Serious Game on a Smartphone for Adolescents Undergoing Hemodialysis: Development and Evaluation.

BACKGROUND: Adolescents with chronic kidney disease have a hard time adhering to hemodialysis as a therapy, indicating a need to establish new alternatives for motivation and adherence to treatment. OBJECTIVE: The objective of this study was to develop and evaluate a serious game to stimulate and motivate adolescents undergoing hemodialysis. METHODS: We describe the technological production followed by a qualitative analysis. We invited 8 adolescents undergoing hemodialysis in the city Goiânia, located in the midwest of Brazil, to participate. The final convenience sample included 7 (87.5% of the target population) adolescents. The process was conducted in 3 phases: creation of a serious game, evaluation of its use, and observation of its motivating effect on behavioral modification with a focus on acquiring the necessary competence for self-care. RESULTS: An app (Bim) in the modality of a serious game was developed to be used during hemodialysis; the player was encouraged to take care of a character with daily actions during his or her treatment. The game was made available to adolescents aged 10-14 years. Mobile devices were offered during the hemodialysis treatment for a period of 30-40 minutes, 3 times a week for 60 days. The usage definitions of the game were freely chosen by the participants. The qualitative evaluation of the use of the Bim app showed that it encompasses scenarios and activities that enable the exercise of daily actions for the treatment of patients. The behavioral evaluation showed that the Bim app worked as a motivating stimulus for behavioral adherence to hemodialysis requirements. CONCLUSIONS: The easy-to-access app interface showed good operability for its users. The description of the character and proposed activities contributed to motivation and ability to cope with hemodialysis care.

Uma abordagem funcional para os comportamentos delirar e alucinar / A functionalist approach for delusion and hallucination behaviors

O presente artigo busca discutir duas categorias psiquiátricas, delírios e alucinações, tradicionalmente descritas como sintomas de transtorno psicótico, com o conceito de comportamento orientado pelo behaviorismo radical de B. F. Skinner. O artigo inicia com a visão da Associação Americana de Psiquiatria, a qual procura descrever essas categorias como sintomas positivos de esquizofrenia e suas repercussões. Uma abordagem funcionalista para os comportamentos de delirar e alucinar são consideradas em alguns importantes detalhes. Os conceitos de visão e audição condicionada são discutidos como experiência comum. Finalmente, considerações são dadas para as implicações dos efeitos desses tipos de comportamentos-problema e sugestões para lidar com eventos dessa natureza no contexto clínico são oferecidas.(AU)

This article discusses two psychiatric symptoms, delusions and hallucinations, traditionally described as a characteristic of psychotic disorders based on the concept of behavior of the radical behaviorism of B. F. Skinner. The article begins with the criteria of the American Psychiatric Association, which describes these categories as positive symptoms of schizophrenia and shows their repercussions. A functionalist approaches to the behaviors of delusion and hallucination are considered in some important details. The concepts of vision and hearing conditioned facilities are discussed as a common experience. Finally, considerations are given to the implications of the effects of these types of behaviors, problems and suggestions are offered for dealing with such events in the clinical setting.(AU)

Uma abordagem funcional para os comportamentos delirar e alucinar / A functionalist approach for delusion and hallucination behaviors

O presente artigo busca discutir duas categorias psiquiátricas, delírios e alucinações, tradicionalmente descritas como sintomas de transtorno psicótico, com o conceito de comportamento orientado pelo behaviorismo radical de B. F. Skinner. O artigo inicia com a visão da Associação Americana de Psiquiatria, a qual procura descrever essas categorias como sintomas positivos de esquizofrenia e suas repercussões. Uma abordagem funcionalista para os comportamentos de delirar e alucinar são consideradas em alguns importantes detalhes. Os conceitos de visão e audição condicionada são discutidos como experiência comum. Finalmente, considerações são dadas para as implicações dos efeitos desses tipos de comportamentos-problema e sugestões para lidar com eventos dessa natureza no contexto clínico são oferecidas.

