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InterACTIV: An Exploratory Study of the Use of a Game Console to Promote Physical Activation of Hospitalized Adult Patients With Cancer

Patrick Jahn

Nicole Lakowa

Margarete Landenberger

Dirk Vordermark

Oliver Stoll

patient compliance, exercise, exercise therapy
ONF 2012, 39(2), E84-E90. DOI: 10.1188/12.ONF.E84-E90

Purpose/Objectives: To explore the application of the Nintendo Wii™ game console to motivate hospitalized adult patients with cancer to be physically active during treatment periods.

Design: An exploratory study with a mixed-method approach, including descriptive statistics and Mayring's qualitative data evaluation method.

Setting: The Department of Radiation Oncology at the University Hospital in Halle (Saale) in Germany.

Sample: Convenience sample of 7 adult inpatients.

Methods: All patients received physical training for five days for 30 minutes per day with Nintendo Wii. After the last training session, patients were interviewed using a semistructured guideline.

Main Research Variables: Applicability of a motion-activated game console during inpatient treatment periods, patients' distraction from the hospital environment.

Findings: In general, the use of a motion-activated game console in a hospital environment was evaluated positively. Participants showed a high degree of acceptance using this kind of physical activity. Because of the Nintendo Wii, the majority of individuals felt stimulated to become physically active during hospitalization. In addition, all patients lost time awareness and felt distracted from the daily hospital routine. A majority of the patients reported an improved mood state from the game sessions.

Conclusions: The results indicate that a motion-activated game console could be useful to motivate adult patients with cancer to be physically active during hospitalization.

Implications for Nursing: Nurses can recommend the use of game consoles such as the Nintendo Wii for physical exercise; in addition, the motivational effects of playing motion-activated game consoles might be particularly helpful for patients with cancer-related fatigue to overcome barriers and begin exercise.

