The proliferation of smartphones has changed many aspects of our lives. While some of us may think of smartphones as devices that are mainly for entertainment or communication, they have also attracted attention in medical and psychological contexts as ways to engage with patients. As one example, one study investigated the ways in which a mobile game could enhance the management of breast cancer by the patients themselves (Kim et al., 2018). This article will briefly discuss the procedure used in this study and the findings obtained.
Methods
The participants in this study consisted of 76 women with metastatic breast cancer between the ages of 18 and 65 who were set to undergo cytotoxic chemotherapy. Of the 76 patients, 36 were sorted into the “mobile game play group” and 40 were sorted into the “conventional education group”. Each group was instructed to followed their designated activity over a three-week period (three days a week, 30 minutes a day):
- In the “conventional education group”, participants were given 26 pages of educational material dealing with the side effects of chemotherapy consisting of the following:
- overall guidelines relating to life patterns
- a definition and the purpose of chemotherapy
- the broad side effects of chemotherapy
- individualized educational material comprising each patient’s purpose for chemotherapy
- names of anticancer drugs
- a chemotherapy schedule
- individualized management of side effects and symptoms
- guidance for daily life and mental attitude
- In the “mobile game play group”, participants played an educational game called the ILOVEBREAST game with the following “key pedagogical features”:
- education for preventing the side effects of anticancer drugs
- support for the prevention of side effects of anticancer drugs including numbness, hair loss, and loss of appetite
- encouragement of mood and activity, including exercise, pet walking, cooking, and social game playing, which may facilitate participation in such activities in real life
- self-assessment using a personal avatar
- Participants in the “mobile game play group” were asked the following questions:
- What percentage of game content do you use while playing the game?
- Is the game difficult to play?
- Is the game fun?
- Is the game helpful for taking your medication?
- Does the game provide you with information about breast cancer and treatment?
- Does the game decrease your unease with chemotherapy?
- Do you plan to play ILOVEBREAST during your next chemotherapy session?
- Would you recommend ILOVEBREAST to other patients with breast cancer?
- The following measures were used to examine trial outcomes:
- Time spent for education
- Compliance to medication (assessed using the Korean version of the Medication Adherence Rating Scale (K-MARS))
- Physical and psychological side effects assessed at baseline and at the end of the three-week period with the following measures:
- Nausea, fatigue, decreased appetite, numbness on hand or foot, stomatitis, diarrhea or constipation, hair loss, and skin rash as assessed using a 5-point Likert scale.
- Beck Depression Inventory (BDI)
- Spielberg State-Trait Anxiety Scale
- World Health Organization Quality of Life-BREF Scale
Results
The authors reported the following results from the “mobile game play group”:
- Patients reported finishing 41% of the game’s contents
- More than half of participants (56%) reported that the game was difficult to use
- However,
- 2/3 of these participants (67%) reported that the game was fun
- 61% reported that it was helpful for taking medications
- 74% reported that the game helped them acquire information
- 74% reported that the game was useful in overcoming the side effects of chemotherapy
- 72% were willing to play the game again
- 81% would recommend the game to other patients with breast cancer
Regarding the results obtained from the two groups:
- Participants in the game group spent more time on self-education than those in the control group
- Those in the game group showed improved medication compliance compared to the control group
- Those in the game group reported lower rates of nausea, fatigue, and numbness in the hand or foot compared to the control group.
- Rates of nausea, fatigue, and hair loss were shown to be lower in the game group than in the control group
- Participants in the game group showed a higher QoL than those in the control group
- Scores on the BDI and state anxiety scales were similar between the two groups
Wrapping up
The results of this study suggest that playing a mobile game focused on chemotherapy education is more beneficial than simply reading similar information. Many benefits were found despite the fact that more than half of the respondents reported that the game was difficult to play. This indicates that more accessible mobile games can be used to improve a number of chemotherapy outcomes even more than indicated by the results of this study.
References
Kim, H.J., Kim, S.M., Shin, H., Jang, J.S., Kim, Y.I., Han, D.H. (2018). A Mobile Game for Patients With Breast Cancer for Chemotherapy Self-Management and Quality-of-Life Improvement: Randomized Controlled Trial. Journal of Medical Internet Research, 20(10), e273. doi: 10.2196/jmir.9559.
