Community-based approach to prevention of pressure injuries: Development and assessment of digital gamification education method

Aim: It was aimed to develop a web-based digital education game (DEG-PreSore) including the use of digital gamification, three-dimensional modeling and animation for the education of patient relatives on the prevention of pressure injuries (PI), and to evaluate the effect of the game developed on the knowledge acquisition of patient relatives, the use of the game and the user experience. Material and Method: The study was carried out in 3 stages (preparation, game development, and implementation and data collection) between August 1, 2020 and April 30, 2022. In the preparation stage of the study, the materials required for the development of PreSore and assessment process were prepared, and the content validity study of these materials was carried out. In the second stage, the PreSore was developed and a pilot study (n=5) was conducted for preliminary assessment. In the third stage, the data of the study were collected by applying the PreSore. The participants of the study (n=55) were relatives of the patients with any PI risk level (low-medium-high). The participants were asked to respond to Pressure Injuries Knowledge Assessment Test (PI-KAT) questions consisting of 20 questions and 3 sub-dimensions (Conceptual Features, Etiology and Physiopathology, Prevention Practices) before the implementation of the developed PreSore (pre-test), at the end of the game (post-test) and within 2-4 weeks after the end of game (re-test) in order to evaluate the knowledge level of the participants. A reflection interview was held with the participants at the end of the game to evaluate the user experience for PreSore. Descriptive statistics, Mann-Whitney U Test, Wilcoxon Test, Kruskal-Wallis Test, Chi-Square Test and the inductive content analysis method were used in the analysis of the data. Results: The average number of games played by the participants was found to be x̄=2.18 ± 0.58. In the scoring between 1-10 points for the level of satisfaction, participants' satisfaction with the PreSore educational game was found to be high (x̄=9.13 ± 0.84). It was determined that there was a significant increase in PI-KAT total and sub-dimension knowledge scores after PreSore implementation compared to before the PreSore implementation (p<0.001). A significant number of the participants indicated that the information in the game was easy to understand (98.2%, n=54) and would enable them to understand the importance of the subject (96.4%, n=53), that they wanted to share their educational experience with others with the digital game method (96.4%, n=53) and that they found the game realistic (94.5%, n=52). Conclusions and Recommendations: The data of the study revealed that PreSore is a method that could be used in the education of patients' relatives on the prevention of PI, and in raising community awareness, and it was accepted by its users. It is recommended to integrate PreSore into daily practice in healthcare institutions and make it widely used, and to conduct prospective observational and randomized controlled studies.