Educational Software: tool directed for health education ... · cuidado de los niños con la Tetralogía de Fallot. Métodos: Informe de la experiencia de elaboración de un juego

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Revista Enfermagem Digital Cuidado e Promoção da Saúde 4 (2) Julho/Dezembro 2019http://www.redcps.com.br / e-mail: [email protected]

Educational Software: tool directed for health education of children with Tetralogy of FallotSoftware Educativo: ferramenta direcionada para educação em saúde de crianças com Tetralogia de Fallot

EXPERIENCE REPORTRELATO DE EXPERIÊNCIA

AutoresThiago Arcanjo Bezerra 1

Sandra Trindade Low 2

Taislane Gomes de Lima 1

Vitoria Maria Costa Dantas Lins 1

Thaís de Souza Maia 1

Ronalberto Lopes de Araujo 1

Sabrina Mayara da Silva Lopes 1

1 Estudantes de Enfermagem. Faculdade de Enfermagem Nossa Senhora das Graças - Universidade de Pernambuco (FENSG-UPE). Recife-PE, Brazil.2 Doutora em Patologia pela UNESP. Professora Adjunta da Universidade de Pernambuco (FENSG-UPE). Recife-PE, Brazil.

Data de submissão: 19/10/2019.Data de aprovação: 28/12/2019.

Correspondência para:Thiago Arcanjo BezerraRua Abdon Batista, 300, Bairro Santo Amaro, Recife–PE, Brasil. CEP: 50.100-460.E-mail: [email protected]

Software Educativo: herramienta dirigida a la educación en salud de niños con Tetralogía de Fallot

DOI: 10.5935/2446-5682.20190022

Resumo

Objective: To report the experience of nursing students in building educational software on the care with chil-dren with Tetralogy of Fallot. Methods: Experience report of the elaboration of an educational game at an online platform called “Scratch”, built by students from the Nursing School of the University of Pernambuco, between April and June 2019. It used prototyping knowledge, focusing on nursing computer skills. Results: Building the “Learning with the Heart” game that provides information about the disease and good lifestyle, focusing on diet, education, exercise and drug treatment.Conclusion: The use of the software allowed for the reflection on the im-portance of basic programming knowledge for health professionals, making the work process more attractive and, consequently, easy to understand for the target audience due to the use of a playful-technological methodology.Keywords: Education nursing; Pediatric nursing; Tetralogy of Fallot; Video games; Educational technology

Abstract

Objetivo: Relatar a experiência de acadêmicos de Enfermagem na construção de um software educativo sobre os cuidados às crianças portadoras da Tetralogia de Fallot. Metodos: Relato de experiência da elaboração de um jogo educativo em uma plataforma online denominada “Scratch”, construído por acadêmicos da Faculdade de Enfermagem da Universidade de Pernambuco, no período entre abril e junho de 2019. Utilizou-se de conhecimentos de prototipagem, focando nas competências sobre informática em Enfermagem. Resultados: Construção do jogo “Aprendendo com o Coração” que fornece informações sobre a doença e bons hábitos de vida, com foco na alimentação, educação, exercício físico e tratamento medicamentoso. Conclusão: O uso do software permitiu a reflexão sobre a importância de conhecimentos básicos de programação para os profissionais de saúde, tornando o processo de trabalho mais atrativo e, consequentemente, de fácil entendimento para o público-alvo devido ao utensílio de uma metodologia lúdico-tecnológica.Palavras-chave: Educação em enfermagem; Enfermagem pediátrica; Tetralogia de Fallot; Jogos de vídeo; Tecnologia educacional

ResumenObjetivo: Relatar la experiencia de los estudiantes de enfermería en la creación de software educativo sobre el cuidado de los niños con la Tetralogía de Fallot. Métodos: Informe de la experiencia de elaboración de un juego educativo en una plataforma en línea llamada “Scratch”, construida por académicos de la Escuela de Enfermería de la Universidad de Pernambuco, entre abril y junio de 2019. Utilizó el conocimiento de prototipos, centrándose en informática en enfermería. Resultados: Creación del juego “Aprender con el corazón” que proporciona información sobre la enfermedad y el buen estilo de vida, centrándose en la dieta, la educación, el ejercicio y el tratamiento con medicaciones. Conclusión: El uso del software permitió reflexionar sobre la importancia del conocimiento básico de programación para los profesionales de la salud, haciendo que el proceso de trabajo sea más atractivo y, en consecuencia, fácil de entender para el público objetivo debido al uso de una metodología lúdica-tecnológica.Palavras-chave: Educación en enfermería; Enfermería pediátrica; Tetralogía de Fallot; Juegos de video; Tecnología educacional

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Rev. Enferm. Digit. Cuid. Promoção Saúde 2019 Jul-Dez; 4(2):134-139Bezerra TA,Low ST, Lima TG, Lins VMCD, Maia TS, Araujo RL, et al.

