Evaluating a serious game to improve childhood cancer patients' treatment adherence

Objective: Childhood cancer patients need to have good treatment adherence. Unfortunately, treatment non-adherence often occurs due to high side-effect burdens of treatment and the lack of knowledge of one's illness and treatment. Therefore, a serious game intervention based on the Protection Motivation Theory (PMT) was designed and developed to motivate childhood cancer patients to undergo treatment and to motivate them to undergo treatment, perform daily self-care and educate them about their illness. Methods: Childhood cancer patients (6-17 years old) and their caregivers were recruited in a multi-centre, single-arm intervention in Malaysia. A total of 24 child-caregiver dyads have completed the study. This study used PMT-based surveys to collect quantitative data regarding children's motivation to adhere to treatment and perform daily self-care. Additionally, a 20-question multiple-choice quiz was used to determine children's knowledge levels. These surveys were conducted pre-test and post-test. Children's and caregivers' feedback were also gathered post-test as qualitative data. Results: The results showed that overall, the children's intention to undergo cancer treatment had increased significantly. A significant increase in the intention to perform daily self-care was found among younger children, while older children showed significant improvement in their cancer knowledge levels. The post-test feedback suggested that the game was liked by both children and caregivers and it provided various benefits to children with cancer. Conclusions: Findings suggest that the intervention has the potential to improve childhood cancer patients' motivation for treatment adherence and daily self-care, in addition to educating them about cancer and treatment.