Giulia Teverini, Annamaria Recupero, Patrizia Marti
pp. 257 – 281, download
(https://doi.org/10.55612/s-5002-065-009)
Abstract
In the healthcare domain there is a growing body of literature addressing the use of games and gamification strategies which go beyond entertainment to positively affect the therapy outcomes and the health status of the patients. This represents an emerging field of experimentation that requires a holistic perspective to consider both the medical requirements and the patients’ characteristics and needs. When approaching this topic, a common framework to guide the game design process is missing. To fill this gap, this paper reports a systematic literature review about the use of games and gamification strategies to stimulate children’s compliance in different therapeutic contexts. The objective is to analyse the state of the art by identifying both opportunities and constraints, and derive a common framework to guide the future design of games. The results show that games and gamification strategies are used in both pharmacological therapy and non-pharmacological therapy, to directly increase the compliance (for practising rehabilitation exercises, for adopting healthy behaviours) or to indirectly affect the compliance for example by making the therapy enjoyable. By categorising the existing literature, it emerged a main conceptual distinction between “therapeutic games” and “games for therapy”, which have peculiar characteristics and implications for their design and evaluation.
Keywords: literature review, therapy, healthcare, children, compliance, game, gamification, game design, therapeutic games, games for therapy.
References
1. Alharthi, S. A., Alsaedi, O., Toups Dugas, P. O., Tanenbaum, T. J., Hammer, J.: Playing to wait: A taxonomy of idle games. In: Proceedings of the 2018 CHI Conference on Human Factors in Computing Systems, pp. 1–15. Association for Computing Machinery (2018) https://doi.org/10.1145/3173574.3174195
2. Amato, F., Di Gregorio, M., Monaco, C., Sebillo, M., Tortora, G., Vitiello, G.:Socially assistive robotics combined with artificial intelligence for ADHD. In: 2021 IEEE 18th Annual Consumer Communications & Networking Conference (CCNC), pp. 1–6. IEEE (2021) https://doi.org/10.1109/CCNC49032.2021.9369633
3. Beaulieu-Gagnon, S., Bélanger, V., & Marcil, V.: Food habits during treatment of childhood cancer: a critical review. Nutrition research reviews, 32(2), pp. 265–281 (2019). https://doi.org/10.1017/s0954422419000131
4. Bridgelal Ram, M., Grocott, P. R., Weir, H. C.: Issues and challenges of involving users in medical device development, Health Expectations, 11, pp. 63–71 (2008) https://doi.org/10.1111/j.1369-7625.2007.00464.x
5. Carretier, J., Boyle, H., Duval, S., Philip, T., Laurence, V., Stark, D. P., Fervers, B.:. A review of health behaviours in childhood and adolescent cancer survivors: toward prevention of second primary cancer. Journal of adolescent and young adult oncology, 5(2), pp. 78– 90 (2016). https://doi.org/10.1089/jayao.2015.0035
6. Damasceno, E. F., da Silva, A. P., Barbosa, J. D.: A serious game-based platform for measuring treatment adherence. Multimedia Tools and Applications, pp. 1–17 (2023). https://doi.org/10.1007/s11042-023-15988-5
7. Damodaran, L.: User involvement in the systems design process-a practical guide for users. Behaviour & information technology, 15(6), pp. 363–377 (1996). https://doi.org/10.1080/014492996120049
8. De Croon, R., Geuens, J., Verbert, K., Vanden Abeele, V.: A systematic review of the effect of gamification on adherence across disciplines. In: International conference on human-computer interaction, pp. 168–184. Springer International Publishing (2021). https://doi.org/10.1007/978-3-030-77277-2_14
9. Deterding, S., Dixon, D., Khaled, R., Nacke, L.: From game design elements to gamefulness: defining “gamification”. In: Proceedings of the 15th International Academic MindTrek Conference: Envisioning Future Media Environments (MindTrek ’11), pp. 9–15. Association for Computing Machinery (2011) https://doi.org/10.1145/2181037.2181040
