Exploring the use of games in palliative care: A scoping review.

OBJECTIVE: There has been increasing recognition of the potential of games in health; however, knowledge of their application in palliative care is lacking. Therefore, this study aimed to identify and map the available evidence on the use of games in palliative care, analyzing how research has been conducted on this topic and identifying gaps in knowledge. METHOD: A scoping review was carried out. The literature search was conducted using the respective descriptors and search syntax appropriate to each of the databases searched. The review included all study types with no time limits. RESULTS: Of the 685 articles initially identified, 53 were included for final analysis. Several different game types were identified, with the majority of studies using role-play (n = 29) and card games (n = 17). The games analyzed were essentially aimed at empowering patients (n = 14), and in some cases, extended to families or caregivers, as well as to medical and nursing students. The analysis of the articles in this review resulted in two major themes: Role-playing for training in palliative care and card games to discuss end-of-life care. SIGNIFICANCE OF RESULTS: Games allow space for the expression of emotions and promote creativity. They can be applied both in a training context, to enable health professionals to develop essential skills in palliative care, and for patients, families, and caregivers, allowing them to talk about serious things while playing.

(Re)'Thinking' family in nursing care in pandemic times.

AIM: This study aimed to identify which strategies are being adopted to deal with family restrictions in health units and assess nurses' perceptions of including families in nursing care during the current pandemic. BACKGROUND: Due to the COVID-19 pandemic, health organisations limited access for visitors. INTRODUCTION: Family centred care needs to be guaranteed, and alternatives for face-to-face interaction should be fostered. Therefore, there is an urgent need to rethink the family in nursing care during a pandemic. METHODS: We conducted a descriptive exploratory mixed-method study in Portugal using an electronic questionnaire. The study included 192 nurses recruited using a non-probabilistic convenience sample. The study was reported using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. RESULTS: A total of 41.1% of participants (n = 79) reported that visits to their services were not authorised, and 66.7% (n = 128) reported resorting to video calls because of the restrictions imposed. Regarding attitude assessment, the average score of the scale was 77.9 (SD = 10.0), ranging between 26 and 98. When analysing the different dimensions of the 'Families' Importance in Nursing Care - Nurses Attitudes' scale, family data stand out as a burden. CONCLUSION: Although a large percentage of participants had a positive attitude towards families and tried to find strategies to maintain family centred care, many nurses still considered the family as a burden. The current COVID-19 pandemic may have aggravated this perception. IMPLICATIONS FOR NURSING PRACTICE, NURSING POLICY AND HEALTH POLICY: The continued implementation of family centred nursing practice is essential for child-well-being, including during the current pandemic. Therefore, having intervention policies with alternative forms of care is highly recommended.

Giving Voice to Caregivers: a game for family caregivers of dependent individuals. / Dar Voz aos Cuidadores: um jogo para o cuidador familiar de um doente dependente.

OBJECTIVE: To construct and assess a board game created to promote the effective transition of family members into caregivers of dependent individuals. METHOD: This was a qualitative exploratory and descriptive case study conducted with family caregivers of dependent individuals. RESULTS: The study resulted in the conceptualization, construction, and assessment of the board game. The game proved to be an important family evaluation tool, enabling open communication and interventions in family dynamics. CONCLUSION: The results showed that the game can help build new family narratives, providing an opportunity for open communication, expression of problems and sharing, representing an important family evaluation and intervention strategy.

Family caregivers: what do they need? An integrative review.

