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Wakabayashi H, Mori T, Nishioka S, Maeda K, Yoshimura Y, Iida Y, Shiraishi A, Fujiwara D. Psychological aspects of rehabilitation nutrition: A position paper by the Japanese Association of Rehabilitation Nutrition (secondary publication). J Gen Fam Med 2024; 25:1-9. [PMID: 38240004 PMCID: PMC10792333 DOI: 10.1002/jgf2.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/26/2023] [Indexed: 01/22/2024] Open
Abstract
Psychological aspects of rehabilitation nutrition affect physical, cognitive, and social rehabilitation nutrition. When depression is recognized, not only pharmacotherapy and psychotherapy, but also non-pharmacological therapies such as exercise, nutrition, psychosocial, and other interventions can be expected to improve depression. Therefore, accurate diagnosis and intervention without overlooking depression is important. Psychological aspects of preventive rehabilitation nutrition is also important because depression can be partially prevented by appropriate exercise and nutritional management. Even in the absence of psychological negatives, increasing more psychological positives from a positive psychology perspective can be useful for both patients and healthcare professionals. Positive rehabilitation nutrition interventions can increase more psychological positives, such as well-being, through cognitive-behavioral therapy and mindfulness on their own, as well as through interventions on environmental factors. Consequently, physical, cognitive, and social positives are also expected to be enhanced.
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Affiliation(s)
- Hidetaka Wakabayashi
- Department of Rehabilitation MedicineTokyo Women's Medical University HospitalTokyoJapan
| | - Takashi Mori
- Department of Oral and Maxillofacial SurgerySouthern Tohoku General HospitalKoriyamaJapan
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food ServiceNagasaki Rehabilitation HospitalNagasakiJapan
| | - Keisuke Maeda
- Nutrition Therapy Support CenterAichi Medical University HospitalNagoyaJapan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition ResearchKumamoto Rehabilitation HospitalKumamotoJapan
| | - Yuki Iida
- Department of Physical TherapyToyohashi SOZO University School of Health SciencesToyohashiJapan
| | - Ai Shiraishi
- Center for Sarcopenia and Malnutrition ResearchKumamoto Rehabilitation HospitalKumamotoJapan
| | - Dai Fujiwara
- Department of Rehabilitation MedicineSaka General HospitalShiogamaJapan
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Zhang B, Guo C, Hui V, Wong KP, Liu Y, Liu Z, Xu Y, Xiao Q, Chen SC, Qin J. Evaluating the effectiveness of video-game based swallowing function training in patients with dysphagia: study protocol for a randomized controlled trial. Trials 2023; 24:735. [PMID: 37974234 PMCID: PMC10655413 DOI: 10.1186/s13063-023-07738-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/17/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Dysphagia can lead to serious complications such as aspiration and aspiration pneumonia, timely and effective rehabilitation training can improve the swallowing function of patients. However, the conventional rehabilitation training methods used in clinical settings have shortcomings such as poor adherence of patients. We present the study design of a randomized controlled trial that evaluated whether video-game based swallowing rehabilitation training can effectively improve swallowing in patients with dysphagia and whether it has additional benefits compared with conventional training methods to improve swallowing function and training compliance among patients with dysphagia. METHODS A randomized controlled trial with 4 weeks of intervention and 4 weeks of follow-up will be conducted in a rehabilitation center in Beijing, China. We will enroll 78 patients aged 18-80 years with dysphagia. Participants will be randomly assigned to the experimental group (video-game based swallowing function training) and the control group (conventional swallowing function training). All participants will receive 30 min of training per day, 5 times per week, for a total of 4 weeks. The primary outcome is swallowing function. Secondary outcomes include patients' quality of life, training compliance, and training satisfaction. Outcomes are assessed at baseline (pre-treatment), 4 weeks of treatment (post-treatment), and 8 weeks (follow-up), and the assessor is not aware of the participants' grouping. DISCUSSION The protocol describes a new rehabilitation training method for dysphagia, which involves participant eligibility recruitment, recruitment strategies, and data analysis plan. The results of the study will inform the rehabilitation training and clinical care management of swallowing function in patients with dysphagia. TRIAL REGISTRATION ClinicalTrials.gov, NCT05978700. Registered on 28 July 2023.
