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Empowering Social Growth Through Virtual Reality-Based Intervention for Children With Attention-Deficit/Hyperactivity Disorder: 3-Arm Randomized Controlled Trial. 通过对注意力缺陷/多动症儿童进行基于虚拟现实的干预,增强其社交能力:三臂随机对照试验》。
IF 3.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-28 DOI: 10.2196/58963
Ka Po Wong, Bohan Zhang, Cynthia Yuen Yi Lai, Yao Jie Xie, Yan Li, Chen Li, Jing Qin

Background: Attention-deficit/hyperactivity disorder (ADHD) usually begins in childhood and is often accompanied by impairments in social functioning. Virtual reality (VR) has emerged as an adjunctive tool to embed in social skills training to enhance the social skills of children with ADHD, but its effectiveness requires further investigation.

Objective: This study aims to enhance the social skills of children with ADHD by examining the feasibility and effectiveness of VR-based training in comparison to traditional social skills training.

Methods: A 3-arm randomized controlled trial was conducted with 90 children with ADHD aged 6-12 years. Participants were randomly assigned to 3 weeks of 12-session VR-based social skills training, traditional social skills training, or a waitlist control group of equivalent duration. Outcome measures included assessments by a clinical psychologist who was blinded to group assignments, the Social Skills Improvement System Rating Scale, the Behavior Rating Inventory of Executive Function, and the Simulator Sickness Questionnaire, conducted at baseline and after the intervention.

Results: The preliminary results support the feasibility and acceptability of VR training for children with ADHD aged 6-12 years. Analysis showed that the VR and traditional social skills training groups experienced a statistically significant improvement in the clinical psychologist assessment of social skills and parent-rated self-control, initiative, and emotional control after the intervention compared with baseline. The VR group performed significantly better than the traditional social skills group on social skills assessed by clinical psychologists (F2,85=76.77; P<.001) and on parent-rated self-control (F2,85=18.77; P<.001), initiative (F2,85=11.93; P<.001), and emotional control (F2,85=17.27; P<.001). No significant between-group differences were found for parent-rated cooperation and inhibition (all P>.05).

Conclusions: The findings provide preliminary evidence supporting the feasibility and superior effectiveness of VR-based social skills training compared to traditional approaches for enhancing social skills and related executive functions in children with ADHD. These results suggest that VR may be a valuable tool to embed within social skills interventions for this population. Further research is warranted to explore the long-term impacts and generalizability of these benefits.

Trial registration: ClinicalTrials.gov NCT05778526; https://clinicaltrials.gov/study/NCT05778526.

International registered report identifier (irrid): RR2-10.2196/48208.