OBJECTIVE: Aimed to identify the main needs expressed by family caregivers in caring for adependent person. METHOD: An integrative review of the literature in the period between 2010 and 2015 using specific search engine tools in the EBSCO and SCOPUSdatabases. RESULTS: 11 articles were selected, and the analysis of the scientific evidence obtained allowed for organizing the results into five thematic areas:transition into care, being responsible for everything, the importance of support, access to formal support, communication and informationprocesses. CONCLUSION: The results showed that caregivers have many needs in different areas, which should be addressed in nursing interventions. OBJETIVO: Este estudo teve como objetivo identificar quais as principais necessidades manifestadas pelo cuidador familiar no cuidado à pessoa dependente. MÉTODO: Realizou-se uma revisão integrativa da literatura no período entre 2010 e 2015 com o recurso de instrumentos de busca específicos, nas bases de dados EBSCO e SCOPUS. RESULTADOS: Foram selecionados 11 artigos A análise da evidência científica obtida permitiu organizar os resultados em cinco áreas temáticas: a transição para o cuidar, o ser responsável por tudo, a importância do suporte, o acesso aos apoios formais, a comunicação e a informação na tomada de decisão. CONCLUSÃO: Os resultados demonstram que o cuidador apresenta inúmeras necessidades em áreas distintas,as quais devem ser abordadasnas intervenções de enfermagem.

Game4NurseSupervisor: Development of a board game for nursing mentoring.

AIM: To describe the stages of developing a board game prototype to promote knowledge about nursing mentorship. BACKGROUND: Clinical supervision in nursing is a vital strategy for the quality of care. The use of gamification through a board game can enhance knowledge about mentoring in nursing. DESIGN: We present a pilot study describing the development phases of the board game "Game4NurseSupervisor®." METHODS: The study comprised three phases. The first phase involved a modified e-Delphi study with experts to collect and validate the content to be integrated into the board game. The second phase focused on constructing the prototype of the board game. Finally, the third phase involved testing the prototype in sessions held in two healthcare units, followed by an evaluation through a questionnaire. RESULTS: The e-Delphi study, involving a panel composed of 59 experts, progressed through two rounds, resulting in 61 cards divided into four categories. The second phase involved constructing the board game, incorporating interactive elements such as "Game4NurseSupervisor®." In the third phase, 25 nurses, consisting of clinical practice nurses, participated in the testing phase and expressed satisfaction with the game. Highlighted benefits included reflective, playful, dynamic, interactive and educational aspects. CONCLUSIONS: The conclusions suggest that "Game4NurseSupervisor®" could be a valuable tool for promoting knowledge about nursing mentorship, providing an innovative and interactive approach to skill development. This study makes a valuable contribution by addressing a previously unexplored aspect of nurse mentor training: the potential of board games.

Impact of Exergames on the Rehabilitation of Cancer Patients Undergoing Major Abdominal Surgery: A Randomized Controlled Trial.

BACKGROUND: Exergames can be an appealing strategy that is integrated into post-abdominal surgery rehabilitation. OBJECTIVE: The aim of this study was to assess the effectiveness of exergame rehabilitation in improving independence in activities of daily living (ADLs) and patient balance after abdominal cancer surgery. METHODS: A randomized control-group study was carried out in an oncological hospital in Portugal. Seventy postoperative patients were included, and data collection took place between January 2023 and May 2023. The patients were randomly assigned to either an exergame rehabilitation program (n = 35) or a traditional rehabilitation program (n = 35). The assessed outcomes were the Barthel and Berg scales, and data collection occurred at 3 different time points: admission, 48 hours postoperatively, and on the seventh day after surgery. RESULTS: At the third assessment, a statistically significant difference was observed between the 2 groups for both indicators, ADLs and balance. CONCLUSIONS: There was an improvement in ADLs and balance in the exergames group. By the seventh day after surgery, the intervention group showed improvement in balance and ADLs compared with the control group. IMPLICATIONS FOR PRACTICE: The use of exergames can be a solution to the challenges of traditional rehabilitation methods after abdominal surgery for cancer for postoperative patients. This is the first study carried out in this specific population.

Development and Validation of the Serious Educational Game in Nursing Appraisal Scale.

