Leonie S Warlo, Souraya El Bardai, Andrica de Vries, Marie-Lise van Veelen, Suzan Moors, Edmond Hhm Rings, Jeroen S Legerstee, Bram Dierckx
{"title":"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》。","authors":"Leonie S Warlo, Souraya El Bardai, Andrica de Vries, Marie-Lise van Veelen, Suzan Moors, Edmond Hhm Rings, Jeroen S Legerstee, Bram Dierckx","doi":"10.2196/55034","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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. 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引用次数: 0
摘要
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。
Game-Based eHealth Interventions for the Reduction of Fatigue in People With Chronic Diseases: Systematic Review and Meta-Analysis.
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.
期刊介绍:
JMIR Serious Games (JSG, ISSN 2291-9279) is a sister journal of the Journal of Medical Internet Research (JMIR), one of the most cited journals in health informatics (Impact Factor 2016: 5.175). JSG has a projected impact factor (2016) of 3.32. JSG is a multidisciplinary journal devoted to computer/web/mobile applications that incorporate elements of gaming to solve serious problems such as health education/promotion, teaching and education, or social change.The journal also considers commentary and research in the fields of video games violence and video games addiction.