背景:注意力缺陷/多动障碍(ADHD)通常始于儿童时期,并常常伴有社交功能障碍。虚拟现实(VR)已成为一种辅助工具,可嵌入社交技能培训中以提高多动症儿童的社交技能,但其有效性还需要进一步研究:本研究旨在通过考察基于虚拟现实技术的培训与传统社交技能培训的可行性和有效性,提高多动症儿童的社交技能:方法:对 90 名 6-12 岁患有多动症的儿童进行了三臂随机对照试验。参与者被随机分配到为期 3 周、共 12 课时的虚拟现实社交技能培训、传统社交技能培训或同等时间的候补对照组。结果测量包括由一名临床心理学家在基线和干预结束后进行的评估,该临床心理学家对小组分配、社交技能改进系统评分量表、执行功能行为评分量表和模拟器晕机问卷调查均未设盲:初步结果表明,对 6-12 岁多动症儿童进行虚拟现实训练是可行的,也是可接受的。分析表明,与基线相比,干预后虚拟现实组和传统社交技能训练组在临床心理学家评估的社交技能和家长评分的自我控制、主动性和情绪控制方面都有显著改善。在临床心理学家评估的社交技能方面,虚拟现实组的表现明显优于传统社交技能组(F2,85=76.77;P2,85=18.77;P2,85=11.93;P2,85=17.27;P.05):研究结果提供了初步证据,证明与传统方法相比,基于 VR 的社交技能培训在提高多动症儿童的社交技能和相关执行功能方面具有可行性和优越性。这些结果表明,虚拟现实技术可能是一种有价值的工具,可用于这一人群的社交技能干预。我们有必要开展进一步研究,探讨这些益处的长期影响和可推广性:ClinicalTrials.gov NCT05778526;https://clinicaltrials.gov/study/NCT05778526.International 注册报告标识符 (irrid):RR2-10.2196/48208。
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引用次数: 0
Exploring Immersive Multimodal Virtual Reality Training, Affective States, and Ecological Validity in Healthy Firefighters: Quasi-Experimental Study. 探索健康消防员的沉浸式多模态虚拟现实训练、情感状态和生态有效性:准实验研究。
IF 3.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-24 DOI: 10.2196/53683
Joana Oliveira, Joana Aires Dias, Rita Correia, Raquel Pinheiro, Vítor Reis, Daniela Sousa, Daniel Agostinho, Marco Simões, Miguel Castelo-Branco
<p><strong>Background: </strong>Firefighters face stressful life-threatening events requiring fast decision-making. To better prepare for those situations, training is paramount, but errors in real-life training can be harmful. Virtual reality (VR) simulations provide the desired realism while enabling practice in a secure and controlled environment. Firefighters' affective states are also crucial as they are a higher-risk group.</p><p><strong>Objective: </strong>To assess the impact on affective states of 2 simulated immersive experiences in a sample of healthy firefighters (before, during, and after the simulation), we pursued a multivariate approach comprising cognitive performance, situational awareness, depression, anxiety, stress, number of previous adverse events experienced, posttraumatic stress disorder (PTSD) severity, and emotions. The efficacy and ecological validity of an innovative VR haptic system were also tested, exploring its impact on performance.</p><p><strong>Methods: </strong>In collaboration with the Portuguese National Fire Service School, we exposed 22 healthy firefighters to 2 immersive scenarios using the FLAIM Trainer VR system (neutral and arousing scenarios) while recording physiological data in a quasi-experimental study. Baseline cognitive performance, depression, anxiety, stress, number of adverse events, and severity of PTSD symptoms were evaluated. Positive and negative affective states were measured before, between, and after each scenario. Situational awareness, sense of presence, ecological validity, engagement, and negative effects resulting from VR immersion were tested.</p><p><strong>Results: </strong>Baseline positive affect score was high (mean 32.4, SD 7.2) and increased after the VR tasks (partial η<sup>2</sup>=0.52; Greenhouse-Geisser F<sub>1.82,32.78</sub>=19.73; P<.001). Contrarily, mean negative affect score remained low (range 11.0-11.9) throughout the study (partial η<sup>2</sup>=0.02; Greenhouse-Geisser F<sub>2.13,38.4</sub>=0.39; P=.69). Participants' feedback on the VR sense of presence was also positive, reporting a high sense of physical space (mean score 3.9, SD 0.8), ecological validity (mean score 3.8, SD 0.6), and engagement (mean score 3.8, SD 0.6). Engagement was related to the number of previously experienced adverse events (r=0.49; P=.02) and positive affect (after the last VR task; r=0.55; P=.02). Conversely, participants reported few negative effects (mean score 1.7, SD 0.6). The negative effects correlated positively with negative affect (after the last VR task; r=0.53; P=.03); and avoidance (r=0.73; P<.001), a PTSD symptom, controlling for relevant baseline variables. Performance related to situational awareness was positive (mean 46.4, SD 34.5), although no relation was found to metacognitively perceived situational awareness (r=-0.12; P=.59).</p><p><strong>Conclusions: </strong>We show that VR is an effective alternative to in-person training as it was considered ecologically v
背景:消防员面临着压力巨大、危及生命的事件,需要快速做出决策。为了更好地应对这些情况,训练是至关重要的,但现实生活中的训练失误可能会造成伤害。虚拟现实(VR)模拟可提供所需的真实感,同时还能在安全可控的环境中进行练习。消防员的情感状态也至关重要,因为他们是风险较高的群体:为了评估两种模拟沉浸式体验对健康消防员情感状态的影响(模拟前、模拟中和模拟后),我们采用了一种多变量方法,包括认知表现、情景意识、抑郁、焦虑、压力、以前经历的不良事件数量、创伤后应激障碍(PTSD)严重程度和情绪。此外,还测试了创新 VR 触觉系统的功效和生态有效性,探索其对表现的影响:我们与葡萄牙国家消防学校合作,在一项准实验研究中,使用 FLAIM Trainer VR 系统让 22 名健康消防员置身于 2 个沉浸式场景(中性场景和唤醒场景)中,同时记录生理数据。对基线认知表现、抑郁、焦虑、压力、不良事件的数量以及创伤后应激障碍症状的严重程度进行了评估。在每个场景之前、之间和之后,对积极和消极情绪状态进行了测量。测试了情境意识、临场感、生态有效性、参与度以及 VR 沉浸带来的负面影响:基线积极情绪得分较高(平均 32.4 分,标准差 7.2 分),并在完成 VR 任务后有所增加(部分 η2=0.52; Greenhouse-Geisser F1.82,32.78=19.73; P2=0.02; Greenhouse-Geisser F2.13,38.4=0.39; P=0.69)。参与者对 VR 临场感的反馈也是积极的,报告了较高的物理空间感(平均分 3.9,标准差 0.8)、生态有效性(平均分 3.8,标准差 0.6)和参与度(平均分 3.8,标准差 0.6)。参与度与之前经历的不良事件数量(r=0.49;P=.02)和积极情绪(最后一次虚拟现实任务后;r=0.55;P=.02)有关。相反,参与者报告的负面影响很少(平均分 1.7,标准差 0.6)。负面影响与消极情绪(最后一项 VR 任务后;r=0.53;P=.03)和回避(r=0.73;PC 结论)呈正相关:我们的研究表明,VR 是替代现场培训的一种有效方法,因为它在促进积极情绪的同时,被认为具有生态有效性和参与性,而且几乎没有负面影响。这证实了使用虚拟现实技术来测试消防员的表现和态势感知能力。还需要进一步研究,以确定有创伤后应激障碍症状的消防员不会受到 VR 的负面影响。本研究赞成使用 VR 训练,并就其对受训者的情绪和认知影响提供了新的见解。
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引用次数: 0
Gamification in the Design of Virtual Patients for Swedish Military Medics to Support Trauma Training: Interaction Analysis and Semistructured Interview Study. 为瑞典军医设计虚拟病人以支持创伤培训中的游戏化:交互分析和半结构式访谈研究。
IF 3.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-22 DOI: 10.2196/63390
Natalia Stathakarou, Andrzej A Kononowicz, Erik Mattsson, Klas Karlgren

Background: This study explores gamification in the design of virtual patients (VPs) to enhance the training of Swedish military medics in trauma care. The challenges related to prehospital trauma care faced on the battlefield require tailored educational tools that support military medics' education and training.

Objective: The aim of the study is to investigate how to design VPs with game elements for Swedish military medics to support learning in military trauma care. By understanding the reasoning and perceptions of military medics when interacting with VPs, this study aims to provide insights and recommendations for designing VPs with game elements that are specifically tailored to their needs.

Methods: The study involved 14 Swedish military medics of the Home Guard-National Security Forces participating in a tactical combat care course. Participants interacted with 3 different VP cases designed to simulate military trauma scenarios. Data were collected through think-aloud sessions and semistructured interviews. The data were analyzed using interaction analysis, structured by the unawareness, problem identification, explanation, and alternative strategies or solutions (uPEA) framework, and reflexive thematic analysis to explore participants' reasoning processes and perceptions and identify possible game elements to inform the VP design.

