Scoping Review of Gamification in Rehabilitation Care of Adults With Chronic Illnesses

Background Gamification uses game-based mechanics, aesthetics, and game thinking to engage people, motivate action, promote learning, and solve problems. However, gaps remain in understanding and implementing gamification in rehabilitation care, necessitating further exploration and clarification of the best evidence for application of gamification. Objective To conduct a scoping review of the use of gamification in rehabilitation care for adults with chronic illnesses, summarizing the scope, forms, elements, guiding theories, effectiveness, and ease of use of gamification. Methods Eight databases in English or Chinese were searched from January 1, 2011 to May 20, 2024 following the standard scoping review framework. Results A total of 24 papers were included. Gamification was applied in the rehabilitation of endocrine, skeletal, circulatory, neurological, and cerebrovascular diseases, primarily using virtual reality and three-dimensional forms. Eight gamification elements were most commonly utilized. Positive outcomes included enhanced rehabilitation knowledge, improved attitudes, better physical function, and increased self-care ability. Most patients found gamified rehabilitation care engaging and easy to use. Discussion The application of gamification in adult chronic disease rehabilitation care shows great promise. However, the lack of theory-driven or longitudinal data in some studies highlights the need for more randomized controlled and longitudinal research to explore the effectiveness of gamified intervention.

Systematic Review and Meta-Analysis of Psychological Distress and Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Consequences

Background People with chronic obstructive pulmonary disease (COPD) occasionally develop acute exacerbation of COPD—a potentially fatal condition. Psychological distress was associated with acute exacerbation of COPD. However, the evidence on the effect of psychological distress on acute exacerbation of COPD remains unclear. Objective The aim of this study was to explore the influence of psychological distress on acute exacerbation of COPD and its consequences. Methods The current review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using three databases (PubMed, CINAHL, and PsyINFO) that were searched to identify relevant articles. Pooled risk ratios and 95% confidential interval were calculated from the included studies’ data with random-effect methods to estimate the effect of psychological distress on acute exacerbation of COPD and its consequences. Results Nineteen articles were included in the review. Most revealed that psychological distress was significantly associated with increased risk of acute exacerbation of COPD and its consequences. The meta-analyses showed that psychological distress increased risk of acute exacerbation of COPD, COPD-related hospitalization, and death. Conclusion Psychological distress had negative effects on acute exacerbation of COPD and its consequences. The results of the meta-analyses show that persons with COPD and psychological distress had a greater risk of acute exacerbation of COPD, hospitalization, and death.

Experiences and Perceptions of E-Cigarette Cessation for Young Adults in Rural Communities

Background Electronic nicotine delivery systems (ENDS), also known as e-cigarettes, are the most commonly used tobacco products among young adults in the United States. Young adults in rural areas have a higher prevalence of ENDS use compared to their urban counterparts, yet there is limited evidence regarding the in-depth understanding of experiences and perspectives directly from young adults. Objectives The aim of this study was to explore individual experiences and perspectives about use and cessation of ENDS from young adults in rural areas. Methods This was a qualitative study using interpretive description for analysis. Young adults (18–24 years) who used ENDS every day but not other tobacco products (cigarettes, smokeless, etc.) in the past month and had an address in a rural county of Wisconsin were eligible; there were nine participants interviewed using Zoom. Interview questions focused on initial use, maintenance of use, experiences of quitting, and social and rural environmental contexts regarding ENDS. Results Three themes emerged with eight categories: (a) addiction to ENDS and health, (b) cessation and resources, and (c) rural environment and culture in ENDS addiction. Discussion Findings have implications for ENDS cessation interventions targeting young adults in rural areas.