Development of a Therapeutic Video Game With the MDA Framework to Decrease Anxiety in Preschool-Aged Children With...

Area of Science:

• Pediatric Oncology
• Game Design
• Child Psychology

Background:

• Preschoolers with acute lymphoblastic leukemia (ALL) face significant anxiety and noncompliance during long-term treatment, increasing healthcare costs.
• Therapeutic video games (TVGs) show potential in reducing anxiety in ill children.
• No TVG specifically designed for Taiwanese preschoolers with ALL was previously available.

Purpose of the Study:

• To develop a TVG for preschool-aged children with ALL using the Mechanics, Dynamics, and Aesthetics (MDA) framework.
• To evaluate the TVG's effectiveness in reducing therapy-related anxiety in this population.

Main Methods:

• A mixed-methods approach involved TVG development (MDA framework), reliability testing with art therapists, and a 6-week randomized controlled trial.
• Participants (preschoolers with ALL) were randomized into an experimental (TVG + usual care) or control group (usual care only).
• Anxiety was measured using the Face Rating Scale (FRS) reported by family caregivers.

Main Results:

• The TVG incorporated six mechanics, four features (character, nursery, tasks, market), and eight aesthetics goals.
• Reliability testing showed high internal consistency (Cronbach's α=.98).
• The experimental group showed a significantly lower mean FRS anxiety score (6.16) compared to the control group (7.45) at 6 weeks (P=.04).

Conclusions:

• The developed TVG significantly decreased anxiety in preschool-aged children with ALL in Taiwan.
• This TVG can serve as a valuable supportive tool for clinicians managing pediatric oncology patients before invasive procedures.
• Further research with increased statistical power is recommended to strengthen findings.