scholarly journals Designing a Virtual World to Mirror the Real Challenges of Life as an Amputee

2020 ◽  
Vol 7 (4) ◽  
pp. 105-110
Author(s):  
Sandra Winkler ◽  
John Kairalla ◽  
Ann Ludwig ◽  
Chris Fowler

The purpose of this research was to further understand the experience of using a customized avatar in a virtual world to practice desired health behaviors. By triangulating the quantitative and qualitative data of 12 amputee participants, we discovered that salient factors of having an amputation had a profound impact on the measure of health outcomes. This in turn masked the measured effect of the virtual self-management intervention on health outcomes. We also learned that our training was not closely enough aligned with the constructs that we measured. We discuss how to address these gaps in future studies including adding serious games to a virtual world environment to facilitate disclosure of and adjustment to the salient factors and to better align the simulations with desired outcomes.

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015452 ◽  
Author(s):  
Elaine Toomey ◽  
James Matthews ◽  
Deirdre A Hurley

Objectives and designDespite an increasing awareness of the importance of fidelity of delivery within complex behaviour change interventions, it is often poorly assessed. This mixed methods study aimed to establish the fidelity of delivery of a complex self-management intervention and explore the reasons for these findings using a convergent/triangulation design.SettingFeasibility trial of the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) intervention (ISRCTN49875385), delivered in primary care physiotherapy.Methods and outcomes60 SOLAS sessions were delivered across seven sites by nine physiotherapists. Fidelity of delivery of prespecified intervention components was evaluated using (1) audio-recordings (n=60), direct observations (n=24) and self-report checklists (n=60) and (2) individual interviews with physiotherapists (n=9). Quantitatively, fidelity scores were calculated using percentage means and SD of components delivered. Associations between fidelity scores and physiotherapist variables were analysed using Spearman's correlations. Interviews were analysed using thematic analysis to explore potential reasons for fidelity scores. Integration of quantitative and qualitative data occurred at an interpretation level using triangulation.ResultsQuantitatively, fidelity scores were high for all assessment methods; with self-report (92.7%) consistently higher than direct observations (82.7%) or audio-recordings (81.7%). There was significant variation between physiotherapists’ individual scores (69.8% - 100%). Both qualitative and quantitative data (from physiotherapist variables) found that physiotherapists’ knowledge (Spearman's association at p=0.003) and previous experience (p=0.008) were factors that influenced their fidelity. The qualitative data also postulated participant-level (eg, individual needs) and programme-level factors (eg, resources) as additional elements that influenced fidelity.ConclusionThe intervention was delivered with high fidelity. This study contributes to the limited evidence regarding fidelity assessment methods within complex behaviour change interventions. The findings suggest a combination of quantitative methods is suitable for the assessment of fidelity of delivery. A mixed methods approach provided a more insightful understanding of fidelity and its influencing factors.Trial registration numberISRCTN49875385; Pre-results.


2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Megan Hofmann ◽  
Charlotte Dack ◽  
Chris Barker ◽  
Elizabeth Murray

This mixed-method study assessed the impact of an internet-based, self-management intervention (“HeLP-Diabetes”) on the psychological well-being of adults with type 2 diabetes. Nineteen participants were recruited from 3 general practices. Data were collected at baseline and at 6 weeks follow-up. Access to HeLP-Diabetes was associated with a significant decrease in participants’ diabetes-related distress (Z=2.04,p=0.04, andd=0.28). No significant differences were found in emotional distress or self-efficacy. The qualitative data found that participants reported improvements including increased self-efficacy and support, better management of low mood, greater diabetes awareness, and taking the condition more seriously. Participants also reported making improvements to their eating habits, exercise routine, and medical management. Some negative experiences associated with using the intervention were mentioned including feelings of guilt for not using the intervention as suggested or not making any behavioral changes, as well as technical and navigational frustrations with the intervention. Internet-based self-management interventions may have the potential to decrease diabetes-related distress in people with type 2 diabetes. The qualitative data also suggests internet interventions can positively impact both psychological and behavioural outcomes of adults with type 2 diabetes.