10. Fielding, D., Duff, A.: Compliance with treatment protocols: interventions for children with chronic illness. Archives of disease in childhood, 80(2), p. 196–200 (1999). https://doi.org/10.1136%2Fadc.80.2.196
11. Fijačko, N., Gosak, L., Cilar, L., Novšak, A., Creber, R. M., Skok, P., Štiglic, G.: The Effects of Gamification and Oral Self-Care on Oral Hygiene in Children: Systematic Search in App Stores and Evaluation of Apps. JMIR mHealth and uHealth, 8(7), pp. e16365 (2020). https://doi.org/10.2196/16365
12. García-Ruiz, M. A., Santana-Mancilla, P. C.: Towards a usable serious game app to support children’s language therapy. In: Proceedings of the IX Latin American Conference on Human Computer Interaction, pp. 1–4. Association for Computing Machinery (2019). https://doi.org/10.1145/3358961.3358978
13. Gast, A., Mathes, T.: Medication adherence influencing factors—an (updated) overview of systematic reviews. Systematic reviews, 8, pp. 1–17 (2019). https://doi.org/10.1186/s13643-019-1014-8
14. Gkintoni, E., Vantaraki, F., Skoulidi, C., Anastassopoulos, P., Vantarakis, A.: Promoting Physical and Mental Health among Children and Adolescents via Gamification—A Conceptual Systematic Review. Behavioral Sciences, 14(2), pp. 102 (2024). https://doi.org/10.3390/bs14020102
15. Hervas, R., Ruiz-Carrasco, D., Mondejar, T., Bravo, J.: Gamification mechanics for behavioral change: a systematic review and proposed taxonomy. In: Proceedings of the 11th EAI International Conference on Pervasive Computing Technologies for Healthcarepp (PervasiveHealth ’17), pp. 395–404. Association for Computing Machinery (2017). https://doi.org/10.1145/3154862.3154939
16. Høiseth, M., Giannakos, M. N., Alsos, O. A., Jaccheri, L., Asheim, J.: Designing healthcare games and applications for toddlers. In: Proceedings of the 12th international conference on interaction design and children, pp. 137-146. Association for Computing Machinery (2013). https://doi.org/10.1145/2485760.2485770
17. Holt, C. J., McKay, C. D., Truong, L. K., Le, C. Y., Gross, D. P., Whittaker, J. L.: Sticking to it: a scoping review of adherence to exercise therapy interventions in children and adolescents with musculoskeletal conditions. Journal of orthopaedic & sports physical therapy, 50(9), pp. 503–515 (2020). https://doi.org/10.2519/jospt.2020.9715
18. Hunicke, R., LeBlanc, M., Zubek, R.: MDA: A formal approach to game design and game research. In: Proceedings of the AAAI Workshop on Challenges in Game AI, pp. 1722. Association for the Advancement of Artificial Intelligence (2004).
19. Johnson, D., Deterding, S., Kuhn, K. A., Staneva, A., Stoyanov, S., Hides, L.: Gamification for health and wellbeing: A systematic review of the literature. Internet interventions, 6, pp. 89–106 (2016). https://doi.org/10.1016/j.invent.2016.10.002
20. Lopes, M., Magalhães, J., Cavaco, S.: A voice-controlled serious game for the sustained vowel exercise. In: Proceedings of the 13th International Conference on Advances in Computer Entertainment Technology, pp. 1–6. Association for Computing Machinery (2016). https://doi.org/10.1145/3001773.3001807
21. Matinolli, H. M., Mieronkoski, R., Salanterä, S.: Health and medical device development for fundamental care: Scoping review. Journal of Clinical Nursing, 29(11-12), pp. 1822–1831 (2020). https://doi.org/10.1111/jocn.15060
22. Matsui, D.: Current issues in pediatric medication adherence. Pediatric Drugs, 9, pp. 283–288 (2007). https://doi.org/10.2165/00148581-200709050-00001
23. Muñoz, J. E., Lopez, D. S., Lopez, J. F., Lopez, A.: Design and creation of a BCI videogame to train sustained attention in children with ADHD. In: Proceedings of 2015 10th Computing Colombian Conference (10CCC), pp. 194–199. IEEE (2015). https://doi.org/10.1109/ColumbianCC.2015.7333431
24. Nüssli, S., Schmidt, T., Denecke, K.: How to Motivate Children with Severe Disabilities to Adhere to Their Therapy?. In dHealth, 271, pp. 168–175, (2020). https://doi.org/10.3233/shti200093
25. Oikonomou, A., Day, D.: Using serious games to motivate children with cystic fibrosis to engage with mucus clearance physiotherapy. In: Proceedings of 2012 Sixth International Conference on Complex, Intelligent, and Software Intensive Systems, pp. 34–39. IEEE (2012). https://doi.org/10.1109/CISIS.2012.108