Results: Mapping the military medics' reasoning to the uPEA framework revealed that study participants became more creative after making a mistake followed by feedback and after receiving a prompt to make a new decision. The thematic analysis revealed 6 themes: motivation, "keep on trying"; agency in interaction with VPs; realistic tactical experience; confidence, "I know that the knowledge I have works"; social influence on motivation; and personalized learning. Participants suggested that game elements such as scoring; badges; virtual goods; progress bars; performance tables; content unlocking; hints; challenge; control; imposed choice; narrative; avatars; sensation; randomness; difficulty adapting; competition; leaderboards; social pressure; progression; and renovation can promote engagement, motivation, and support confidence in decision-making.

Conclusions: Gamification in the design of VPs represents a promising approach to military medical training, offering a platform for medics to practice medical and tactical decision-making in a risk-free environment. The insights gained by the study may encourage designing VPs with game elements, as well as including possibly wrong decisions, their consequences, and relevant feedback, that may support military medics' reflections and decision-making.

背景:本研究探讨了虚拟病人(VPs)设计中的游戏化,以加强瑞典军队医护人员在创伤护理方面的培训。战场上面临的院前创伤救护相关挑战需要量身定制的教育工具,以支持军事医护人员的教育和培训:本研究旨在探讨如何为瑞典军事医护人员设计具有游戏元素的虚拟视图,以支持军事创伤救护方面的学习。本研究旨在通过了解军事医护人员在与虚拟项目互动时的推理和感知,为设计具有游戏元素的虚拟项目提供见解和建议,以专门满足他们的需求:这项研究涉及 14 名参加战术战斗护理课程的瑞典国民警卫队-国家安全部队的军医。参与者与 3 个不同的虚拟病例进行了互动,这些虚拟病例是为模拟军事创伤场景而设计的。数据通过思考-朗读环节和半结构化访谈收集。数据分析采用了互动分析法,以 "无意识"、"问题识别"、"解释"、"替代策略或解决方案"(uPEA)框架和反思性主题分析法为基础,探索参与者的推理过程和感知,并确定可能的游戏元素,为 VP 设计提供参考:结果:将军事医务人员的推理映射到 uPEA 框架后发现,研究参与者在犯错并得到反馈后,以及在收到做出新决定的提示后,会变得更有创造力。主题分析揭示了 6 个主题:动机,"继续尝试";与虚拟人物互动的能动性;真实的战术体验;自信,"我知道我掌握的知识是有用的";社会对动机的影响;以及个性化学习。与会者认为,计分、徽章、虚拟物品、进度条、成绩表、内容解锁、提示、挑战、控制、强加选择、叙事、头像、感觉、随机性、难度适应、竞争、排行榜、社会压力、进步和翻新等游戏元素可以促进参与、激励和支持决策信心:VP 设计中的游戏化是军事医学培训的一种很有前途的方法,它为医护人员提供了一个在无风险环境中练习医疗和战术决策的平台。本研究获得的启示可能会鼓励在设计虚拟病例时加入游戏元素,以及可能的错误决策、其后果和相关反馈,从而支持军事医务人员的反思和决策。
{"title":"Gamification in the Design of Virtual Patients for Swedish Military Medics to Support Trauma Training: Interaction Analysis and Semistructured Interview Study.","authors":"Natalia Stathakarou, Andrzej A Kononowicz, Erik Mattsson, Klas Karlgren","doi":"10.2196/63390","DOIUrl":"10.2196/63390","url":null,"abstract":"<p><strong>Background: </strong>This study explores gamification in the design of virtual patients (VPs) to enhance the training of Swedish military medics in trauma care. The challenges related to prehospital trauma care faced on the battlefield require tailored educational tools that support military medics' education and training.</p><p><strong>Objective: </strong>The aim of the study is to investigate how to design VPs with game elements for Swedish military medics to support learning in military trauma care. By understanding the reasoning and perceptions of military medics when interacting with VPs, this study aims to provide insights and recommendations for designing VPs with game elements that are specifically tailored to their needs.</p><p><strong>Methods: </strong>The study involved 14 Swedish military medics of the Home Guard-National Security Forces participating in a tactical combat care course. Participants interacted with 3 different VP cases designed to simulate military trauma scenarios. Data were collected through think-aloud sessions and semistructured interviews. The data were analyzed using interaction analysis, structured by the unawareness, problem identification, explanation, and alternative strategies or solutions (uPEA) framework, and reflexive thematic analysis to explore participants' reasoning processes and perceptions and identify possible game elements to inform the VP design.</p><p><strong>Results: </strong>Mapping the military medics' reasoning to the uPEA framework revealed that study participants became more creative after making a mistake followed by feedback and after receiving a prompt to make a new decision. The thematic analysis revealed 6 themes: motivation, \"keep on trying\"; agency in interaction with VPs; realistic tactical experience; confidence, \"I know that the knowledge I have works\"; social influence on motivation; and personalized learning. Participants suggested that game elements such as scoring; badges; virtual goods; progress bars; performance tables; content unlocking; hints; challenge; control; imposed choice; narrative; avatars; sensation; randomness; difficulty adapting; competition; leaderboards; social pressure; progression; and renovation can promote engagement, motivation, and support confidence in decision-making.</p><p><strong>Conclusions: </strong>Gamification in the design of VPs represents a promising approach to military medical training, offering a platform for medics to practice medical and tactical decision-making in a risk-free environment. The insights gained by the study may encourage designing VPs with game elements, as well as including possibly wrong decisions, their consequences, and relevant feedback, that may support military medics' reflections and decision-making.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e63390"},"PeriodicalIF":3.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Game-Based eHealth Interventions for the Reduction of Fatigue in People With Chronic Diseases: Systematic Review and Meta-Analysis. 基于游戏的电子健康干预措施可减轻慢性病患者的疲劳:系统回顾与元分析》。
IF 3.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-17 DOI: 10.2196/55034
Leonie S Warlo, Souraya El Bardai, Andrica de Vries, Marie-Lise van Veelen, Suzan Moors, Edmond Hhm Rings, Jeroen S Legerstee, Bram Dierckx

Background: Fatigue is a common and debilitating side effect of chronic diseases, significantly impacting patients' quality of life. While physical exercise and psychological treatments have been shown to reduce fatigue, patients often struggle with adherence to these interventions in clinical practice. Game-based eHealth interventions are believed to address adherence issues by making the intervention more accessible and engaging.