Educational Software: tool directed for health education of children

INTRODUCTION

The gamification comes as a strategy of thinking and acting, through a game, but in a context outside of the game, like a professional performance space, such as a university hospital, where they are used systematic, mechanical and dynamic games for contextualize educational activities of this practice. With the idea of gamification, comes the “Educational Softwa-re” which aims to contribute to the learning of new knowledge on a particular subject. An example of this mechanism is the “Serious game”: called “serious game”, is intended to present new situations, discuss the best ways of resolution, and enable the construction of knowledge and training(1).

Information and Communication Technologies (ICTs) have impacted the work process in health and nursing, raising the need for prior preparation of these professionals for use in various scenarios of professional practice. Thus, a current concern is the training of professionals as a way to ensure that their knowledge and skills are in line with the new paradigms of attention to health, specifically on the issues facing the insertion of ICTs(2).

The National Curriculum Guidelines (DCNs) for undergra-duate nursing point, from the perspective of competencies and skills related to communication, which the nurse Racing mastery of these ICTs. Thus, issues such as the development of knowledge, skills and attitudes regarding the use of compu-ting and programming in professional practice need to select desirable skills roster of enfermeiro(1).

The games test limits, solve problems and collaborate in facing challenges. Are a useful and well received by the people tool because formulate hypotheses, have recreational activities and promote entertainment. The playful environment favors also the children’s learning process. Given this aspect, you can use this tool as a means to spread in health education about various themes, such as heart disease congênitas(2).

The congenital cyanotic and acyanotic diseases are a group of disorders that affect the oxygenation to the child’s body in which the deoxygenated blood (venous blood) can not reach the lungs in amounts sufficient to return oxygen to the left side of the heart.The cyanotic heart disease is related to the greatest potential for gravity. This type of disease causes re-duction in the hemoglobin concentration in blood and, as the most common pathology, has tetralogy of Fallot(3).

Tetralogy of Fallot is a rare heart disease and is the com-bination of four (4) holes in cardiac anatomical features: ven-tricular septal defect (VSD), pulmonary stenosis, overriding of the aorta and right ventricular hypertrophy.The same may have mild patient changes to the patient, as it may be aggregated with other anomalies, defects or other syndromes complicating diagnosis efetivo(4).

In childhood, birth defects found are the most frequent causes emergency in pediatric cardiology. Some risk factors increase the incidence of congenital heart defects, such as family history (first degree relatives), maternal factors, inclu-ding chronic diseases such as diabetes or poorly controlled

PKU, alcohol consumption, exposure to environmental toxins and infections can also increase considerably the likelihood of an anomaly cardíaca(5).

In this perspective, understanding the need for health education about Tetralogy of Fallot in children and using di-gital media, this study aimed to report the nursing students experience in building an educational software about the care of children suffering from Tetralogy of Fallot.

METHODOLOGY

This is a descriptive study, the story kind of experience, in order to integrate theoretical and practical knowledge in the solidification of a scientific learning acquired in the curricular components of the nursing coursethrough a “Se-rious games” produced an online platform called “Scratch” followingstages of development of a game. This platform is an online and free software, graphical programming language, developed at the Media Lab. It was created with the purpose of introducing programming and mathematical concepts, while encouraging creative thinking, systematic thinking and work collaborative(6).

So with Scratch, you can mix media such as images, gra-phics, sounds and music to create interactive stories, games or animations, for example. The same stands out as an excellent tool for teaching programming logic concepts for having a friendly and simple visual interface, leading intuitively, the main structures of a language, such as variables, operators, decision-making structures and repetition and others. Through this tool, you can zoom the user increasingly programming environment, without the need to learn a specific program-ming language(6).

Moreover, it enables the creation of simpler and dynami-cally programs, and encourage logical reasoning and allow graphically display the execution of the program created. The procedure was performed followed the planning phase with development of educational goals and curriculum proposal, based on skills in the computer field in Nursing, where de-senvolvido by academics from the Faculty of Nursing at the University of Pernambuco and didactically prepared in three stages that tend to enhance and / or providing knowledge to parents and families about the care of children affected by Tetralogy of Fallot. The construction period fHi between April and June 2019, using scientific substantiation, prototyping, production and objectives of Educational Curriculum Guideli-nes for its effectiveness.

