [11] or a game to raise awareness about bullying and cyberbullying [12].…”

Formation des médecins et infirmières à l’utilisation des opiacés par un jeu sérieux

“…Dans le domaine de l'enseignement, les jeux sérieux apparaissent comme des outils pédagogiques innovants pour acquérir des compétences, notamment dans le domaine de la santé. Il s'agit d'applications logicielles utilisant les principes et la mécanique du ludique pour atteindre des objectifs sérieux tels que la formation ou la motivation à suivre un traitement médical par exemple [8], y compris pour la douleur [9].…”