Study On Construction And Preliminary Application Of Inhalants Guidance Program For Patients With COPD Based On Serious Game

Objective:The purpose of this study is to construct "Inhalants guidance program for patients with COPD based on Serious Game" through Literature review,Semi-structured Interview,expert group discussion and to design the serious game combing with Agile Software Development,and preliminary apply the program to COPD patients to verify its effect.Method:The study was divided into three parts.First,we worked out the domestic and foreign guidelines,expert consensus,randomized controlled trials and systematic reviews related to inhalants guidance of COPD patients by systematic retrieval of Chinese and English databases.With reference to the content of literature,and combined with the result of semi-structured interview for 8 COPD patients,the draft of " Inhalants guidance program for patients with COPD" was formulated.Then,the program was further revised and improved through expert group discussion,forming the final draft of "Inhalants guidance program for patients with COPD".In the second part,we designed and developed the Serious Game based on this proposal,combing with the concept of agile software development.In the third part,30 COPD patients using inhalants were enrolled by the convenience sampling method from the outpatient clinic of a tertiary care hospital in Suzhou City from October to November 2022.The patients were instructed to try Serious Game after obtaining informed consent,and complete the initial application.Results:1.Construction of "Inhalants guidance program for patients with COPD based on Bloom’s Taxonomy of Cognitive"(1)After systematic retrieval and screening of the database,8 guidelines,2 expert consensus,3 randomized controlled trials and 1 systematic review were finally included.We formed the first draft of "Inhalants guidance program for patients with COPD" based on Bloom’s Taxonomy of Cognitive,combining with the results of semi-structured interview.The inhalants guidance program consists of 4 parts,including disease and therapeutic baseline,inhalation techniques,precautions,medication side effects and prevention.(2)A total of 10 experts participated in the expert group discussion,and the positive coefficients were 100%,the expert authority coefficients were 0.84.After two-round expert group discussions,the final draft was formulated,which consists of seven modules and 120 valid items,each containing basic knowledge,inhalation techniques,precautions and adverse effects,and so on,for seven different inhalation devices:pressurized metered—dose inhalers(pMDI),Handihaler(?),Breezhaler(?),Turbuhaler(?),Diskus(?),Ellipta(?) dry powder inhalers(DPI)and nebulizer.2.Design and development of Serious Game based on "Inhalants guidance program for patients with COPD"Serious Game based on inhalants guidance was developed with seven pre-defined interactive modules targeting different inhaler devices,each containing three blocks:"knowledge hall","skills training room",and "test place".The first two modules belonged to the training component of the hospital scenario,and the "test place" module belonged to the home appraisal scenario.Taking into account the actual R&D costs and the regional prevalence of inhaler device use among patients with COPD,this study ultimately has completed the development of the Turbuhaler(?) and Diskus(?) modules.3.Preliminary application of inhalants guidance program for COPD patients based on Serious GameThe inhalants guidance program for patients with COPD is presented as a serious game,so that the preliminary applications included both a usability test of the serious game and an evaluation of the patient’s application effectiveness.30 patients with COPD using these two types of inhaler devices were included in the study and were instructed to try out a serious game.During the period of game usage,the system did not break down.The average time was 8.73 minutes,and the occurrence of operational errors was 1.98%,and the rate of requesting assistance was 2.22%;more than 90.00%of patients were satisfied with the ease of use and usability of the game,93.33%of patients believed that the game scenario setting matched the knowledge they needed,and 90.00%of patients believed that the game satisfied their desire for inhaler knowledge;93.33%of patients were generally satisfied with the use of the game,and 90.00%of patients were willing to recommend the game to others.However,some patients also suggested improvements such as making the game more interesting.In terms of application effectiveness,key steps of the inhalation technique were significantly improved in 73.33%of patients after experiencing the game;medication forbearance showed varying degrees of improvement in 53.33%of patients.According to the analysis of interview data,it can be seen that the experience of serious game is better,and we get fairly good application effect for patients.Conclusion:1.The Inhalants Guideline program is strong scientific and practical based on literature review,semi-structured interviews,and expert group discussion.2.The serious game designed by this study has clear modules,practical contents,appropriate targets,and which is beneficial for COPD patients to pertinently mater the knowledge of relevant inhaler modules.3.The inhalants guidance program for COPD patients in the form of a serious game has good usability and a good user experience,which can meet the need for inhalants guidance and have some effect on improve inhaler technique and adherence and high patient satisfaction.