Objective: This study aims to compile empirical evidence on game-based eHealth interventions for fatigue in individuals with chronic diseases and to evaluate their effectiveness in alleviating fatigue.

Methods: A comprehensive literature search was performed across Embase, MEDLINE ALL, PsycINFO, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and Google Scholar in August 2021. Study characteristics and outcomes from the included studies were extracted, and a random-effects meta-analysis was conducted. Sensitivity and subgroup analyses were performed to identify sources of heterogeneity.

Results: Of 1742 studies identified, 17 were included in the meta-analysis. These studies covered 5 different chronic diseases: multiple sclerosis (n=10), cancer (n=3), renal disease (n=2), stroke (n=1), and Parkinson disease (n=1). All but 1 study used exergaming interventions. The meta-analysis revealed a significant moderate effect size in reducing fatigue favoring the experimental interventions (standardized mean difference [SMD] -0.65, 95% CI -1.09 to -0.21, P=.003) compared with control conditions consisting of conventional care and no care. However, heterogeneity was high (I2=85.87%). Subgroup analyses were conducted for the 2 most prevalent diseases. The effect size for the multiple sclerosis subgroup showed a trend in favor of eHealth interventions (SMD -0.47, 95% CI -0.95 to 0.01, P=.05, I2=63.10%), but was not significant for the cancer group (SMD 0.61, 95% CI -0.36 to 1.58, P=.22). Balance exercises appeared particularly effective in reducing fatigue (SMD -1.19, 95% CI -1.95 to -0.42, P=.002).

Conclusions: Game-based eHealth interventions appear effective in reducing fatigue in individuals with chronic diseases. Further research is needed to reinforce these findings and explore their impact on specific diseases. Additionally, there is a lack of investigation into interventions beyond exergaming within the field of game-based learning.

背景:疲劳是慢性病常见的副作用,会使人衰弱,严重影响患者的生活质量。虽然体育锻炼和心理治疗已被证明可以减轻疲劳,但在临床实践中,患者往往难以坚持这些干预措施。基于游戏的电子健康干预措施被认为可以通过使干预措施更容易获得和更有吸引力来解决依从性问题:本研究旨在汇编有关基于游戏的电子健康干预对慢性病患者疲劳的实证证据,并评估其在缓解疲劳方面的有效性:2021 年 8 月,我们对 Embase、MEDLINE ALL、PsycINFO、Web of Science Core Collection、Cochrane Central Register of Controlled Trials 和 Google Scholar 进行了全面的文献检索。从纳入的研究中提取研究特征和结果,并进行随机效应荟萃分析。进行了敏感性分析和亚组分析,以确定异质性的来源:在确定的 1742 项研究中,有 17 项纳入了荟萃分析。这些研究涉及 5 种不同的慢性疾病:多发性硬化症(10 项)、癌症(3 项)、肾病(2 项)、中风(1 项)和帕金森病(1 项)。除一项研究外,其他研究均采用了游戏外干预措施。荟萃分析表明,与常规护理和无护理组成的对照条件相比,实验性干预措施在减轻疲劳方面具有显著的中度效应(标准化平均差 [SMD] -0.65,95% CI -1.09 至 -0.21,P=.003)。然而,异质性很高(I2=85.87%)。针对两种最常见的疾病进行了分组分析。多发性硬化症亚组的效应大小显示出有利于电子健康干预的趋势(SMD -0.47,95% CI -0.95至0.01,P=.05,I2=63.10%),但对癌症组的效应大小不显著(SMD 0.61,95% CI -0.36至1.58,P=.22)。平衡练习似乎对减轻疲劳特别有效(SMD-1.19,95% CI -1.95 至 -0.42,P=.002):结论:基于游戏的电子健康干预似乎能有效减轻慢性病患者的疲劳。还需要进一步的研究来巩固这些发现,并探讨其对特定疾病的影响。此外,在基于游戏的学习领域中,还缺乏对外显子游戏以外的干预措施的研究。
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引用次数: 0
Effects of Virtual Reality Therapy for Patients With Breast Cancer During Chemotherapy: Randomized Controlled Trial. 虚拟现实疗法对化疗期间乳腺癌患者的影响:随机对照试验
IF 4.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-17 DOI: 10.2196/53825
Mengdan Li, Zhifu Yu, Hui Li, Li Cao, Huihui Yu, Ning Deng, Yunyong Liu

Background: Patients with breast cancer endure high levels of psychological and physical pain. Virtual reality (VR) may be an acceptable, safe intervention to alleviate the negative emotions and pain of patients with cancer.

Objective: We aimed to test the long-term effects of VR on psychological distress and quality of life (QOL) with traditional care in Chinese patients with breast cancer. We also explored the intervention mechanism and the acceptability of VR.

Methods: A total of 327 eligible participants were randomly assigned to a VR intervention group or a control group. The Distress Thermometer, QLQ-C30 (Quality of Life Questionnaire version 3.0), and Virtual Reality Symptom Questionnaire were assessed at baseline, postintervention (3 mo), and follow-up (6 mo). Analysis followed the intention-to-treat (ITT) principle. The generalized estimating equations model was used to analyze the longitudinal data, and the PROCESS macro was used to analyze the mediating effect.

Results: Compared with the control group, patients with breast cancer in the VR group had lower distress scores (P=.007), and higher health-related QOL scores (physical, role, emotional, cognitive, and social functioning) after 6 months (P<.05). Psychological distress had mediating effects on the longitudinal association between VR and the health-related QOL (indirect effect=4.572-6.672, all P<.05).

Conclusions: VR intervention technology may help reduce distress and improve QOL for patients with breast cancer over time. By incorporating a mediating analysis, we showed that the QOL benefits of VR intervention was manifested through positive effects on psychological distress risk factors.