OBJECTIVES: This study aims to develop and validate the Serious Educational Game in Nursing Appraisal Scale (SEGiNAS), a tool designed to evaluate the implementation of serious games within nurse education contexts of quantity of process, quality of process, and learning outcomes. METHODS AND MATERIALS: This methodological and psychometric study aimed to develop and validate a scale. The item generation phase was based on the cognitive theory of multimedia learning, resulting in a 20-item scale. The validation phase involved evaluating the psychometric scale by surveying 160 Portuguese nurses. RESULTS: A factor analysis revealed a three-factor structure corresponding to the scale's designed dimensions, explaining a total variance of 64.5%. The scale demonstrated high internal consistency for all factors, including engagement and teaching effectiveness (0.925), learning impact and practical application (0.883), and content relevance and clarity (0.848). The dimensions were engagement and teaching effectiveness, learning impact and practical application, and content relevance and clarity. CONCLUSIONS: The SEGiNAS scale represents a valid and reliable tool for evaluating serious games in nursing education. Its development fills an existing gap in assessing the teaching-learning process with serious games. This study was not registered.

RehabApp to promote patient participation in the rehabilitation process after HIP replacement: Development and usability study.

OBJECTIVE: This study aims to present the developmental stages of a Mobile App Prototype designed to enhance patient participation in the rehabilitation process after hip replacement. METHODS: To ensure effective interaction between the system and the end user, a User-Centered Design methodology was followed, encompassing three phases: Requirements gathering, Prototyping, and Evaluation. Usability tests were conducted to assess the usability of the developed system. RESULTS: The RehabApp for mobile devices was created, and the testing results were positive. Users expressed satisfaction with the outcome, deeming it a valuable tool for their recovery. This outcome demonstrates the high receptiveness of these technologies in the healthcare sector, making it a project that can readily be expanded into other areas of rehabilitation. CONCLUSION: This study demonstrated the potential of the RehabApp in the rehabilitation process after hip replacement surgery. This accomplishment was realized by ensuring the active participation of patients, potential users, and healthcare professionals throughout the app's development. INNOVATION: The RehabApp is a mobile application to provide users with all the necessary knowledge, enabling them to undergo a smoother and safer rehabilitation. Feedback from both patients and healthcare professionals played a crucial role in refining the app's features and addressing usability concerns.

Exergame-based rehabilitation for cancer patients undergoing abdominal surgery: Effects on pain, anxiety, depression, and fatigue - A pilot study.

PURPOSE: This study aimed to determine the efficacy of an exergame rehabilitation program on pain, anxiety or depression, and fatigue in oncology patients undergoing abdominal surgery. METHODS: The randomized controlled trial evaluated the efficacy of exergame rehabilitation on Pain, Anxiety, Depression, and Fatigue in oncology patients undergoing abdominal surgery. Patients were recruited from October 2022-March 2023 and were randomly assigned to the intervention group (postoperative traditional rehabilitation plus an exergame rehabilitation program) or control group (postoperative traditional rehabilitation). Data were collected at three different times: on admission, in the first 48 h, and on the 7th day after surgery. Primary outcomes were evaluated and monitored with different validated instruments: numeric rating scale (NRS) for pain, Hospital Anxiety and Depression Scale (HADS) to assess the level of anxiety and depression, and the Fatigue Assessment Scale (FAS) to assess physical and psychological fatigue. The length of stay and program completion were secondary outcomes. RESULTS: A total of 128 postoperative patients were recruited. Of these, 58 patients were excluded from the study due to clinical complications related to the surgical procedure (n = 53) or healthcare staff-related reasons (n = 5). Both the control and intervention groups were the same size (n = 35). Lower pain scores were observed on the 7th postoperative day in the group subject to the "exergame rehabilitation program" (p = 0.006). No statistically significant differences were observed for anxiety and depression between the 2 groups. Regarding fatigue, statistically significant differences were observed on admission (p = 0.03), which disappeared 48 h after surgery (p = 0.143). Differences between the groups were observed again on the 7th day after surgery (p = 0.005). CONCLUSIONS: The intervention using exergames was effective in reducing the postoperative pain of the patient undergoing major abdominal surgery and in restoring the levels of fatigue before surgical intervention. However, no differences were observed for anxiety or depression. Future studies with larger samples should be carried out.

