Effectiveness of a gamified mobile health intervention for children and parents in pediatric day surgery: Randomized controlled trial

This study assesses the effectiveness of a gamified mobile health intervention designed for the pediatric day surgery pathway in reducing children's anxiety, fear, and pain, as well as reducing parents' anxiety and increasing parental satisfaction. The study was conducted as a two-arm randomized controlled trial (RCT). Children aged 7–12 years (n=40) and their parents, equal to the number of children, were recruited from the day surgery unit of a university hospital in Finland between August 2020 and August 2021. The control group (n=20 children) received routine care, including a parental mobile care path solution (the BuddyCare App) to inform parents about procedures in the children's day-surgery pathway. Whereas, the intervention group (n=20 children) received the same routine care with a parental care path solution and an additional mobile game (the Triumf Game App) designed to help children cope with anxiety, fear, and pain during the day surgery process. Assessments were conducted before the treatment at home, at the hospital before and after the treatment, and at home 7 days after treatment. In total, 86 were found eligible for this RCT study, and 40 participated. Median age of participants was 9.5 [IQR: 8.0–11.0] years and 15 (39%) were girls. In the control group median mYPAS scores were 32.0 (at the hospital before the treatment), 38.0 (during induction before anaesthesia), and 28.0 (in the recovery room). The corresponding numbers for the intervention group were 33.0, 43.0, and 28.0. No statistically significant differences were observed in mYPAS scores between the intervention and control group (all p-values >0.5). Furthermore, secondary outcomes (children´s fear and pain and parent´s anxiety and satisfaction) did not differ statistically significantly between the intervention and control group. A gamified health intervention may not be superior to routine care in reducing children’s anxiety, fear, pain, or parents’ anxiety and satisfaction. Routine care, including a parental care path solution, prepares parents and children for day surgery and boosts treatment-related satisfaction. This approach may be safe and support digital transformation in healthcare settings, such as hospitals.