At the end, it was assessed by teachers in the area of health and information technology. The literature review followed selected descriptors crossing through the Descriptors in Health ScienceVirtual Health Library (MeSH / BVS), such as. “Nursing Education”, “Pediatric Nursing”, “Tetralogy of Fallot”, “Video Games” and “Educational Technology” for mounting the game This process took place between the period April-June 2019. we used items found in the Lilacs portals, PubMed, BVS and SciELO.

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Inclusion criteria were articles published between 2014 and 2019, considering new discoveries about the theme. Thus, they used content articles already approved by ethics committees in research with human beings, respecting Resolution CNS 466/12. At the end totaled 160 items available, these, forty (40) fell within the objectives and were selected for reading. After reading, ten (10) items were used in the study construct, therefore, they were in accordance with the desired parame-ters: year of publication, and subject descriptors associated with the target audience.

RESULTS

Construction of a game called “Learning from the Heart” prepared in three (3) steps to provide, in the first instance, basic cardiac anatomy and physiology, soon after, general in-formation about the disease and ultimately care associated the good life habits, focusing on food, school life, physical exercise and drug treatment.

Prototype game

This game is based on the junction of three steps, giving the player a unique experience, combining the playful with learning, thus providing health education. The game’s main objective is to test the knowledge of the Tetralogy of Fallot, facing various levels with varying degrees of difficulty.

Initially, begins in the “start” option on the online platform, and (a) player (a) is facing the loading screen consisting of the appearance of the name of the game “Learning from the Heart”. Then, automatically, it is directed (a) a school setting that is the start screen, containing the option “Start,” “Rules” and “About” (Figure 1).

a “menu” (list of choices) specific to the explanation of this subject, allowing individuals to receive information to rely on their knowledge of the operation and origin of the pathology in question.

This option is divided into six (6) scenarios, where the first (1st) scenario, corresponding questions and answersconcept of congenital heart defects. The second deals with game ob-jectives, these being segregated into different scenarios. Sub-sequently (3, 4 and 5 scenarios) explains about the pathology is entitled by “Tetralogy of Fallot” (Figure 2). Finally, the sixth (6th) scenario is for the identification of developers, academic affiliation thereof and guiding the project.

Figure 1. Start of the game screen.

Figure 2. Information about Tetralogy of Fallot.

Menu 2: “Rules”

In this option, (a) player (a) can deepen the rules and the operation of the game, assisting in the progression of the same understanding. They are divided into three (3) scenarios that have relationship with each game step ( “Step 1: Game of errors,” “Step 2: True or False?” And “Step 3: Pick or Pass”).

Menu 3: “Start”

The “Start” button (Start) is the main marker due to its func-tionality to allow the continuation of the game. Clicking this item, (a) player (a) is intended (a) to a classroom setting with a teacher and several students, which explains that human cardiac physiology. In the scene, a student falls asleep in class, in the subjective that he was “dreaming”, starting immediately, the first step of the game: “Game of Errors.”

Game errors

The first stage of the game is analogous to the “Game of the 7 errors”. The reference allows the player to demonstrate (a) is as human cardiac physiology in healthy individuals and, subse-quently, the same complications in patients with Tetralogy of Fallot. Thus, the (a) thereof (a) can understand the anatomical and physiological changes present in this pathology.

Menu 1: “About”

Starting from that good assumption of the people are unaware of and / or have basic knowledge of the definition of congenital heart disease, Tetralogy of Fallot, he designed

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True or false?

Corresponding to 2nd (second) stage of the game, this step appears with a colorful scene, sending up the idea of being returned to a family-children. With the inclusion of four (4) balloons in the colors yellow, purple, green and red, each of these has questions about Tetralogy of Fallot. Randomly or not,the (a) player (a) can choose one (balloon) at a time, answering the stated assertions.

The goal is that (a) it (a) hit at least three (3) questions from four (4) available by balloons (for this, (s) he has two lives. If you lose them, turns the start of the game). Moreover, every question answered both correctly erroneously as an explana-tion of why that is provided is correct and / or wrong, allowing the gamer to construct and / or deconstruct thoughts on the pathology (Figure 4).

