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

Brynja Ingadottir; Katrin Blondal; David Thue; Sigridur Zoega; Ingela Thylen; Tiny Jaarsma

doi:10.2196/games.6894

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

JMIR Serious Games. 2017 May 10;5(2):e10. doi: 10.2196/games.6894.

Authors

Brynja Ingadottir^{1

2

3}, Katrin Blondal^{1

3}, David Thue⁴, Sigridur Zoega^{1

3}, Ingela Thylen⁵, Tiny Jaarsma²

Affiliations

¹ Landspitali - the National University Hospital of Iceland, Surgical Services, Reykjavik, Iceland.
² Division of Nursing, Department of Social and Welfare Studies, Linkoping University, Linkoping, Sweden.
³ Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
⁴ School of Computer Science, Reykjavik University, Reykjavik, Iceland.
⁵ Department of Cardiology and Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden.

Abstract

Background: Postoperative 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.

Objective: The 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.

Methods: A 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.

Results: Theories 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).

Conclusions: A 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.

Keywords: evaluation studies; knowledge; pain management; patient education; self care; surgical procedures, operative; video games.

©Brynja Ingadottir, Katrin Blondal, David Thue, Sigridur Zoega, Ingela Thylen, Tiny Jaarsma. Originally published in JMIR Serious Games (http://games.jmir.org), 10.05.2017.