A systematic review of game technologies for pediatric patients

[EN] Children in hospital are subjected to multiple negative stimuli that may hinder their development and social interactions. Although game technologies are thought to improve children's experience in hospital, there is a lack of information on how they can be used effectively. This paper presents a systematic review of the literature on the existing approaches in this context to identify gaps for future research. A total of 1305 studies were identified, of which 75 were thoroughly analyzed according to our review protocol. The results show that the most common approach is to design mono-user games with traditional computers or monitor-based video consoles, which serve as a distractor or a motivator for physical rehabilitation for primary school children undergoing fearful procedures such as venipuncture, or those suffering chronic, neurological, or traumatic diseases/injures. We conclude that, on the one hand, game technologies seem to present physical and psychological benefits to pediatric patients, but more research is needed on this. On the other hand, future designers of games for pediatric hospitalization should consider: 1. The development for kindergarten patients and adolescents, 2. Address the psychological impact caused by long-term hospitalization, 3. Use collaboration as an effective game strategy to reduce patient isolation, 4. Have purposes other than distraction, such as socialization, coping with emotions, or fostering physical mobility, 5. Include parents/caregivers and hospital staff in the game activities; and 6. Exploit new technological artifacts such as robots and tangible interactive elements to encourage intrinsic motivation.This work is supported by the Spanish Ministry of Economy and Competitiveness and the European Development Regional Fund (EDRF-FEDER) with Project TIN2014-60077-R.El Jurdi, S.; Montaner-Marco, J.; García Sanjuan, F.; Jaén Martínez, FJ.; Nácher-Soler, VE. (2018). A systematic review of game technologies for pediatric patients. Computers in Biology and Medicine. 97:89-112. https://doi.org/10.1016/j.compbiomed.2018.04.019S891129

Healthy snacks consumption and the Theory of Planned Behaviour. The role of anticipated regret

Two empirical studies explored the role of anticipated regret (AR) within the Theory of Planned Behavior (TPB) framework (Ajzen, 1991), applied to the case of healthy snacks consumption. AR captures affective reactions and it can be defined as an unpleasant emotion experienced when people realize or imagine that the present situation would be better if they had made a different decision. In this research AR refers to the expected negative feelings for not having consumed healthy snacks (i.e., inaction regret). The aims were: a) to test whether AR improves the TPB predictive power; b) to analyze whether it acts as moderator within the TPB model relationships. Two longitudinal studies were conducted. Target behaviors were: consumption of fruit and vegetables as snacks (Study 1); consumption of fruit as snacks (Study 2). At time 1, the questionnaire included measures of intention and its antecedents, according to the TPB. Both the affective and evaluative components of attitude were assessed. At time 2, self-reported consumption behaviors were surveyed. Two convenience samples of Italian adults were recruited. In hierarchical regressions, the TPB variables were added at the first step; AR was added at the second step, and the interactions at the last step. Results showed that AR significantly improved the TPB ability to predict both intentions and behaviours, also after controlling for intention. In both studies AR moderated the effect of affective attitude on intention: affective attitude was significant only for people low in AR

Exploring perspectives of people with type-1 diabetes on goalsetting strategies within self-management education and care

Background. Collaborative goal-setting strategies are widely recommended for diabetes self-management support within healthcare systems. Creating self-management plans that fit with peoples’ own goals and priorities has been linked with better diabetic control. Consequently, goal-setting has become a core component of many diabetes selfmanagement programmes such as the ‘Dose Adjustment for Normal Eating (DAFNE) programme’. Within DAFNE, people with Type-1 Diabetes (T1D) develop their own goals along with action-plans to stimulate goal-achievement. While widely implemented, limited research has explored how goal-setting strategies are experienced by people with diabetes.Therefore, this study aims to explore the perspectives of people with T1D on theimplementation and value of goal-setting strategies within DAFNE and follow-up diabetes care. Furthermore, views on barriers and facilitators to goal-attainment are explored.Methods. Semi-structured interviews were conducted with 20 people with T1D who attended a DAFNE-programme. Following a longitudinal qualitative research design, interviews took place 1 week, and 6-8 months after completion of DAFNE. A recurrent cross-sectional approach is applied in which themes will be identified at each time-point using thematic analyses.Expected results. Preliminary identified themes surround the difference in value that participants place on goal-setting strategies, and the lack of support for goal-achievement within diabetes care.Current stage. Data collection complete; data-analysis ongoing.Discussion. Goal-setting strategies are increasingly included in guidelines for diabetes support and have become essential parts of many primary care improvement schemes. Therefore, exploring the perspectives of people with T1D on the value and implementation of goal-setting strategies is vital for their optimal application