背景:乳腺癌患者承受着巨大的心理和生理痛苦。虚拟现实(VR)可能是一种可接受的、安全的干预措施,可减轻癌症患者的负面情绪和痛苦:我们的目的是测试虚拟现实技术对中国乳腺癌患者的心理压力和生活质量(QOL)的长期影响。我们还探讨了 VR 的干预机制和可接受性:共有 327 名符合条件的参与者被随机分配到 VR 干预组或对照组。分别在基线、干预后(3 个月)和随访(6 个月)时对窘迫温度计、QLQ-C30(生活质量问卷 3.0 版)和虚拟现实症状问卷进行评估。分析遵循意向治疗(ITT)原则。广义估计方程模型用于分析纵向数据,PROCESS宏用于分析中介效应:结果:与对照组相比,VR 组乳腺癌患者的痛苦评分较低(P=.007),6 个月后的健康相关 QOL 评分(身体、角色、情感、认知和社会功能)较高(结论:VR 干预技术可能有助于减轻乳腺癌患者的痛苦:随着时间的推移,VR 干预技术可能有助于减轻乳腺癌患者的痛苦并改善其 QOL。通过中介分析,我们发现 VR 干预的 QOL 益处体现在对心理困扰风险因素的积极影响上。
{"title":"Effects of Virtual Reality Therapy for Patients With Breast Cancer During Chemotherapy: Randomized Controlled Trial.","authors":"Mengdan Li, Zhifu Yu, Hui Li, Li Cao, Huihui Yu, Ning Deng, Yunyong Liu","doi":"10.2196/53825","DOIUrl":"10.2196/53825","url":null,"abstract":"<p><strong>Background: </strong>Patients with breast cancer endure high levels of psychological and physical pain. Virtual reality (VR) may be an acceptable, safe intervention to alleviate the negative emotions and pain of patients with cancer.</p><p><strong>Objective: </strong>We aimed to test the long-term effects of VR on psychological distress and quality of life (QOL) with traditional care in Chinese patients with breast cancer. We also explored the intervention mechanism and the acceptability of VR.</p><p><strong>Methods: </strong>A total of 327 eligible participants were randomly assigned to a VR intervention group or a control group. The Distress Thermometer, QLQ-C30 (Quality of Life Questionnaire version 3.0), and Virtual Reality Symptom Questionnaire were assessed at baseline, postintervention (3 mo), and follow-up (6 mo). Analysis followed the intention-to-treat (ITT) principle. The generalized estimating equations model was used to analyze the longitudinal data, and the PROCESS macro was used to analyze the mediating effect.</p><p><strong>Results: </strong>Compared with the control group, patients with breast cancer in the VR group had lower distress scores (P=.007), and higher health-related QOL scores (physical, role, emotional, cognitive, and social functioning) after 6 months (P<.05). Psychological distress had mediating effects on the longitudinal association between VR and the health-related QOL (indirect effect=4.572-6.672, all P<.05).</p><p><strong>Conclusions: </strong>VR intervention technology may help reduce distress and improve QOL for patients with breast cancer over time. By incorporating a mediating analysis, we showed that the QOL benefits of VR intervention was manifested through positive effects on psychological distress risk factors.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e53825"},"PeriodicalIF":4.3,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Social Gaming to Decrease Loneliness in Older Adults: Recruitment Challenges and Attrition Analysis in a Digital Mixed Methods Feasibility Study. 通过社交游戏减少老年人的孤独感:数字混合方法可行性研究中的人员招募挑战与流失分析》(Recruitment Challenges and Attrition Analysis in a Digital Mixed Methods Feasibility Study)。
IF 3.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-16 DOI: 10.2196/52640
Bas D L Châtel, Jeroen H M Janssen, Geeske M E E Peeters, Rense Corten, Rob Tieben, Menno Deen, Elmy J M Hendriks, Marcel G M Olde Rikkert

Background: Digital mental health interventions could sustainably and scalably prevent and reduce loneliness in older adults. We designed an app containing 29 text-based games and a questionnaire-administering chatbot to stimulate intergenerational contact.

Objective: This study aims to evaluate the feasibility of a social gaming app in reducing loneliness among older adults by evaluating recruitment strategies, data collection procedures, and gameplay activity.

Methods: This mixed methods study recruited participants via newsletters, articles, and a social media campaign. We used semistructured interviews and descriptive analysis of questionnaire answers and game data to assess feasibility. Key measures included recruitment reach and efficiency, participant demographics, in-app activity, and app usability and engagement feedback.

Results: The social media campaign reached 192,641 potential participants, resulting in 1363 game downloads. A total of 155 participants (aged 65 years and older: n=34, 21.9% and aged less than 65 years: n=121, 78.1%) provided informed consent, yielding a conversion rate of 0.08%. The recruitment campaign focusing on distanced playful interaction had a significantly (P<.001) higher click-through rate (1.98%) than a campaign focusing on research participation (click-through rate=0.51%; P<.001). The overall conversion rate from advertisement exposure to research participation was 0.08%. Participants had a mean age of 48 (SD 16) years. The 65 years and older group averaged 70 (SD 5) years, while the less 65 years group averaged 42 (SD 12) years. Additionally, 45.2% (57/126) reported at least moderate levels of loneliness at baseline. Of the initial 554 players, 91 (16.4%) remained active after the first week, and 32 (5.8%) remained active for more than 90 days. Active participants tended to interact with those within their own age group, as indicated by a Pearson correlation of r=0.31 between the ages of the message sender and receiver. Interviews with 12 (48%) participants (aged 65-79 years; female: n=12, 83%) revealed barriers such as excessive chatbot questions and a mismatch between the target group and app design focus. Questionnaire completion rates dropped from 46% at baseline to 10% at follow-up.