2016 ◽  
Vol 30 (12) ◽  
pp. 1175-1185 ◽  
Author(s):  
Nienke S Tielemans ◽  
Vera PM Schepers ◽  
Johanna MA Visser-Meily ◽  
Jolanda CM van Haastregt ◽  
Wendy JM van Veen ◽  
...  

Objective: To investigate whether the self-management intervention was implemented as intended. Additionally, we studied involvement in and satisfaction with the intervention among patients, their partners and therapists. Design: Mixed method, prospective study. Setting: Outpatient facilities of hospitals/rehabilitation centres. Participants: Stroke patients, their partners and therapists from the experimental arm of the Restore4Stroke Self-Management study. Intervention: ‘Plan Ahead!’ is a 10-week self-management intervention for stroke patients and partners, consisting of seven two-hour group sessions. Proactive action planning, education and peer support are main elements of this intervention. Main measures: Session logs, questionnaires for therapists, patients and their partners, and focus groups. Data analysis: Qualitative data were analysed with thematic analysis supplemented by quasi-statistics. Quantitative data were reported as descriptive statistics. Results: The study sample consisted of 53 patients and 26 partners taking part in the intervention, and all therapists delivering the intervention ( N = 19). At least three-quarters of the intervention sessions were attended by 33 patients and 24 partners. On a scale from 1 to 10, patients, partners and therapists rated the intervention with mean scores of 7.5 (SD1.6), 7.8 (SD.7) and 7.4 (SD.7), respectively. Peer support was the most frequently appreciated element for participants and therapists. The proactive action planning tool was adequately applied in 76 of the 96 sessions. Conclusion: Although the target audience was reached and both participants and therapists were satisfied with the intervention, the proactive action planning tool that distinguishes the current intervention from existing stroke-specific self-management interventions was only partly implemented according to protocol.


Author(s):  
Lindsey Rosman ◽  
Tiffany Armbruster ◽  
Sayyad Kyazimzade ◽  
Zachary Tugaoen ◽  
Anthony J. Mazzella ◽  
...  

2019 ◽  
Author(s):  
Pablo Rodrigo Guzman Cortez ◽  
Matias Marzocchi ◽  
Neus Freixa Fontanals ◽  
Mercedes Balcells-Olivero

BACKGROUND Computerized mental health interventions have shown evidence of their potential benefit for mental health outcomes in young users. All of the studied interventions available in the review and scientific literature can be classified as "serious games". Serious games are computerized interventions designed from the start with the objective of improving specific desired health outcomes. Moreover, there are reports of users experiencing subjective benefits in mental health after playing specific commercial games. These were games not intentionally made with a therapeutic objective in the design process. An example is the videogame "Journey", first released for the Playstation 3 console in 2012 which won "Game of the Year" in the 2013 D.I.C.E awards. The creator of the game describes the game as a short, 2-3-hour narrative experience in which the player goes through the "Hero's Journey" following a classic 3-part structure. There were more than 100 testimonials from players describing how the game helped them cope with psychological or personal issues. Some of them explicitly described recovering from depressive episodes through playing the game. OBJECTIVE To conduct a pilot test of the efficacy of the videogame Journey in reducing depressive symptoms in an acute impatient setting METHODS Depressive symptomatology was measured before and after the intervention using the Hamilton Rating Scale for Depression (HRSD) The intervention was conducted in an isolated room using a Playstation 3 console with the videogame "Journey" developed by Thatgamecompany. No internet access was allowed. The game was played over the course of 4 30-45 min sessions in a two week period. RESULTS The initial score in the Hamilton Rating Scale for Depression (HRSD) was 30, indicating a very severe depression. After the intervention the HRSD score was 10, showing a mild depression. CONCLUSIONS The Videogame Journey, a commercial game first available for the Playstation 3 console in 2012, was not created as a serious game with potential health benefits. Our pilot test is the first case report of a commercial game showing a potential effect in reducing depressive symptoms, which is consistent with the previous informal reports of users online.


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