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Affiliation(s)
- Bohan Zhang
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Cai Guo
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
- School of Computing and Information Engineering, Hanshan Normal University, Guangdong, China
| | - Vivian Hui
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Ka Po Wong
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Yue Liu
- Tiantan Xiaotangshan Rehabilitation Center, Beijing Xiaotangshan Hospital, Beijing, China.
| | - Zihan Liu
- Tiantan Xiaotangshan Rehabilitation Center, Beijing Xiaotangshan Hospital, Beijing, China
| | - Yanan Xu
- Tiantan Xiaotangshan Rehabilitation Center, Beijing Xiaotangshan Hospital, Beijing, China
| | - Qian Xiao
- School of Nursing, Capital Medical University, Beijing, China
| | - Shu-Cheng Chen
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Jing Qin
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
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Bergmann M, Wollbrandt I, Gittel L, Halbe E, Mackert S, Philipsen A, Lux S. Effects of a video game intervention on symptoms, training motivation, and visuo-spatial memory in depression. Front Psychiatry 2023; 14:1173652. [PMID: 37692312 PMCID: PMC10484510 DOI: 10.3389/fpsyt.2023.1173652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023] Open
Abstract
Background People with Major Depressive Disorder (MDD) often experience reduced affect, mood, and cognitive impairments such as memory problems. Although there are various treatments for MDD, many of them do not address the cognitive deficits associated with the disorder. Playing 3D video games has been found to improve cognitive functioning in healthy people, but it is not clear how they may affect depressed mood and motivation in people with MDD. The aim of this study was to investigate whether a six-week video game intervention leads to improvements in depressed mood, training motivation, and visuo-spatial (working) memory functions in patients with MDD. Methods A total of 46 clinically depressed individuals were randomly assigned to one of three groups: an experimental "3D video gaming" group (n = 14) which played a video game, an active control group (n = 16) which trained with a computer program "CogPack," and a treatment-as-usual group (n = 16) which received a standard clinical treatment including psychotherapy and/or pharmacotherapy. Participants performed a neuropsychological assessment, including self-report questionnaires asking for depressive symptoms, training motivation, and visuo-spatial (working) memory functions before and after the training intervention. Results Regarding depressive symptoms, a significant decrease in the proportion of participants who showed clinical levels of depressive symptoms as measured by the Beck Depression Inventory was only found in the 3D video gaming group. Additionally, mean motivational levels of performing the training were significantly higher in the 3D video gaming group when compared with the active control group. Moreover, whereas the 3D Video Gaming group only significantly improved on one visuo-spatial memory test, the active control group improved in all visuo-spatial memory functions. The 3D video gaming group did not perform significantly better than the CogPack group, and the TAU group. Conclusion Besides a standalone cognitive training, the current findings suggest that cognitive trainings using a video game have potential to increase subjective well-being, show higher levels of training motivation, and lead to improvements in visuo-spatial (working) memory functions in MDD. However, given the mixed and unblinded nature of this study, the results should be interpreted with caution. Further research with larger samples and follow-up measurements is needed.