Take or Spend

If consisting like the last game of the stage, being ti-tled “Pick or Pass”, it is associated with the previous step: the aim is to help parents and family members about the basic needs of social interactions, nutrition and healthy lifestyles to children with tetralogy of Fallot. In a back colorful scenery, and taking up the aid of keys “left” and “right, the (a) player (a) has forty (40) seconds to” get “components that are essential to the well-being of a child with the disease in question, such as “school”, “friends” and “healthy food”, however, should deviate from other factors that are harmful, such as “fight,” “excess burgers,” among others (Figure 5).

Each caught beneficial component is converted into one (1) point, and each malefic -1 (minus one) point. The goal for passage of this stage are twenty (20) points in forty (40) seconds. If there is the end of time and the “gamer” (player) has failed to achieve the goal, he will be prompted to start the phase automatically.

If (a) player (a) reach the target and hence can pass Stage, (s) he wins the game, being directed (a) for a school setting, where there are several children playing, amusing, smiling and showing the following message: “Congratulations! You could provide a good quality of life for children. “ Approximately within fifteen (15) seconds, the zero up game and back to the home screen where the gamer can resume it.

DISCUSSION

Scale thepotential of Information and Communication Technologies use (ICT) and gamification elements into edu-

At first, the (a) practitioner must observe for thirty (30) seconds to anatomy and physiology of the human heart, se-eking to understand their appearance and function in normal parameters. Moving up the thirty (30 seconds), the picture is replaced by the figure of a heart affected by congenital heart disease in question, so that (a) player (a) can click on different parts of the previous representation, giving to understand what are 4 (four) areas affected by pathology, namely: septal defect (VSD), pulmonary stenosis, aortic thrust and right ventricular hypertrophy (Figure 3). By clicking on the four (4) errors that associate the disease, (a) practitioner goes to “Step 2: True or False.

Figure 3 . 4 (four) error anatomical alterations that constitute the heart of an individual with Tetralogy of Fallot.

Figure 4. Question shown when the individual clicks the “purple ballo-on” of “Step 2: True or False?”

Figure 5. Scenario “Pick or Pass”

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cational strategies, and the need for action to contribute to the development of computer skills in the area of nursing, has emerged as the profession innovation by offering tools impro-vement of practice. discover the importance of learning new tools in health education is essential in boosting information transfer(7).

In practice, we used the basic setting, operation and side effects of Tetralogy of Fallot for parents and families of children with this condition, it is inevitable to use a simple and easy to understand language, and the use of tools creative and interactive (eg, audio and color images), providing a greater engagement of those involved with the subject(8).

Once the game was created by nursing students, some obstacles were encountered during its programming: the basic level of knowledge of students about the available tools for the platform to build the game, limitations of special actions, inter-net access, etc. . Points like these have made the development and performance were slow, plus the many other dilemmas presented by technical problems with the site in question. These issues are still a reality in developed countries, despite such dilemmas they could be solved with the aid of computer science professionals(9).

The game was considered by health professionals who deal personally with the audience as a great potential and relevance of strategy and can be considered as an innovative tool and useful for health education of those involved (children with the disease, parents and family). Health professionals, especially nurses, engage positively when they are stimulated to this instrument, allowing care humanized and unique way(9).

Throughout the study, we realized the value of the develo-pment of new technologies in healthcare, focusing on digital games for learning needs of motivational stimuli for a deep involvement and use of those resources trigger a more reliable acceptance of promotion health by the target audience. At the end of this project, it was estimated that the objectives were achieved and it was possible to establish the role of educational game as an educational technology with the experts(10).

The game “Learning from the Heart” by presenting the steps “Game of errors,” “True or false?” And “Pick or Pass” holds the proposal focused on health education of parents and relatives of the Tetralogy of Fallot, spreading information safe on the main aspects of the disease and quality of life. The highlight of it we understand the approach of a complex and rare theme, but it is a reality that affects mainly the public and child(10).

It is considered that the consequences of a disease in chil-dren cause problems for her and all her primary relationships and interpersonal (school, family, friends, etc.). Based on that, the game text needs to have a simple and understandable des-cription for the understanding of all. The “Serious game” also allows individuals to learn, along with those of children with Tetralogy of Fallot, encouraging their autonomy and offering a teaching-learning scenario for the child’s health(11).

The human learning ability is directly related to emotional feelings of passion and interest(11). Thus, the three stages of

the game were specially developed with the aim of providing the feeling of “security”, with games that probably were part of the childhood of beings, facilitating compliance by feelings of affection stimulated.

