We all know that despite the existence of effective medicines and highly trained healthcare professionals, a majority of patients don’t comply with the treatment regimens or lifestyle changes that could save their lives. To help address the psychological and behavioural barriers that hinder adherence and behavioural change, healthcare communicators and practitioners have been looking to one of the most innovative and engaging media we have today: video games.
Using video games within healthcare isn’t a new idea. Since the early 1980s, video games have been used in patient care to encourage adherence, and work alongside treatments to improve treatment outcomes.
How do video games change behaviour?
The repetitive nature of video game play is thought to be a key mechanism that promotes learning. Using games as a form of pain or stress relief relies more on the immersion and distraction they can offer.
One of the earliest examples of this is in paediatric oncology and the associated side effects of chemotherapy – nausea, vomiting, anxiety and pain. During the study, oncology patients were given a video game to play while they received their chemotherapy. The patients who played the game showed a significant reduction in nausea compared with control patients. The therapeutic effects of the game were attributed to the distraction that it provided, by focusing attention away from side effects.
Snow World
Building on this distractive method of pain management, a team of researchers and game designers developed a virtual reality game for burn patients called Snow World. Players are immersed in a virtual reality world where they fly through icy landscapes shooting snowballs at snowmen and penguins. The game was designed to minimize body motion and distract from pain during wound care. The cool imagery and immersive game play were shown to be a viable alternative to strong drugs. Patients who played the game reported a significant reduction in pain, and fMRI scans showed a reduction in neurological pain signals. Doctors even noted a wider range of movement from patients in physiotherapy sessions.
Packy and Marlon
Video games have not only been used in pain management; gaming has also been shown to be a powerful motivator and behavioural change tool. One well-known example is Packy and Marlon, which was originally made for the Super Nintendo game console system, and modified for children with diabetes. The two main characters, Packy and Marlon, are diabetic elephants who thwart camp invaders while protecting and finding missing supplies (insulin and healthy food). To stay in good shape during four simulated days, players must keep their character’s diabetes under control by measuring and monitoring blood glucose, taking insulin, selecting a balanced diet in three meals and three snacks a day, and handling diabetic emergencies.
A study over 6 months showed that ‘gaming’ patients demonstrated greater self-management, increased communication with parents about diabetes and better adherence to insulin therapy. Most impressively, the ‘gaming’ group had a 77% decrease in diabetes-related emergencies and urgent care clinical visits compared with controls.
Bronciasaurus
A similar example is Bronciasaurus, a video game for young children with asthma. The game is set in a world which is covered in dust because the fan that usually keeps the dust at bay has broken. Players help the in-game characters keep their asthma at bay by avoiding triggers such as dust and smoke while they go on their quest to repair the fan. There are some question-and-answer inserts in the game that need to be answered correctly in order to proceed. A series of studies on the game found that patients’ asthma-related self-concepts, social support, knowledge, self-care behaviors, and self-efficacy improved significantly after playing the game compared with the control group.
The potential for video games in health care is continuing to expand beyond behavioural change and pain management. Most recently virtual reality has demonstrated its use as a unique form of physiotherapy in stroke victims, laying the foundation for gaming to not only be an important adjunct to therapy but to even be part of treatment itself.