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GAMES FOR HEALTH EUROPE CONFERENCE 2018
Dreamcatcher
Presented by:
Katrín Jónsdóttir
Vallý Helgadóttir
Background
Children undergoing anesthesia are frequently anxious
• Children who are highly anxious in the perioperative period have a significantly higher incidence
of emergence delirium, pain and maladaptive behavioural changes postoperatively.
Education can reduce anxiety
• Effective interventions for anxiety are play therapy with video modelling, hospital tours or puppet
show and educating parents about distraction and shaping and exposure with the anaesthesia
mask.
• Future educational interventions should focus on internet based interventions tailored to the
specific needs of children and parents
Gunnarsdottir, 2012 (Effectiveness of education on perioperative anxiety in children and adolescents: A systematic review
Challenges
• Short hospitalisation – limited time for
education within the hospital
• Play the game at home - repeat
Dreamcatcher
• Serious game
• Preparation prior to full anaesthesia
• Users:
• Children (age 4 – 7)
• Healthcare professionals
• Families / Caregivers
Aim of the game
To prepare preschool children for
anesthesia by educating them about
what to expect and teach them to
cope with anxiety
Dreamteam
• Katrín Jónsdóttir – RN, multimediadesigner
• Dr. Brynja Ingadóttir - RN, Clinical Nurse Specialist, Assistant Professor
• Karitas Gunnarsdóttir- RN, MSc (Pediatric nursing)
• Berglind Brynjólfsdóttir – Cand. Psych (children psychologist)
• Guðlín Katrín Jónsdóttir – RN, Dipl. Nurse anaesthetist
• Berglind Þorbergsdóttir – RN, Dipl. Nurse anaesthetist
• Björgvin - 14 year old with long experience of surgery and anaesthesia
• Pre-school Teacher
National University Hospital of Iceland
University of Iceland
University of Turku, Finland
Team of nurses, psycologist, users,
designers, programmers
Our environment
• Population 353.000
• 142.000 < 16 years old
• 25.000 < 7 years old
• +1.600 kids undergo operation at LSH
• Native language
https://hagstofa.is and https://www.landspitali.is/
Our environment
• Computer-and online usage
for Icelanders 2002 – 2014
• Three months interval
Ratio of those using computer 
Ratio of those accessing online
https://hagstofa.is/
Our users
The game
The game
Expectations
• Better experience for the child
• Better sleep
• Better wake up!
• For the families / caregivers
• Professional help to the healthcare staff
Next steps
• Complete the development of the
game - first prototype!
• Usability testing – with children
outside hospital playing the game
• Feasibility study within LSH in Iceland
• The modified Yale Preoperative
Anxiety Scale (mYPAS) will be used
to assess anxiety (activity,
vocalization, emotional explicitly
and state of apparent arousal)
Questions?
Comments?

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Dreamcatcher, educational computer game

  • 1. GAMES FOR HEALTH EUROPE CONFERENCE 2018 Dreamcatcher Presented by: Katrín Jónsdóttir Vallý Helgadóttir
  • 2. Background Children undergoing anesthesia are frequently anxious • Children who are highly anxious in the perioperative period have a significantly higher incidence of emergence delirium, pain and maladaptive behavioural changes postoperatively. Education can reduce anxiety • Effective interventions for anxiety are play therapy with video modelling, hospital tours or puppet show and educating parents about distraction and shaping and exposure with the anaesthesia mask. • Future educational interventions should focus on internet based interventions tailored to the specific needs of children and parents Gunnarsdottir, 2012 (Effectiveness of education on perioperative anxiety in children and adolescents: A systematic review
  • 3. Challenges • Short hospitalisation – limited time for education within the hospital • Play the game at home - repeat
  • 4. Dreamcatcher • Serious game • Preparation prior to full anaesthesia • Users: • Children (age 4 – 7) • Healthcare professionals • Families / Caregivers
  • 5. Aim of the game To prepare preschool children for anesthesia by educating them about what to expect and teach them to cope with anxiety
  • 6. Dreamteam • Katrín Jónsdóttir – RN, multimediadesigner • Dr. Brynja Ingadóttir - RN, Clinical Nurse Specialist, Assistant Professor • Karitas Gunnarsdóttir- RN, MSc (Pediatric nursing) • Berglind Brynjólfsdóttir – Cand. Psych (children psychologist) • Guðlín Katrín Jónsdóttir – RN, Dipl. Nurse anaesthetist • Berglind Þorbergsdóttir – RN, Dipl. Nurse anaesthetist • Björgvin - 14 year old with long experience of surgery and anaesthesia • Pre-school Teacher
  • 7. National University Hospital of Iceland University of Iceland University of Turku, Finland Team of nurses, psycologist, users, designers, programmers
  • 8. Our environment • Population 353.000 • 142.000 < 16 years old • 25.000 < 7 years old • +1.600 kids undergo operation at LSH • Native language https://hagstofa.is and https://www.landspitali.is/
  • 9. Our environment • Computer-and online usage for Icelanders 2002 – 2014 • Three months interval Ratio of those using computer  Ratio of those accessing online https://hagstofa.is/
  • 13. Expectations • Better experience for the child • Better sleep • Better wake up! • For the families / caregivers • Professional help to the healthcare staff
  • 14. Next steps • Complete the development of the game - first prototype! • Usability testing – with children outside hospital playing the game • Feasibility study within LSH in Iceland • The modified Yale Preoperative Anxiety Scale (mYPAS) will be used to assess anxiety (activity, vocalization, emotional explicitly and state of apparent arousal)

