Moving on: Use of Computer Games During Transitional Care for Young People with Long Term Medical Conditions

Young people with long-term medical conditions eventually have to 'transfer' from child to adult care. Transition involves careful planning and preparation for this event. Predictors for successful transition include increasing independence, active involvement in self-care and the ability to independently discuss care with the doctor. However, many young people and their families feel that they are not adequately prepared for transition. They can find it difficult to get information in an appropriate, age-related format. Therefore there is interest in how information can be presented in a youth-friendly way and how technology might support this. We have reviewed the literature for issues that are common to young people with long-term conditions and their needs as they move into adult care. The impact of computer games on healthcare education was also reviewed with findings extrapolated to scenarios where they might be of benefit during transition. Several computer games have been developed and evaluated in young people. Improvements in knowledge, self-efficacy, adherence to treatment and improved communication were reported. However the games were often disease specific meaning that their information cannot be generalised to other long term conditions. Some of the important skills required for transition include self-advocacy, teaching of age appropriate self-management, improved communication skills, understanding the importance of compliance to drug therapies and awareness of potential side effects as well as understanding of and being able to distinguish between similar conditions. Some of the inherent characteristics of games which could promote acquisition of these skills include goals, feedback, rewards, challenges and the ability to invoke curiosity and hence encourage involvement in the care process. We have made recommendations for design features that would allow the creation of games for transitional care which would reinforce appropriate skills and provide a format for delivering important health care information. Caveats are the acceptance of games by the young person, different ages and genders as well as by the clinical team. Therefore it will be very important to include these stakeholders when designing and developing health education games.