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Video Games as Nursing Interventions

Video games and video game systems are a multi-billion dollar industry that is a part of the homes of millions of Americans and even more worldwide (Nayak, 2013). While video games have historically offered entertainment, new games have been developed to offer deeper meaning, and some have been developed for use in healthcare settings, many showing positive effects on patient outcomes when opposed to traditional therapies (Kato, 2010;Merry, Stasiak, Shepherd, Frampton, Fleming, L Rahmani B Rusch, Shattell, & Rana, 2014; Shattell, Rusch, & Rana, 2014). For the Records incorporates video games and film in a multimedia open access website and enhances understanding of young adults with bipolar disorder, attention deficit disorder, eating disorder (anorexia nervosa), and obsessive compulsive disorder. We believe that video games have a place in health care by providing a unique opportunity for nurses to expand the repertoire of nursing interventions. Our involvement in For the Records, and Kagan’s interest in innovative nursing practice (Kagan, Smith, & Chinn, 2014) and in documentary film-making as an innovative research methodology (Kagan, 2009), led us to explore the literature on video games as healthcare interventions. The purpose of this commentary therefore, is to review what we found, and to discuss the potential use of video games as non-pharmacological and potentially effective nursing interventions for enhancing health and quality of life. METHODS We sought to the answer the following question in the review of literature: How have video games been used to treat specific patient problems and populations, and were these video games efficacious? Electronic databases CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE (PubMed), and ProQuest were searched, along with published articles that were highlighted in the popular press, to find articles that met the following inclusion criteria: (1) studied a video game in a healthcare setting; (2) used live subjects (i.e., is not a simulation); (3) used quantitative methods in an effort to show efficacy of treatments (outcomes); and (4) reported outcomes. Articles in academic and professional journals that were displayed at the 2013 Games for Health Conference were also included. The search term ‘video games’ alone yielded too many results about a myriad of issues (many having to do with the ills of video game addiction and the benefits of owning a Nintendo Wii). With respect to the Nintendo Wii, the aim of our study was to find video games designed and built specifically for particular patient problems and populations, and not games, such as Nintendo Wii Bowling, which was designed for the primary purpose of entertainment. Video games tested in relevant studies must have followed McGonigal’s (2011) four traits of a game – they must have goals, rules, a feedback system, and be designed for voluntary participation. Articles that met the inclusion criteria were reviewed and assessed using Whittemore and Knafl’s (2005) methodology for integrative literature reviews, which requires that the data collected from the literature to be ordered, coded, categorized, and summarized into a rational, unified conclusion. Articles that met the inclusion criteria were then read, re-read, and then synthesized into the following categories: background information of video games in health care and benefits of video games for select patient problems and populations (i.e., depression, anxiety, anger management, community psychiatric settings for US veterans, and fall risk, pain management, rehabilitation from stroke, and oncology treatment adherence). We conclude here with a discussion about the viability of video games as nursing interventions, the potential barriers and potential ways to overcome these barriers.