FINAL CONSIDERATIONS

The games have been used in different contexts, seeking immersion of the players so that the communication and in-formation objectives are achieved. Based on this perspective, the use of this educational software allowed the reflection on the importance of basic programming knowledge to health professionals, making work more attractive process and hence easy to understand for the audience due to the tool of a recre-ational and technological methodology.

Moreover, this study presented certain challenges, such as non-experience of students with the programming language and difficulties in software structure, however ended with po-sitive feelings of gratitude and interest in programming, both by academics, and by faculty evaluation. To the authors, the tool was demonstrated as a new approach to health education process, assisting in the learning process of the same and users about the relevant information about the care of the child with tetralogy of Fallot.

The software has brought very favorable results to students and teachers, as the very technological learning, as the platform has an interactive environment, colorful, attractive, easy to understand and more intuitive. After application to a group of teachers and other students, it was noticed the interest of many in attendance to recognize the process experienced by the team. Therefore, the use of educational tool allowed, despite the difficulties encountered in the software structure, the sight of how important is the role of the nursing professional as a health educator, and can facilitate audience understanding with the help of a playful methodology -technological.

In the health care context, educational games are gaining significant space, since it serves as a facilitator of the rela-tionship student and knowledge, promoting constructivist practices that seek the learner empowerment, however, emotional distress to reconcile learning new skills teamwork is challenging, built by long discussions and persistence to answer an academic demand.

Through this, Nursing can hold its assistance, providing some care, as clarify the family risk factors that can interfere with infant growth and cognitive development, involve the family in planning actions for the welfare of the child, promote the comfort of the child with occupational skills that decrease the level of stress, such as the use of playful methodologies - the elaborate software itself is an example - and explain to families the importance of educational and care to these children in the pathological process

Thus, the production of dynamic and educational processes that give emphasis to human essence, consolidate more effecti-ve and transformers results, requiring that stimulus for develo-

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pment of health practices. Thus, the use of Scratch can soften the biopsychosocial complications of children with Tetralogy of Fallot by allowing parents and family members participate in this care process, in addition to the enhancement of nursing professionals as a promising health education.

REFERENCES

1. developed in Health: Integrative Literature Review. J Inf Health, 2016.; 8 (3): 110-6.

2. TC Castro, Gonçalves LS. The use of gamification to teach nursing in the field. Rev. Bras. Enferm. 2018; 71 (3): 1038-45.

3. ARDS Silva, Silva FD, Moura MCM, RM Santos, Luna TR, Barbosa FK. Advances in the treatment process of Tetralogy of Fallot. Rev. UNILUS Education and Research. 2018; 14 (37): 21-31.

4. Belo WA, Oselame GB, Neves EB. Clinical-hospital care of children with congenital heart disease. Cad Health Collective. 2016; 7; 24 (2): 216-20.

5. Bertoletti J Marx GC Hattge JSP Pellanda LC. Quality of Life and Congenital Heart Disease in Childhood and Adolescence. Arq. Bras. Cardiol. 2014; 102 (2): 192-198.

6. Rodeghiero DC, Sperotto RI, Ávila CMO. creative and scratch learning: methodological possibilities of innovation in higher education. Time - Dialogues in Educ. 2018; 27 (1): 188-207.

7. Day JD, MS Mekaro Cheng Lu JK, Otsuka JL, Fonseca LMM, Zem-Mascarenhas SH. Serious game development as a strategy for promoting health and addres-sing childhood obesity. Rev. Latino-Am. Nursing. 2016; 24 (e2759): 1-9.

8. Gurgel PC, MC Fernandes. educational games in the teaching of Nursing in Public Health: Experience Report. UFPE J Nurs. 2015; 9: 9320-3.

9. Lancaster RJ. Serious Game Simulation as a Teaching Strategy in Pharma-cology. Clin. Simul. Nurs. 2014; 10 (3): E129-E137.

10. Almeida ER, Moutinho CB, S. MT Milk Pedagogical practice of family health nurses in the development of Health Education Interface. - Comm Health, Educ. 2016; 20 (57): 389-402.

11. Moreira APA VM Savoie, Camacho ACLF Daher DV Tan E. Educational game drug delivery: a validation study. Rev. Bras. Enferm. 2014; 67 (4): 528-34.

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Educational Software: tool directed for health education ... · cuidado de los niños con la Tetralogía de Fallot. Métodos: Informe de la experiencia de elaboración de un juego