Health and literacy: a study of literacy practices in a day hospital in the Western Cape

Located in the Hout Bay Day Hospital, this research project focused on literacy practices as embedded in social context. In exploring how patients - both those regarded as literate arid non literate - engaged with the discourses of medicine as represented by medical texts, symbols and artifacts, their constructions of identity, agency, voice and meaning within the medical domain were examined. It was at the interface between the formal as represented by the medical institution and the informal, represented by individuals from within the community that diverse literacy practices were encountered. While individuals were dependent on the system for medical entitlements and treatment, they were able to rescript dominant medical literacies and technologies within the context of their own health and social needs. What was more important was not patients' encoding and decoding of medical texts but rather how they used their own socially embedded literacies to mediate and gain access to these health care entitlements and medical treatment and the discursive skills and resources that they employed in doing so. Uncovering the processes whereby patients were able to recontextualize their experiences of medical literacy and technologies in the context of their material and social realities was one of the key issues explored in this thesis. The research findings suggested that a discursive boundary existed between patients' conceptions of health and illness and those presented by the medical institution. An understanding of patients' different discursive strategies and their social constructions was developed through ethnographic research methods. A socio-spatial analysis of 'hidden' literacy practices lead me beyond the confines of print literacy (alphabetic literacy and numeracy) and suggested differing ways of 'seeing' and 'reading' literacy, further broadening the concept of literacy to include body or somatic literacy. The manner in which the patient's body was 'read' and narrated as a text on entering the medical space was examined and interpreted. In addition, the way in which patients created their own space from within formal institutional space was discussed. In conclusion I argue that the ways in which local knowledge is constructed by the recipients of health care needs to be explored and examined and that these constructions should be taken into consideration when planning future health care initiatives

The role of online support groups for parents of adolescents with type 1 diabetes during the transition to adult diabetes services

Paediatric type 1 diabetes is often referred to as a 'family disease' due to the importance of family interactions and parental supervision required to achieve optimal blood glucose levels and quality of life. The treatment regime for this chronic disease in children is complex and requires co-management by parents, many of whom experience psychosocial problems whilst undertaking this responsibility. Parents managing their child’s diabetes care need informational and emotional support that is not always adequately met by existing sources of support. With Internet access becoming increasingly ubiquitous, parents can search online for health information, advice and support, augmented by the use of diabetes online support groups. Previous research has identified potential benefits health-related online support groups can afford patients with chronic health conditions; addressing their information and support needs in a safe, non-judgemental environment with others in a similar situation, shown to empower individuals. However, little is known about the role of diabetes online support groups for parents of children with type 1 diabetes as they transition from paediatric to adult diabetes services during late adolescence; a particularly stressful event for some parents. The present thesis aimed to address this disparity by exploring parents of adolescent’s experiences of using diabetes online support groups during a period of change; investigating if group membership affects psychological well-being and if participation empowers parents. Using a mixed methods approach, three empirical studies were conducted. The first study used an online survey completed by 88 parents. This garnered information about parents’ experiences of using diabetes online support groups. It assessed the illness representations held about diabetes, along with reported levels of parental diabetes distress. Perceptions of empowering processes and outcomes within the diabetes online support groups were also investigated. For Study 2, qualitative one-to-one interviews were carried out with 13 parents who had previously completed the online survey, to gain a greater understanding of parents’ initial motivation to join a diabetes online support group, and what factors influence their continued participation. The final study was a thematic analysis of 945 messages posted on two UK diabetes online support groups to identify and examine the types of social support in group members’ communications. The combined results from the three studies indicate diabetes online support groups play an important role in providing informational and emotional support to parents of adolescents with type 1 diabetes. Furthermore, the availability and reciprocity of social support within diabetes online group were considered empowering by parents, with positive psychosocial benefits noted as being associated with group membership rather than dependant on the level of participation. Findings from this thesis also identified a disparity between mothers and fathers using diabetes online support groups, suggesting a more targeted approach should be considered for future research to investigate fathers’ perspectives and experiences. This thesis provides a deeper understanding of issues pertinent to the use of diabetes online support groups by parents of adolescents with type 1 diabetes. It provides a unique insight into the implications and potential benefits diabetes online support groups can have for the psychological well-being of parents for whom relinquishing control of their child’s diabetes management may be a determinant of increased anxiety, fear and diabetes distress