Editor's Notes

  1. By serious we don´t mean boring!! But serious games are computer games designed for educational purposes, to affect knowledge, attitudes or behaviour¹ AGENDA! Talking points
  2. Children undergoing anesthesia are frequently anxious Children who are highly anxious in the perioperative period have a significantly higher incidence of emergence delirium, pain and maladaptive behavioural changes postoperatively. Education can reduce anxiety Effective interventions for anxiety are play therapy with video modelling, hospital tours or puppet show and educating parents about distraction and shaping and exposure with the anaesthesia mask. Future educational interventions should focus on internet based interventions tailored to the specific needs of children and parents
  3. Katrín Jónsdóttir – RN, multimedia designer, project manager Dr. Brynja Ingadóttir – RN, Clinical Nurse Specialist, Assistant Professor Karitas Gunnarsdóttir- RN, MSc (Pediatric Nursing) Berglind Brynjólfsdóttir – Cand. Psych (children psychologist) Guðlín Katrín Jónsdóttir – RN, Dipl. Nurse Anaestethisnurse anesthesia Berglind Þorbergsdóttir – RN, nurse anesthesia NN – Pre-school Teacher Björgvin – 14 year old with long experience of surgery and anaesthesia Vallý Helgadóttir – co-presenter
  4. Setja inn University of Turku og University of Iceland og Landspitali – University Hospital eða Landspitali – the National University Hospital of Iceland heitir hann fullu nafni Hér gæti líka verið smart að setja inn bara starfsheiti, hvernig er/verður teymið samansett? Sbr mynd á veggspjaldinu okkar
  5. In Dreamcatcher we use the potentials learning abilities of a computergame and teach the children some tricks to control their wellbeing and also inform about the procedure. We do that by giving positive feedback and help them to fill their courage o meter. Teach coping strategies like: relaxation, count to 10, breath, distraction, „go somewhere else“ Collect points and fill your couragemeter! Support empowerment by giving coping strategies and reasources Make something more visual and fun for kids in a difficult situation The setting is an adventure forrest and a walkingpath is leading through it. We are telling a story of child who travelled through the woods, collected courgae and gain friends. In the beginning of the game the child can choose character and a helper/friend. The friend can be a dog, a cat, dragon or a knight and their role is to stay beside the child on the journey throught the woods. On this path the child have to solve some challenges and gain courage points. On the way the storyteller is going to give some pieces of information about the procedure „ from now on you can´t eat“ and later „ from now on you can´t drink“ Show the mask used for anesthesia. Tell about the „ Horrorshower“ The „horrorshower! Is when you have to shower and wash you with Hibiscrub soap (quotation one of our superusers, a boy who have undergone many operations) We will have a courageOmeter in the game and it will grow and grow until full. Visual stimuli. At the end of the journey there is a castle and inside the castle you will find the operation room.
  6. In Dreamcatcher we use the learning abilities of a computergame and teach the children some tricks to control their wellbeing and also inform about the procedure. We do that by giving positive feedback and help them to fill their courage o meter. Teach coping strategies like: relaxation, count to 10, breath, distraction, „go somewhere else“ Collect points and fill your couragemeter! Support selfempowering by giving coping strategies and reasources Make something more visual and fun for kids in a difficult situation
  7. Need for more powerful and modern approach in patient education Of course should we make informations for kids on their terms! Professional and personal interest to make a good equipment for kids, parens and hospitalsstaff in hope to make life better!
  8. The game is going to be ready for test next year. In the beginning we are going to do usability tests with kids which are not going to a hospital, just to get their opinion and input. After that and of course some tweeks and fixes in the game we are going to test Dreamcatcher together with children who are undergoing full anesthisa in a hospital. Development of a short version of the modified Yale Preoperative Anxiety Scale. The modified Yale Preoperative Anxiety Scale (mYPAS) is the current "criterion standard" for assessing child anxiety during induction of anesthesia and has been used in >100 studies.  It is an observational instrument and looks into a) attention of the child b) activity, c) emotional explicity, d) state of apparent arousal