Conclusions: These findings underscore the challenges of recruitment and retention for older adults in a fully digital social gaming intervention. Effective recruitment strategies and targeted app design are crucial for engagement. Based on these insights, future interventions should focus on simplified interfaces, clear guidance for gameplay, and addressing the specific needs and preferences of older adults, thereby enhancing the effectiveness of digital mental health interventions.

背景:数字心理健康干预措施可以持续、大规模地预防和减少老年人的孤独感。我们设计了一款应用程序,其中包含 29 个基于文本的游戏和一个可进行问卷调查的聊天机器人,以促进代际接触:本研究旨在通过评估招募策略、数据收集程序和游戏活动,评估社交游戏应用程序在减少老年人孤独感方面的可行性:这项混合方法研究通过通讯、文章和社交媒体活动招募参与者。我们采用半结构式访谈以及对问卷答案和游戏数据的描述性分析来评估可行性。主要衡量指标包括招募范围和效率、参与者人口统计数据、应用内活动以及应用可用性和参与度反馈:结果:社交媒体活动覆盖了 192,641 名潜在参与者,促成了 1363 次游戏下载。共有 155 名参与者(65 岁及以上:34 人,占 21.9%;65 岁以下:121 人,占 78.1%)提供了知情同意书,转化率为 0.08%。以疏远的游戏互动为重点的招募活动取得了显著的效果(PConclusions:这些发现强调了在全数字化社交游戏干预中招募和留住老年人所面临的挑战。有效的招募策略和有针对性的应用设计对参与度至关重要。基于这些见解,未来的干预措施应侧重于简化界面、明确的游戏指导以及满足老年人的特殊需求和偏好,从而提高数字心理健康干预措施的有效性。
{"title":"Social Gaming to Decrease Loneliness in Older Adults: Recruitment Challenges and Attrition Analysis in a Digital Mixed Methods Feasibility Study.","authors":"Bas D L Châtel, Jeroen H M Janssen, Geeske M E E Peeters, Rense Corten, Rob Tieben, Menno Deen, Elmy J M Hendriks, Marcel G M Olde Rikkert","doi":"10.2196/52640","DOIUrl":"10.2196/52640","url":null,"abstract":"<p><strong>Background: </strong>Digital mental health interventions could sustainably and scalably prevent and reduce loneliness in older adults. We designed an app containing 29 text-based games and a questionnaire-administering chatbot to stimulate intergenerational contact.</p><p><strong>Objective: </strong>This study aims to evaluate the feasibility of a social gaming app in reducing loneliness among older adults by evaluating recruitment strategies, data collection procedures, and gameplay activity.</p><p><strong>Methods: </strong>This mixed methods study recruited participants via newsletters, articles, and a social media campaign. We used semistructured interviews and descriptive analysis of questionnaire answers and game data to assess feasibility. Key measures included recruitment reach and efficiency, participant demographics, in-app activity, and app usability and engagement feedback.</p><p><strong>Results: </strong>The social media campaign reached 192,641 potential participants, resulting in 1363 game downloads. A total of 155 participants (aged 65 years and older: n=34, 21.9% and aged less than 65 years: n=121, 78.1%) provided informed consent, yielding a conversion rate of 0.08%. The recruitment campaign focusing on distanced playful interaction had a significantly (P<.001) higher click-through rate (1.98%) than a campaign focusing on research participation (click-through rate=0.51%; P<.001). The overall conversion rate from advertisement exposure to research participation was 0.08%. Participants had a mean age of 48 (SD 16) years. The 65 years and older group averaged 70 (SD 5) years, while the less 65 years group averaged 42 (SD 12) years. Additionally, 45.2% (57/126) reported at least moderate levels of loneliness at baseline. Of the initial 554 players, 91 (16.4%) remained active after the first week, and 32 (5.8%) remained active for more than 90 days. Active participants tended to interact with those within their own age group, as indicated by a Pearson correlation of r=0.31 between the ages of the message sender and receiver. Interviews with 12 (48%) participants (aged 65-79 years; female: n=12, 83%) revealed barriers such as excessive chatbot questions and a mismatch between the target group and app design focus. Questionnaire completion rates dropped from 46% at baseline to 10% at follow-up.</p><p><strong>Conclusions: </strong>These findings underscore the challenges of recruitment and retention for older adults in a fully digital social gaming intervention. Effective recruitment strategies and targeted app design are crucial for engagement. Based on these insights, future interventions should focus on simplified interfaces, clear guidance for gameplay, and addressing the specific needs and preferences of older adults, thereby enhancing the effectiveness of digital mental health interventions.</p>","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":"12 ","pages":"e52640"},"PeriodicalIF":3.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11525082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Serious Game Development for Public Health: Participatory Design Approach to COVID-19 Quarantine Policy Education. 为公共卫生开发严肃游戏:COVID-19 检疫政策教育的参与式设计方法。
IF 3.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-15 DOI: 10.2196/54968
Myunghwan Kwak, Byeong-Je Kim, Ji-Bum Chung
<p><strong>Background: </strong>Public health education plays a crucial role in effectively addressing infectious diseases such as COVID-19. However, existing educational materials often provide only foundational information, and traditional group education faces challenges due to social distancing policies.</p><p><strong>Objective: </strong>Addressing these gaps, our study introduces a serious game called "Flattening the Curve." This interactive experience immerses learners in the role of quarantine policy managers, offering unique insights into the effects and challenges of social distancing policies.</p><p><strong>Methods: </strong>The development of the game adhered to the SERES framework, ensuring a scientifically designed foundation. To achieve its learning objectives, the game incorporated learning and game mechanics including an agent-based infection model, a social distancing policy model, and an economic model, which were developed based on previous literature. After defining a broad concept of scientific and design foundations, we used a participatory design process. This study included 16 undergraduates and took place over one semester. Participants played the game, gave feedback, and answered surveys. The game was improved based on participants' feedback throughout the process. Participants' feedback was analyzed based on the Design, Play, and Experience framework. Surveys were conducted before and after the activity and analyzed to assess participants' evaluation of and satisfaction with the game.</p><p><strong>Results: </strong>The game successfully achieved its learning objectives, encompassing a comprehensive understanding of infectious disease characteristics; the disease transmission process; the necessity and efficacy of quarantine policies and their delicate balance with economic factors; and the concept of flattening the curve. To achieve this, the game includes the following: (1) an agent-based infection model based on the modified Susceptible-Exposed-Infectious-Hospitalized-Recovered (SEIHR) model with five infectious disease scenarios; (2) a quarantine policy model with social distancing, travel control, and intensive care unit management; and (3) an economic model that allows users to consider the impact of quarantine policies on a community's economy. In response to participatory design feedback, the game underwent meticulous modifications, including refining game systems, parameters, design elements, the user interface, and interactions. Key feedback included requests for more scenarios and engaging yet simple game elements, as well as suggestions for improving the scoring system and design features. Notably, concerns about the fairness of the outcome evaluation system (star rating system), which could incentivize prioritizing economic activity over minimizing casualties, were raised and addressed by replacing the star rating system with a progress-based vaccine development system. Quantitative evaluation results refle
背景:公共卫生教育在有效应对 COVID-19 等传染病方面发挥着至关重要的作用。然而,现有的教育材料往往只提供基础信息,而传统的集体教育由于社会疏远政策而面临挑战:针对这些差距,我们的研究引入了一款名为 "拉平曲线 "的严肃游戏。这种互动体验让学习者沉浸在检疫政策管理者的角色中,从而对社会隔离政策的影响和挑战有独特的见解:方法:游戏的开发遵循了 SERES 框架,确保了设计的科学性。为实现学习目标,游戏融入了学习和游戏机制,包括基于代理的感染模型、社会隔离政策模型和经济模型。在确定了科学和设计基础的广泛概念后,我们采用了参与式设计过程。这项研究包括 16 名本科生,历时一个学期。参与者玩了游戏,提供了反馈意见,并回答了调查问卷。在整个过程中,我们根据参与者的反馈对游戏进行了改进。根据设计、游戏和体验框架对参与者的反馈进行了分析。在活动前后进行了调查,并对调查进行了分析,以评估参与者对游戏的评价和满意度:该游戏成功地实现了学习目标,包括全面了解传染病的特征、疾病传播过程、检疫政策的必要性和有效性及其与经济因素之间的微妙平衡,以及平缓曲线的概念。为此,游戏包括以下内容:(1) 基于修改后的易感-暴露-感染-住院-康复(SEIHR)模型的代理感染模型,包含五种传染病情景;(2) 包含社会隔离、旅行控制和重症监护室管理的检疫政策模型;(3) 允许用户考虑检疫政策对社区经济影响的经济模型。根据参与式设计的反馈意见,对游戏进行了细致的修改,包括完善游戏系统、参数、设计元素、用户界面和互动。主要的反馈意见包括要求提供更多的场景和引人入胜而又简单的游戏元素,以及改进计分系统和设计功能的建议。值得注意的是,有人对结果评价系统(星级评价系统)的公平性表示担忧,认为该系统可能会鼓励优先考虑经济活动,而不是尽量减少人员伤亡。定量评估结果反映了参与者通过以学习者为中心的方法对游戏的积极评价:通过参与式设计方法开发的严肃游戏 "拉平曲线 "是公共卫生教育,特别是有关社会疏远政策的教育的重要工具。该游戏及其源代码可在网上公开获取,从而可广泛用于研究和教育目的。
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引用次数: 0
Interactive Serious Game to Teach Basic Life Support Among Schoolchildren in Brazil: Design and Rationale. 在巴西学童中教授基本生命支持的互动式严肃游戏:设计与原理
IF 3.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-09 DOI: 10.2196/55333
Uri Adrian Prync Flato, Emilio José Beffa Dos Santos, Isabella Bispo Diaz T Martins, Vinicius Gazin Rossignoli, Thais Dias Midega, Lucas Kallas-Silva, Ricardo Ferreira Mendes de Oliveira, Adriana do Socorro Lima Figueiredo Flato, Mario Vicente Guimarães, Hélio Penna Guimarães
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引用次数: 0
The Role of Relevance in Shaping Perceptions of Sleep Hygiene Games Among University Students: Mixed Methods Study. 相关性在塑造大学生睡眠卫生游戏观念中的作用:混合方法研究
IF 3.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-08 DOI: 10.2196/64063
Zilu Liang, Edward Melcer, Kingkarn Khotchasing, Samantha Chen, Daeun Hwang, Nhung Huyen Hoang