26. Ou, Y. K., Wang, Y. L., Chang, H. C., Yen, S. Y., Zheng, Y. H., Lee, B. O.: Development of virtual reality rehabilitation games for children with attention-deficit hyperactivity disorder. Journal of Ambient Intelligence and Humanized Computing, 11, pp. 5713–5720 (2020). https://doi.org/10.1007/s12652-020-01945-9
27. Panceri, J. A. C., Freitas, É., de Souza, J. C., da Luz Schreider, S., Caldeira, E., Bastos, T. F.: A New Socially Assistive Robot with Integrated Serious Games for Therapies with Children with Autism Spectrum Disorder and Down Syndrome: A Pilot Study. Sensors, 21(24), p. 8414 (2021). https://doi.org/10.3390/s21248414
28. Peñuelas-Calvo, I., Jiang-Lin, L.K., Girela-Serrano, B., Delgado-Gomez, D., Navarro-Jimenez, R., Baca-Garcia, E., Prras-Segovia, A.: Video games for the assessment and treatment of attention-deficit/hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry 31, pp. 5–20 (2022). https://doi.org/10.1007/s00787-020-01557-w
29. Phillips, C., Johnson, D., Wyeth, P.: Videogame reward types. In: Proceedings of the First International Conference on Gameful Design, Research, and Applications (Gamification ’13) pp. 103–106. Association for Computing Machinery (2013). https://doi.org/10.1145/2583008.2583025
30. Richter, G., Raban, D. R., Rafaeli, S.: Studying gamification: The effect of rewards and incentives on motivation (pp. 21-46), in Gamification in Education and Business, pp. 21–46, Springer International Publishing, (2015). https://doi.org/10.1007/978-3-319-10208-5_2
31. Santer, M., Ring, N., Yardley, L., Geraghty, A. W., Wyke, S.: Treatment non-adherence in pediatric long-term medical conditions: systematic review and synthesis of qualitative studies of caregivers’ views. BMC pediatrics, 14(1), pp. 1–10 (2014). https://doi.org/10.1186/1471-2431-14-63
32. Subramaniam, A., Hensley, E., Stojancic, R., Vaughn, J., Shah, N.: Careful considerations for mHealth app development: lessons learned from QuestExplore. Mhealth, 8 (2022). https://doi.org/10.21037/mhealth-21-51
33. Suleiman-Martos, N., García-Lara, R. A., Martos-Cabrera, M. B., Albendín-García, L., Romero-Béjar, J. L., Cañadas-De la Fuente, G. A., Gómez-Urquiza, J. L.: Gamification for the Improvement of Diet, Nutritional Habits, and Body Composition in Children and Adolescents: A Systematic Review and Meta-Analysis. Nutrients, 13(7), 2478, (2021). https://doi.org/10.3390/nu13072478
34. Tebbi, C. K.: Treatment compliance in childhood and adolescence. Cancer, 71(S10), pp. 3441–3449 (1993). . https://doi.org/10.1002/1097-0142(19930515)71:10+%3C3441::aid-cncr2820711751%3E3.0.co;2-p
35.Valencia-Jiménez, N. J., Ramírez-Duque, A. A., Rodríguez-Timaná, L. C., Castillo-García, J. F., Silveira, M. L., Da Luz, S., Frizera-Neto, A.: Effect of an Intervention Based on Multisensory Environment for Proprioception Assessment in Children With Down Syndrome: Case Study. IEEE Access, 11, pp. 9326–9338. (2023) https://doi.org/10.1109/ACCESS.2023.3239589
36. Xiao, Y., Watson, M.: Guidance on conducting a systematic literature review. Journal of planning education and research, 39(1), pp. 93–112 (2019). https://doi.org/10.1177/0739456X17723971
37. Xie, H.: A scoping review of gamification for mental health in children: Uncovering its key features and impact. Archives of Psychiatric Nursing, 41, pp. 132–143 (2022). https://doi.org/10.1016/j.apnu.2022.07.003
38. Wang, I. F., Wang, D., Chen, C. Y., Jheng, J. F.: PinchFun: A Fine Motor Training Game for Preschool Children with Developmental Delay. In: Proceedings of the 2016 CHI Conference Extended Abstracts on Human Factors in Computing Systems, pp. 152–155. Association for Computing Machinery (2016) https://doi.org/10.1145/2851581.2890371
39. Winnick, S., Lucas, D. O., Hartman, A. L., Toll, D.: How do you improve compliance? Pediatrics, 115(6), pp. E718-e724 (2005). https://doi.org/10.1542/peds.2004-1133
40. WHO – World Health Organisation. 2023. Rehabilitation. Available at https://www.who.int/news-room/fact-sheets/detail/rehabilitation (Accessed February 23, 2024)
back to Table of Contents