為失智症患者設計之「嚴肅遊戲」－可行性與治療效果的評估

Feasibility and effects of serious games for people with dementia: a systematic review and recommendations for future research

白麗

《福祉科技與服務管理學刊》 6卷1期 (2018/04) Pp. 1-15

https://doi.org/10.6283/JOCSG.201804_6(1).1

摘要

現今全球已有近五千萬人罹患失智症，體能活動常是失智症治療項目之一，可延緩如健忘、沒有方向感等症狀。「嚴肅遊戲(serious game)」結合多媒體、娛樂、體能活動等特性，以遊戲方式融入失智症治療能否帶來額外幫助，目前仍未完全證實。本文旨在鑑別現有研究，分析嚴肅遊戲對失智患者的可行性及治療效果，並依據系統性評量研究提出幾點建議，以供為失智症患者設計之「嚴肅遊戲」之參考。本文使用系統性文獻回顧，並於眾多資料庫內以失智症、嚴肅遊戲等關鍵字，在不同領域文獻中搜尋。研究論文的標題、摘要、全文經過篩選之後，只要達到列入條件便會以可行性、治療效果、研究品質的角度切入分析。本文從11,198 份相關研究中，選擇11份納入本文分析。可行性分析顯示嚴肅遊戲應有專人監督、以小組進行，失智患者不懂得怎麼玩遊戲或不熟操作方式時，有人可以從旁協助；嚴肅遊戲另有可促進失智患者人際互動、持續投入遊戲療法的效果。總體來說，嚴肅遊戲大致安全無害，對失智症患者是可行的治療方法。然而由於現有研究數量不多、研究品質不一，導致嚴肅遊戲對失智患者的治療效果究竟有多大幫助，目前仍未完全證實。

關鍵字

失智症 ； 阿茲海默症 ； 嚴肅遊戲 ； 電腦輔助

並列摘要

Background and purpose of study: Over 40 million people worldwide are living with dementia, currently. Physical activity is one treatment option for this target group and delays the occurrence of symptoms, such as forgetfulness or disorientation. So far, it is unclear whether integrating serious games, which combine multimedia, entertainment and training, into dementia therapy can bring additional benefits. The aim of this paper is to identify the available studies, and to analyze the feasibility and effectiveness of serious games for people with dementia. Based on a systematic evaluation of studies, the paper tries to present recommendations for future research. Methods: A systematic literature search was conducted in various databases using key words related to dementia, serious games and different outcome domains (i.e. cognitive and physical functioning, and personal/behavioral aspects). After screening titles, abstracts and full-texts, studies meeting the inclusion criteria were analysed with regard to feasibility, effectiveness and study quality. Results: Out of 11.198 potentially relevant studies, 11 studies were included in the analysis. Feasibility analysis showed that serious games should be played under supervision and in groups in order to support understanding and handling of the technology, to foster social interaction and adherence to the program. Overall, serious games were found to be safe. Six studies with a controlled study design were available for analyzing effectiveness. These studies were of low methodological quality and represented a wide variety of intervention and assessment approaches. Four studies showed that serious games improved cognition, and in one study physical performance improved equally in IG and CG. An added benefit of serious gaming compared to traditional interventions could not be identified. Conclusion: Serious games seem feasible in people with dementia. However, due to the limited number of available studies, the low methodological quality and a large heterogeneity of studies the overall effectiveness of serious games for people with dementia is unclear. Further research with solid study designs combining supervised group-based serious gaming and traditional therapist-led interventions is recommended.

並列關鍵字

Dementia ； Alzheimer's disease ； Serious games ； Computer-assisted