Exploring the barriers and facilitators experienced by patients with heart failure when using popular exergaming platforms for self-management-a systematic review

Abstract

Objective: To systematically explore the barriers and facilitators experienced by patients with heart failure when using the most popular commercially-accessible digital exergaming platforms for self-management. Methods: A systematic literature search was conducted in: Embase, SCOPUS, PubMed, and ProQuest. Qualitative/mixed methods studies published in English between 2000 and 2024, including adults >18 years with heart failure using digital gaming platforms for exercise as self-management (i.e. Microsoft Xbox/Kinect, Sony PlayStation, Nintendo Wii) were considered. Risk of bias was assessed using the Critical Appraisal Skills Program. The grounded theory method was used to extract, analyze, and synthesize the data. Results: Three articles which qualitatively reported on the experiences of the patients with heart failure when using Nintendo Wii for self-management were included. Seventy-nine participants (male and female, age 32-81 years) were included in the studies. The three included studies were of high quality. Extracted qualitative data were grouped into subthemes, which were grouped into main themes, namely, Engagement, Apathy, Convenience, Health-related benefits and Gaming Platforms. The main themes were categorized into Barriers and Facilitators. Patients reported that gaming platforms were simple, easy to use, interesting, and motivating (Facilitators). Boredom while playing specific games, preferring other activities and technical issues were reported as Barriers. Conclusion: This review provides the first insights into the barriers and facilitators patients with heart failure experience when using popular digital exergaming platforms to participate in exercise programs in the self-management of their condition. However, few high-quality studies exist which limits the conclusions made and warrants further research in this area.