Patients with cervical spondylotic myelopathy and dependency in activities of daily living during hospitalization-descriptive and correlational study.

Background and Aim: Cervical spondylotic myelopathy (CSM) causes progressive spinal cord compression and consequent functional decline. Surgical decompression is considered effective in halting disease progression, producing improvements in neurological prognosis. During hospitalization, several conditions may alter these patients' dependency levels. This study aimed to describe patients with CSM and their evolution regarding dependence in activities of daily living (ADL), from hospital admission to discharge. Methods and Materials: Descriptive and correlational study based on document analysis. Results: Included 96 files of patients with CSM who were admitted to Neurosurgery Department. The sample was 58.3% men, with a mean age of 64.4 years. Of the participants, 96.9% had surgery, mainly an anterior cervical approach. Hygiene was the ADL involving most dependence, both at admission (39.6%) and at discharge (71.9%). Worsening of dependence levels in ADLs was found at the midterm evaluation (mean 13.34; SD 5.59) and at discharge (mean 11.59; SD 5.28) in relation to the functional condition at admission (mean 9.77; SD 6.06). Gender was not associated with any differences, but age and days of hospitalization were associated with variations in participants' dependency levels (P<.05). Conclusion: The level of dependence on ADLs increased during the hospitalization of patients with CSM.

Nurse-Led Approaches to Lowering Alcohol Use among Adolescents: Study Findings.

This study delves into how motivational sessions and brief interventions impact students' alcohol consumption, highlighting the vital role of nurses in fostering positive behavioural changes. The study aims to discern the effects of these interventions, starting with a pre-and post-intervention setup involving 62 students from a private school in northern Portugal. The intervention comprised a session delivered by school and mental health nurses, utilizing the motivational intervention and FRAMES method and a poster offering feedback on alcohol consumption scores. The results indicated that females tended to drink for fewer days and engage in less binge drinking than males. Furthermore, the intervention hinted at a reduction in the number of heavy drinking days. This study underscores the importance of including healthcare professionals, particularly nurses, in delivering brief interventions within school settings. The findings carry weight for crafting evidence-based interventions to cultivate healthier adolescent behaviours and enhance overall well-being.

Practices of primary health care nurses in the care for people in psychological distress.

OBJECTIVE: To understand the practices of nurses working in Primary Health Care in caring for people in psychological distress. METHOD: Qualitative study conducted with 30 nurses working directly in Primary Health Care. Data were collected from January to March 2023 through semi-structured interviews, which were fully transcribed. The resulting material was organized in the IRaMuTeQ® software and subjected to the thematic content analysis, anchored in the precepts of Eric Cassell's Theory of the Nature of Human Suffering. RESULTS: Five categories emerged: 1. Causes of Psychological Distress (14.65%), 2. Needs of the person in psychological distress (31.3%), 3. Team case discussions (26.5%), 4. Care network for the person in psychological distress (15.99%) and 5. Care instruments (11.57%). FINAL CONSIDERATIONS: The practices that nurses perform involve listening spaces to express feelings, case discussions within the team and matrixing and the understanding that psychological distress is the result of environmental, social, and family factors. However, they report a lack of training to assess individuals experiencing psychological distress and request the development of institutional protocols and training to support care.

Digitisation of patient preferences in palliative care: mobile app prototype.

BACKGROUND: Engaging in advance care planning can be emotionally challenging, but gamification and technology are suggested as a potential solution. OBJECTIVE: Present the development stages of a mobile app prototype to improve quality of life for patients in palliative care. DESIGN: The study started with a comprehensive literature review to establish a foundation. Subsequently, interviews were conducted to validate the proposed features of the mobile application. Following the development phase, usability tests were conducted to evaluate the overall usability of the mobile application. Furthermore, an oral questionnaire was administered to understand user satisfaction about the implemented features. RESULTS: A three-phase testing approach was employed based on the chosen user-centred design methodology to obtain the results. Three iterations were conducted, with improvements being made based on feedback and tested in subsequent phases. Despite the added complexity arising from the health status of patients in palliative care, the usability tests and implemented features received positive feedback from both patients and healthcare providers. CONCLUSION: The research findings have demonstrated the potential of digitisation in enhancing the quality of life for patients in palliative care. This was achieved through the implementation of patient-centred design, personalised care, the inclusion of social chatrooms and facilitating end-of-life discussions.