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Affiliation(s)
- Moritz Bergmann
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
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Babichenko D, Radovic A, Patel R, Hester A, Powell K, Eggers N, Happe D. Evaluating the Feasibility of a Multiplayer Role-Playing Game as a Behavioral Health Intervention in Adolescent Patients With Chronic Physical or Mental Conditions: Protocol for a Cohort Study. JMIR Res Protoc 2023; 12:e43987. [PMID: 37368477 DOI: 10.2196/43987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/28/2023] [Accepted: 04/04/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Numerous studies have revealed that adolescents with chronic physical or mental conditions (CPMCs) are at an increased risk for depression and anxiety, with serious direct and indirect negative effects on treatment adherence, family functioning, and health-related quality of life. As game-based approaches are effective interventions in treating anxiety and depression, we propose to explore the use of a multiplayer role-playing game (RPG) as a potential intervention for social isolation, anxiety, and depression. OBJECTIVE The objectives of this study were to (1) determine the feasibility of using Masks, a multiplayer RPG, as an intervention for social isolation, anxiety, and depression in adolescents with CPMCs; (2) evaluate the viability of the research process; and (3) gauge participation in and engagement with RPG-based interventions. METHODS This study is a remote synchronous game-based intervention for adolescents with CPMCs aged 14-19 years. Eligible participants completed a web-based baseline survey to assess anxiety, depression, and social isolation and to identify their gaming habits. After completing the baseline survey, they participated in 5 moderated Masks game sessions. In Masks, players assume the roles of young superheroes; select their character types, superpowers; and perform actions determined by the game's rule system and dice rolls. All game sessions were played using Discord, a communication platform commonly used by gaming communities. Games were led and moderated by game masters (GMs). After each game session, participants completed surveys to assess changes in anxiety, depression, and social isolation, and their attitude toward the game and the user experience. The participants also completed an exit survey after all 5 game sessions (modified version of the Patient Health Questionnaire and the Generalized Anxiety Disorder Questionnaire, and 17 open-ended questions). The GMs rated each game session and reported on gameplay, player behavior, comfort, and engagement levels of the players. RESULTS As of March 2020, six participants were recruited for the pilot study to participate in moderated web-based game sessions of Masks; 3 completed all game sessions and all required assessments. Although the number of participants was too low to draw generalizable conclusions, self-reported clinical outcomes did seem to indicate a positive change in depression, anxiety, and social isolation symptoms. Qualitative analysis of postgame survey data from participants and GMs indicated high levels of engagement and enjoyment. Furthermore, the participants provided feedback about improved mood and engagement related to weekly participation in Masks. Lastly, responses to the exit survey showed interest in future RPG-related studies. CONCLUSIONS We established a workflow for gameplay and evaluated a research protocol for evaluating the impact of RPG participation on isolation, anxiety, and depression symptoms in adolescents with CPMCs. Preliminary data collected from the pilot study support the validity of the research protocol and the use of RPG-based interventions in larger clinical studies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/43987.
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Affiliation(s)
- Dmitriy Babichenko
- School of Computing and Information, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ana Radovic
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ravi Patel
- School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United States
| | - Alexis Hester
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Koehler Powell
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Nicholas Eggers
- School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United States
| | - David Happe
- School of Engineering, University of Pittsburgh, Pittsburgh, PA, United States
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Bocci F, Ferrari A, Sarini M. Putting the Gaming Experience at the Center of the Therapy-The Video Game Therapy ® Approach. Healthcare (Basel) 2023; 11:1767. [PMID: 37372884 DOI: 10.3390/healthcare11121767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Video games have been increasingly used as a form of therapy for various mental health conditions. Research has shown that video games can be used to treat conditions such as depression, anxiety, PTSD, and addiction. One of the main benefits of video games in therapy is that they can provide a sense of engagement and immersion that traditional therapy methods may lack. Additionally, video games can teach valuable skills such as problem solving, decision making, and coping strategies. Video games can also simulate real-life scenarios, allowing individuals to practice and improve social skills in a safe and controlled environment. Furthermore, video games can provide feedback and track progress objectively and quantifiably. This paper proposes an approach, the Video Game Therapy® (VGT®) approach, where game experience is put at the center of the therapy in a tailored way, connecting the individual patient's personality, the therapy's goals, and the suggested type of video game through the Myers Briggs Type Indicator (MBTI).VGT®'s core assumption is that playing video games could facilitate patients in reaching conditions where traditional methodologies and therapeutic approaches could work best. VGT® was elaborated according to the Adlerian therapy vision and, consequently, the different phases of Adlerian therapy and VGT® match. Despite the use of video games in psychotherapy might have some adverse effects in specific cases, VGT® is currently used in three associations with positive results in promoting emotional experimentation and literacy, social feeling, sense of identity, and activating cognitive processes. Future developments include expanding the use of VGT® further to validate such results from a statistical point of view.