This article discusses two psychiatric symptoms, delusions and hallucinations, traditionally described as a characteristic of psychotic disorders based on the concept of behavior of the radical behaviorism of B. F. Skinner. The article begins with the criteria of the American Psychiatric Association, which describes these categories as positive symptoms of schizophrenia and shows their repercussions. A functionalist approaches to the behaviors of delusion and hallucination are considered in some important details. The concepts of vision and hearing conditioned facilities are discussed as a common experience. Finally, considerations are given to the implications of the effects of these types of behaviors, problems and suggestions are offered for dealing with such events in the clinical setting.

Análise comportamental em um caso de dependência à nicotina / Behavioral analysis in a case of dependence to the nicotine

O presente trabalho procurou levantar relações entre o estado emocional negativo e o desenvolvimento de respostas negativas, possibilitando a contrução de comportamentos disfuncionais, tais como o ato de fumar, e teve como suporte a terapia comportamental cognitiva. O participante deste estudo é do sexo masculino, adulto, e apresentou-se como dependente de nicotina há trinta anos. Desse modo, o ato de fumar estava comprometendo sua saúde. Foi submetido à intervenção psicoterapêutica, focada no controle de sua ansiedade e dos comportamentos desadaptados. Os resultados obtidos demonstraram que a intervenção proposta, para este estudo de caso, foi eficaz: houve diminuição em mais de 90

This paper had as its support the cognitive behavioral therapy. Its objetive was to investigate if and how the negative emotional state can lead the individual to develop negative responses, making possible the construction of dysfunctional behaviors, such as the action of smoking. The participant, of this study was a male, adult, and he became dependent of nicotine through thirty years of use. This way, the action of smoking was endangering his health. He was submitted to the psychotherapeutic intervention, focused in the control of his anxiety and of the non-adapted behaviors. The obtained results demonstrated that the proposed intervention, for this case study, was effective: there has been a decrease in more than 90

do comportamento de fumar, a redução da ansiedade e o aumento do comportamento assertivo. Concluiu-se que o processo psicoterapêutico definido auxiliou na melhoria da qualidade de vida do cliente.(AU)

of the behavior of smoking, the reduction of the anxiety and the increase of the assertive behavior. It was concluded tha the defined psychotherapeutic process aided in the improvement of the quality of the customer´s life.(AU)

Análise comportamental em um caso de dependência à nicotina / Behavioral analysis in a case of dependence to the nicotine

O presente trabalho procurou levantar relações entre o estado emocional negativo e o desenvolvimento de respostas negativas, possibilitando a contrução de comportamentos disfuncionais, tais como o ato de fumar, e teve como suporte a terapia comportamental cognitiva. O participante deste estudo é do sexo masculino, adulto, e apresentou-se como dependente de nicotina há trinta anos. Desse modo, o ato de fumar estava comprometendo sua saúde. Foi submetido à intervenção psicoterapêutica, focada no controle de sua ansiedade e dos comportamentos desadaptados. Os resultados obtidos demonstraram que a intervenção proposta, para este estudo de caso, foi eficaz: houve diminuição em mais de 90% do comportamento de fumar, a redução da ansiedade e o aumento do comportamento assertivo. Concluiu-se que o processo psicoterapêutico definido auxiliou na melhoria da qualidade de vida do cliente.

This paper had as its support the cognitive behavioral therapy. Its objetive was to investigate if and how the negative emotional state can lead the individual to develop negative responses, making possible the construction of dysfunctional behaviors, such as the action of smoking. The participant, of this study was a male, adult, and he became dependent of nicotine through thirty years of use. This way, the action of smoking was endangering his health. He was submitted to the psychotherapeutic intervention, focused in the control of his anxiety and of the non-adapted behaviors. The obtained results demonstrated that the proposed intervention, for this case study, was effective: there has been a decrease in more than 90% of the behavior of smoking, the reduction of the anxiety and the increase of the assertive behavior. It was concluded tha the defined psychotherapeutic process aided in the improvement of the quality of the customer´s life.