Background: Sleep games are an emerging topic in the realm of serious health game research. However, designing features that are both enjoyable and effective at engaging users, particularly university students, to develop healthy sleep habits remains a challenge.

Objective: This study aims to investigate user preferences for 3 sleep game prototypes, that is, Hero's Sleep Journey, Sleep Tamagotchi, and Sleepland, and to explore their popularity and perceived utility in promoting sleep health.

Methods: A mixed methods approach was used in this study. Quantitative and qualitative data were collected through a co-design workshop involving 47 university students. Participants were presented with storyboard cards of game features and were asked to provide an overall rating on each game, as well as ratings for individual features. They were also encouraged to provide free-form comments on the features and suggest improvements. In addition, participants were asked to express their preferences among the 3 games regarding which game they would most like to play and which one they found most useful for promoting sleep health.

Results: Surprisingly, while Hero's Sleep Journey was the most popular choice among participants, Sleep Tamagotchi was perceived as the most beneficial for improving sleep health. Relevance emerged as an overarching theme in the qualitative data analysis, with 3 interconnected dimensions: psychological relevance to users' personal lives, logical relevance to sleep health, and situational relevance to users' circumstantial context. We discussed how the 3 dimensions of relevance address the autonomy and relatedness constructs outlined in the self-determination theory and proposed 3 design recommendations.