The use of games by nurses in palliative care: a scoping review.

Background: Nursing is at the forefront of palliative care. Games are an innovative strategy in palliative care training. Aims: This study aimed to examine the usefulness of games for nurses in palliative care. Methods: A scoping review was conducted using the following databases: CINAHL and PUBMED (which includes MEDLINE, PsycINFO, SCOPUS and SciELO). The steps outlined by the Joanna Briggs Institute were followed. Findings: Of the 685 articles initially identified, 17 were included for analysis. Games used were role-play (n=12), card games (n=1), digital games (n=1), board games (n=1), reflection games (n=1) and experimental games (n=1). Games were aimed at nurses (n=6) and nursing students (n= 1 1). Game advantages included: improved palliative care knowledge, increased communication skills, reduced negative emotions and increased multidisciplinary team skills. Conclusions: Effective and innovative pedagogical techniques are required training techniques for nurses and nursing students who provide palliative care, as they can reduce negative emotions such as fear, anguish and guilt.

Older person's experience of PT4Ageing-A programme on self-management «support¼ in chronic illness.

OBJECTIVE: This study sought to describe the experience of a group of older adults who participated in a chronic illness self-management program. METHODS: The study employed a qualitative phenomenological approach. Participants were eight elders and data collected using semi-structured interviews Data was analysed using thematic analysis. RESULTS: Five themes emerged from the analysis: (1) Tips to improve our daily lives, (2) I was always motivated, (3) Sharing and mutual help, (4) They made us believe we were capable (5). It would be great if it did not end here. Globally, the participants of the program described their experience as very positive. They identified gains from participating in the program, such as learning strategies to help them cope with their health problems, improving their ability to manage their illnesses more autonomously and building social support, that even persisted after the conclusion of the intervention. CONCLUSION: The findings of this study provide insight into how older adults experience a program for the self-management of chronic illness. For the development of future programs, support building must be considered. Older adults who participate in self-management programmes exhibit improved self-efficacy in relation to the management their chronic illnesses and greater autonomy in self-care.

Perception of Nursing Activities That Contribute to the Quality of Care: Validity and Reliability Testing of the French Version.

Background and purpose: Measuring nurses' perceptions of the activities contributing to the quality of care needs to be emphasized, providing visibility to professional practice and their contributions to achieving health quality. This study aimed to translate, validate, and culturally adapt the "Perception of Nursing Activities that Contribute to the Quality of Care" (EPAECQC), scale to provide a reliable instrument to assist nurse managers in measuring nurses' perceptions of their activities in French reality. Methods: A quantitative, descriptive, and cross-sectional study, in two phases, was conducted. First, by translation and cultural adaptation, and second, through the validation of the scale. Results: The factor structure of the final version was reduced to 22 items. Content and construct validity and reliability were supported by internal consistency (Cronbachs' alpha = .913). Conclusions: The results show that the final version is a reliable and valid instrument, showing a high potential to be used in research and clinical practice.

Developing a Card Game for Assessment and Intervention in the Person and the Family in Palliative Care: "Pallium Game".