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Affiliation(s)
- Francesco Bocci
- Playability Association, Via Sersane, 56, 25050 Ome, Italy
- Game Science Research Center, Via San Ponziano, 6, 55100 Lucca, Italy
| | - Ambra Ferrari
- Playability Association, Via Sersane, 56, 25050 Ome, Italy
| | - Marcello Sarini
- Game Science Research Center, Via San Ponziano, 6, 55100 Lucca, Italy
- Department of Psychology, University of Milano, Bicocca Piazza Ateneo Nuovo 1, 20126 Milano, Italy
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Habitual Videogame Playing Does Not Compromise Subjective Sleep Quality and Is Associated with Improved Daytime Functioning. Brain Sci 2023; 13:brainsci13020279. [PMID: 36831822 PMCID: PMC9954627 DOI: 10.3390/brainsci13020279] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Research on the effects of videogames (VGs) on health has produced mixed results. Here, we assess the relationships of VG playing with sleep; chronotype; sleepiness; and levels of depression, anxiety, and stress; and how they are modulated by the level of exposure to VGs. Four hundred-and two adult participants (age = 26.2 ± 7.84; 227 F) completed an online survey including questions on VG use and a set of standardized questionnaires. The sample was divided into three groups: habitual gamers (HGs, 42.2%), nonhabitual gamers (NHGs, 36.5%), and non-gamers (NGs, 21.3%). No between-group differences emerged in sleepiness (Epworth Sleepiness Scale) or Pittsburgh Sleep Quality Index measures except the sleep disturbances subscore, which was higher in NHGs. HGs showed delayed bed- and risetimes and higher eveningness (reduced Morningness-Eveningness Questionnaire). HGs and NHGs showed higher depression subscores (Depression Anxiety Stress Scale) but remained in the subclinical range. Moreover, hours/week of VG playing predicted delayed sleep timing, lower daytime dysfunction, and lower sleepiness. Our data suggest that VG playing does not necessarily compromise sleep quality and may even benefit daytime functioning, underlining the need to reconsider the relationships between VG use and health by taking into account possible modulating factors such as habitual VG exposure.
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Li X, Zheng M, Zhang Y, Wang Y, Nie L, Yuan Y, Qian T, Ku Y. Music-based casual video game training alleviates symptoms of subthreshold depression. Front Public Health 2022; 10:961425. [PMID: 35991062 PMCID: PMC9381992 DOI: 10.3389/fpubh.2022.961425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives In this preregistered study, we investigated the beneficial effects of music-based casual video game training on the depression, anxiety and stress symptoms in a cohort of young individuals with subthreshold depression and the underlying mechanisms. Methods The study included 56 young individuals (18–26 years of age) with subthreshold or mild depression based on the Beck Depression Inventory-II (BDI-II) scores between 14 and 19. They were randomly assigned into the experimental group (n = 28) or the control group (n = 28). The experimental group underwent music-based casual video game training for 4 weeks. During the same time, the control group participants conducted daily life activities without any intervention. The study participants in the two groups were analyzed using the Depression Anxiety and Stress Scale (DASS-21) during the baseline before the intervention, as well as DASS-21, Positive and negative Affect Scale (PANAS), General Self-efficacy Scale (GSES), and the Emotional Regulation Questionnaire (ERQ) twice a week during the 4 weeks of intervention. Results The depression, anxiety, and stress symptoms were significantly reduced in the experimental group participants after 4 weeks of music-based video game training compared with the control group. The DAS scores in the experimental group were alleviated in the third and fourth weeks of training compared with the control group. Moreover, analysis using the general linear model demonstrated that the number of training weeks and self-efficacy were associated with significant reduction in depression, anxiety and stress. Furthermore, our results demonstrated that self-efficacy was correlated with positive emotion and emotional regulation. Conclusion Our study showed that music-based casual video game training significantly decreased depression, anxiety, and stress in the young individuals with subthreshold depression by enhancing self-efficacy.
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Affiliation(s)
- Ximeng Li
- Center for Brain and Mental Wellbeing, Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Moyi Zheng
- Center for Brain and Mental Wellbeing, Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Yuchang Zhang
- Center for Brain and Mental Wellbeing, Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Yueyun Wang
- Center for Brain and Mental Wellbeing, Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Lu Nie
- Center for Brain and Mental Wellbeing, Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Yuan Yuan
- School of Art, Sun Yat-sen University, Guangzhou, China
- Yuan Yuan
| | - Tianyi Qian
- Tencent Healthcare, Shenzhen, China
- Tianyi Qian
| | - Yixuan Ku
- Center for Brain and Mental Wellbeing, Department of Psychology, Sun Yat-sen University, Guangzhou, China
- Peng Cheng Laboratory, Shenzhen, China
- *Correspondence: Yixuan Ku
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