Conclusions: Our serious sleep game prototypes demonstrated the potential to engage university students to develop healthy sleep hygiene. Future sleep game designs should aim to create a sense of relevance to users' personal lives, sleep health goals, and situational contexts. Rather than a one-size-fits-all approach, it is essential to develop a wide range of game genres and features to cater to diverse users. Aligning game features with sleep health goals and educating users on the design rationale through sleep knowledge are also important aspects. Furthermore, allowing users to customize their game experience and manage technology boundaries is necessary to nurture a sense of control and autonomy in the process of forming good sleep hygiene.

背景:睡眠游戏是严肃健康游戏研究领域的一个新兴课题。然而,如何设计出既令人愉快又能有效吸引用户(尤其是大学生)养成健康睡眠习惯的游戏功能仍是一项挑战:本研究旨在调查用户对《英雄的睡眠之旅》、《睡眠玉兔》和《睡眠乐园》这三款睡眠游戏原型的偏好,并探讨它们在促进睡眠健康方面的受欢迎程度和感知效用:本研究采用了混合方法。方法:本研究采用了混合方法,通过有 47 名大学生参加的共同设计研讨会收集定量和定性数据。向参与者展示了游戏功能的故事板卡,要求他们对每个游戏进行总体评分,并对单个功能进行评分。他们还被鼓励对游戏功能提供自由评论,并提出改进建议。此外,参与者还被要求表达他们对 3 款游戏的偏好,即他们最想玩哪款游戏,以及他们认为哪款游戏对促进睡眠健康最有用:结果:令人惊讶的是,《英雄的睡眠之旅》是参与者最受欢迎的选择,而《睡眠玉兔》则被认为是对改善睡眠健康最有益的游戏。在定性数据分析中,"相关性 "是一个首要主题,它包含三个相互关联的维度:与用户个人生活相关的心理相关性、与睡眠健康相关的逻辑相关性以及与用户环境相关的情景相关性。我们讨论了相关性的 3 个维度如何与自我决定理论中概述的自主性和相关性建构相联系,并提出了 3 项设计建议:我们的严肃睡眠游戏原型展示了吸引大学生养成健康睡眠卫生习惯的潜力。未来的睡眠游戏设计应致力于创造一种与用户个人生活、睡眠健康目标和情境相关的感觉。与其采用 "一刀切 "的方法,不如开发多种游戏类型和功能,以满足不同用户的需求。使游戏功能与睡眠健康目标相一致,并通过睡眠知识教育用户了解设计原理也是很重要的方面。此外,允许用户定制自己的游戏体验和管理技术边界对于培养用户在形成良好睡眠卫生习惯过程中的控制感和自主性也是必要的。
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引用次数: 0
Impact of Video-Based Error Correction Learning for Cardiopulmonary Resuscitation Training: Quasi-Experimental Study. 基于视频的纠错学习对心肺复苏培训的影响:准实验研究。
IF 3.8 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-03 DOI: 10.2196/53577
Yun Wang, Junzuo Fu, Shaoping Wang, Huijuan Wang, Wei Gao, Lina Huang

Background: Video-based error correction (VBEC) in medical education could offer immediate feedback, promote enhanced learning retention, and foster reflective practice. However, its application in cardiopulmonary resuscitation (CPR) training has not been investigated.

Objective: The objective of this study is to assess whether the VBEC procedure could improve the training performance of CPR among anesthesiology residents.

Methods: A quasi-experimental study was conducted among anesthesiology residents between December 2022 and April 2023. Primary outcomes included a posttraining knowledge test and practical assessment scores. Secondary outcomes included the number of residents who correctly conducted CPR at each step, the rate of common mistakes during the CPR process, and the self-assessment results. A total of 80 anesthesiology residents were divided into a VBEC group (n=40) and a control group (n=40). The VBEC group underwent a 15-minute VBEC CPR training, whereas the control group underwent a 15-minute video-prompting CPR training.

Results: The posttraining knowledge test score of the VBEC group was significantly higher than that of the control group (73, SD 10.5 vs 65.1, SD 11.4; P=.002). The residents in the VBEC group had lower error rates in "failure to anticipate the next move" (n=3, 7.5% vs n=13, 32.5%; P=.01) and "failure to debrief or problem solve after the code" (n=2, 5% vs n=11, 27.5%; P=.01), as well as better performance in the "secure own safety" step (n=34, 85% vs n=18, 45%; P<.001) than those in the control group. The VBEC group showed significantly higher confidence in CPR than the control group (n=?, 62.5% vs n=?, 35%; P=.03).

Conclusions: VBEC may be a promising strategy compared to video prompting for CPR training among anesthesiology residents.

背景:医学教育中的视频纠错(VBEC)可提供即时反馈、促进学习保持和培养反思性实践。然而,其在心肺复苏术(CPR)培训中的应用尚未得到研究:本研究旨在评估 VBEC 程序是否能提高麻醉科住院医师的心肺复苏术培训成绩:在 2022 年 12 月至 2023 年 4 月期间,在麻醉科住院医师中开展了一项准实验研究。主要结果包括培训后知识测试和实践评估得分。次要结果包括正确进行心肺复苏各步骤的住院医师人数、心肺复苏过程中的常见错误率以及自我评估结果。共有 80 名麻醉科住院医师被分为 VBEC 组(40 人)和对照组(40 人)。VBEC组接受了15分钟的VBEC心肺复苏培训,而对照组则接受了15分钟的视频提示心肺复苏培训:结果: VBEC 组培训后知识测试得分明显高于对照组(73 分,SD 10.5 vs 65.1 分,SD 11.4;P=.002)。VBEC 组住院医师在 "未能预测下一步行动"(3 人,7.5% vs 13 人,32.5%;P=.01)和 "编码后未能汇报或解决问题"(2 人,5% vs 11 人,27.5%;P=.01)方面的错误率较低,在 "确保自身安全 "步骤中的表现较好(34 人,85% vs 18 人,45%;PC 结论:在麻醉科住院医生的心肺复苏培训中,VBEC 可能是一种比视频提示更有前途的策略。
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JMIR Serious Games
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