Communication between the multidisciplinary team, the person, and the family in palliative and end-of-life situations implies, in most situations, a high negative emotional burden. Therefore, innovative strategies are needed to reduce it. The goal of this study is to describe the various stages of development and validation of a collaborative card game for people in palliative care and their families. Phase one is an exploratory study, Phase two is a Delphi study, and Phase three is a multiple case study. Participants for phases 2 and 3 were recruited using a convenience sampling method. The results demonstrate in an organized and structured way the different phases required to build a collaborative card game. The use of the game was found to be useful and effective. Four categories emerged from the content analysis of the open-ended responses: usability, evaluation tool, communication and therapeutic relationship, and meaning when using the game. A collaborative game in palliative care helps to create a space for individuals and families to express feelings and experiences, meeting the myriad of physical, psychosocial, and spiritual needs. The "Pallium game" is a useful and impactful approach to discussing sensitive topics in palliative care.

Healthcare Experience of People with Acute Spinal Cord Injury: A Phenomenological Study.

Living with spinal cord injury (SCI) is a challenge that begins in the acute phase, when the disease, the limitations, and the treatments fill the days at the hospital. This study aims to understand the healthcare experience of the person with SCI in the acute phase, based on the Activities of Living Nursing Model (ALNM). It is a qualitative and phenomenological study based on the Standards for Reporting Qualitative Research. Data were collected via semi-structured interviews. Content analysis was performed using the ATLAS.ti software and Bardin's methodology. The article was written following the COREQ guidelines. The categories were defined using the Roper-Logan-Tierney Model for Nursing. The sample included 16 people with incomplete SCI, different etiology, and neurological levels. Eleven of the twelve ALNM emerged from the interviews. The activities of mobilizing, eliminating, maintaining a safe environment, and communicating were emphasized the most. Controlling body temperature was not relevant. Mobility deficits and pain increased dependence. Feelings of motivation, encouragement, and frustration were highlighted. Professional expertise, rehabilitation resources, and support equipment promoted independence. The results in this sample revealed that people with SCI in the acute phase have complex challenges related to dependence awareness and treatments, but they always keep recovery expectations in mind.

The potential of games for vulnerable groups like refugees: a scoping review.

OBJECTIVE: To map existing studies on the development of games for refugees, identifying the developed games, characteristics and possible application to health care. METHOD: A scoping review study, carried out in July 2022, using the MEDLINE® (Medical Literature Analysis and Retrieval System Online), CINAHL® (Cumulative Index to Nursing and Allied Health Literature), SPORTDiscus, Scopus, SciELO (Scientific Electronic Library Online), Psychology and Behavioral Sciences Collection, Cochrane Central Register of Controlled Trials databases. RESULTS: 8 studies were identified, with 8 different types of games published between 2016 and 2022. The characteristics of the games found essentially fall on their use to increase empathy towards refugees. CONCLUSION: This study identifies opportunities to strengthen the current body of knowledge in nursing, using games as ways of welcoming, training and integrating populations in situations of social vulnerability in which refugees find themselves.

Exergames to Improve Rehabilitation for Shoulder Injury: Systematic Review and GRADE Evidence Synthesis.

INTRODUCTION: The use of exergames has become an increasingly frequent intervention in rehabilitation, referred to as a fun and motivating activity that involves patients. This systematic review aimed to evaluate the effectiveness of exergames in the rehabilitation of the shoulder joint compared to other types of care. METHODS: We performed a systematic review and GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) evidence synthesis. The search was conducted using the following databases: MEDLINE, CINAHL, SPORTDiscus, SCOPUS, SciELO, Psychology and Behavioral Sciences Collection, Cochrane Central Register of Controlled Trials, and PEDRo. Databases were searched from the first record until July 2021. Randomized controlled trials using exergames as an intervention were included. RESULTS: The search resulted in 1,048 records. A total of 10 articles published between 2013 and 2020 met inclusion criteria and were reviewed for this study. A positive impact was observed in using exergames to increase shoulders' range of motion, namely, extension, flexion, abduction, internal and external rotation, and functionality postinjury. CONCLUSIONS: The results of this review provide evidence of the benefits of exergames in shoulder joint rehabilitation. However, more robust clinical trials need to be developed that assess the effectiveness of using exergames as a complement to traditional rehabilitation and assess participants' degree of satisfaction, motivation, and adherence.