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    Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., … de Haes, J. C. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85, 365-376.
    Ainsworth, B. E., Jacobs, D. R., Jr., & Leon, A. S. (1993). Validity and reliability of self-reported physical activity status: The Lipid Research Clinics questionnaire. Medicine and Science in Sports and Exercise, 25, 92-98. doi:10.1249/00005768-199301000-00013
    Bandura, A. (1995). Exercise of personal and collective efficacy in changing societies. In A. Bandura (Ed.), Self-efficacy in changing societies (pp. 1-45). Cambridge, England: Cambridge University Press.
    Bandura, A. (1997). Self-efficacy: The exercise of control. Freeman, NY: Worth Publishers.
    Baumann, F., Schüle, K., Kraut, L., & Fauser, A. A. (2005). Auswirkungen von bewegungstherapie bei und nach knochenmark-/stammzelltransplantation [Impact of exercise therapy at and after bone marrow and stem cell transplantation]. Deutsche Zeitschrift für Onkologie, 37, 152-158. doi:10.1055/s-2005-918019
    Burish, T. G., Carey, M. P., Krozely, M. G., & Greco, F. A. (1987). Conditioned side effects induced by cancer chemotherapy: Prevention through behavioral treatment. Journal of Consulting and Clinical Psychology, 55(1), 42-48. doi:10.1037/0022-006X.55.1.42
    Csikszentmihalyi, M. (1975). Beyond boredom and anxiety. San Francisco, CA: Jossey-Bass.
    Fuchs, R. (2006). Motivation für fitness und bewegung [Motivation for fitness and exercise.] In B. Strauss & M. Tietjens (Eds.), Handbuch Sportpsychologie (pp. 270-278). Schorndorf, Germany: Hofmann.
    Hobfoll, S. E. (1988). The ecology of stress: Series in health psychology and behavioral medicine. New York, NY: Hemisphere.
    Kato, P. M., Cole, S. W., Bradlyn, A. S., & Pollock, B. H. (2008). A video game improves behavioral outcomes in adolescents and young adults with cancer: A randomized trial. Pediatrics, 122, e305-e317.
    Knols, R., Aaronson, N. K., Uebelhart, D., Fransen, J., & Aufdemkampe, G. (2005). Physical exercise in cancer patients during and after medical treatment: A systematic review of randomized and controlled clinical trials. Journal of Clinical Oncology, 23, 3830-3842. doi:10.1200/JCO.2005.02.148
    Kolko, D. J., & Rickard-Figueroa, J. L. (1985). Effects of video games on the adverse corollaries of chemotherapy in pediatric oncology patients: A single-case analysis. Journal of Consulting and Clinical Psychology, 53, 223-228. doi:10.1037/0022-006X.53.2.223
    Lazarus, R. S. (1991). Emotion and adaptation. Oxford, England: Oxford University Press.
    Lazarus, R. S., & Launier, R. (1981). Stressbezogene transaktion zwischen person und umwelt [Transactions among individuals and environment relating to stress]. In J. R. Nitsch (Ed.), Stress: Theorien, untersuchungen, maßnahmen (pp. 213-260). Bern, Germany: Huber.
    Mayring, P. (2003). Einführung in die qualitative sozialforschung [Introduction to qualitative research]. Weinheim/Basel, Germany: Beltz and Verlag.
    Redd, W. H., Jacobsen, P. B., Die-Trill, M., Dermatis, H., McEvoy, M., & Holland, J. C. (1987). Cognitive/attentional distraction in the control of conditioned nausea in pediatric cancer patients receiving chemotherapy. Journal of Consulting and Clinical Psychology, 55, 391-395.
    Schmitz, K. H., Holtzman, J., Courneya, K. S., Mâsse, L. C., Duval, S., & Kane, R. (2005). Controlled physical activity trials in cancer survivors: A systematic review and meta-analysis. Cancer Epidemiology, Biomarkers and Prevention, 14, 1588-1595.
    Schneider, S. M., & Hood, L. E. (2007). Virtual reality: A distraction intervention for chemotherapy. Oncology Nursing Forum, 34, 39-46. doi:10.1188/07.ONF.39-46
    Schwarz, R., & Hinz, A. (2001). Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. European Journal of Cancer, 37, 1345-1351. doi:10.1016/S0959-8049(00)00447-0
    Schwenkmezger, P. (2001). Psychologische aspekte des gesundheitssports [Psychological factors of fitness and exercise]. In H. Gabler, J. R. Nitsch, & R. Singer (Eds.), Einführung in die sportpsychologie, Teil 2: Anwendungsgebiete (2nd ed., pp. 237-262). Schorndorf, Germany: Hofmann.
    Sobin, L. H., Gospodarowicz, M. K., & Wittekind, C. (Eds.). (2009). TNM classification of malignant tumours (7th ed.). Hoboken, NJ: Wiley-Blackwell.
    Stoll, O. (1999). Wirken koerper- und bewegungsbezogene interventionen ressourcenprotektiv? Eine studie aus dem bereich des rehabilitations- und behindertensports [Does sports therapy protect resources? Results of a field study in field of adapted physical research]. Psychologie and Sport, 6, 18-22.
    Stoll, O. (2001). Wirkt sportliche aktivitaet ressourcenprotektiv? [Does physical activity protect resources?] Lengerich, Germany: Pabst Science.
    Stoll, O., & Schega, L. (2000). Sporttherapie und ressourceneinschätzungen [Sports therapy and resources evaluation]. Psychologie and Sport, 7, 153-163.
    Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19, 349-357. doi:10.1093/intqhc/mzm042
    Vasterling, J., Jenkins, R. A., Tope, D. M., & Burish, T. G. (1993). Cognitive distraction and relaxation training for the control of side effects due to cancer chemotherapy. Journal of Behavioral Medicine, 16(1), 65-80. doi:10.1007/BF00844755
    Wood, R. T., & Griffiths, M. D. (2007). A qualitative investigation of problem gambling as an escape-based coping strategy. Psychology and Psychotherapy, 80(Pt. 1), 107-125. doi:10.1348/147608306X107881
    Wood, R. T., Griffiths, M. D., & Parke, A. (2007). Experiences of time loss among videogame players: An empirical study. Cyberpsychology and Behavior, 10(1), 38-44. doi:10.1089/cpb.2006.9994