快樂學習於老年人運動效益之應用－以「遊戲」策略為例

The Efficacy of Joyful Learning on Exercise in Older Adults: The GAME Strategy

10.6224/JN.202408_71(4).05

吳佳珊(Chia-Shan WU)；蔡俊欽(Chun-Chin TSAI)；陳岷莘(Ming-Hsin CHEN)；陳美芳(Mei-Fang CHEN)

快樂 ； 老年人 ； 遊戲 ； 策略 ； happiness ； older adults ； game ； strategies

護理雜誌

71卷4期（2024 / 08 / 01）

25 - 31

繁體中文;英文

運動可以有效減緩老化、預防老年人慢性病及合併症的發生。然而，約1/3老年人不運動。快樂學習是促進運動的不二法門。遊戲是可行的快樂學習策略，可以讓個案全心全意地投入運動，享受運動。因此，為促進老年人運動，遊戲策略值得探討。本文根據文獻與實務經驗提出一套遊戲策略，稱為「G」、「A」、「M」、「E」：目標設定與教育內容發展（goal setting and educational content development, G）、活動設計與遊戲內容創建（activity design and game content creation, A）、機制與動態實現（mechanics and dynamics implementation, M）及定性和定量健康成果評估（evaluation of qualitative and quantitative health outcomes, E）。此系統性的描述方法有助於清晰展示如何通過遊戲化策略來促進老年人的身體運動和健康。本文可在老年人健康促進的教育、研究和臨床實踐層面提供參考和指南。

Exercise can effectively slow aging and prevent the onset and reduce the complications of chronic diseases in the elderly. However, roughly one-third of older adults are inactive. Joyful learning is an effective method for promoting physical activity, while using games is a feasible strategy for achieving joyful learning that enables individuals to fully immerse themselves in and enjoy an activity. Therefore, exploring gaming strategies to enhance physical activity among the elderly is worthwhile. In this paper, a set of gaming strategies based on the literature and practical experience is proposed. The name of this strategy, GAME, is an acronym of the following: goal setting and educational content development (G), activity design and game content creation (A), mechanics and dynamics implementation (M), and evaluation of qualitative and quantitative health outcomes (E). This systematic descriptive approach helps clearly demonstrate how gamification strategies can promote physical activity and health in older adults. The aim of this paper is to provide a reference and guide for education, research, and clinical practice in health promotion programs targeting older adults.

1. 吳寂禎、蔡淳娟（2016）．「嚴肅型遊戲」與醫療人員教育．台灣擬真醫學教育期刊，3（1），40–44。[Wu, C.-C., & Tsai, T.-C. (2016). Serious games and health personnel education. Journal of Taiwan Simulation Society in Healthcare, 3(1), 40–44.] https://doi.org/10.6582/JTSSH.2016.3(1).06
   連結：
2. 李昆翰（2014）．遊戲化的機制與設計．國教新知，61（4），13–21。[Lee, K.-H. (2014). Mechanisms and design of gamification. The Elementary Education Journal, 61(4), 13–21.] https://doi.org/10.6701/TEEJ.201412_61(4).0002
   連結：
3. 周文修、曾彥能（2011）．數位休閒遊戲愉悅性之評估與分析．設計學研究，14（2），47–70。[Chou, W.-S., & Tseng, Y.-N. (2011). The evaluation and analysis of enjoyment for digital casual games. Journal of Design Science, 14(2), 47–70.] https://doi.org/10.30105/JDS.201112.0003
   連結：
4. 張佐任、劉玫舫、張文典、吳鴻文、陳淑雅（2022）．遊戲式運動影響苗栗社區衰弱前期老人身體功能與運動動機之先導研究．大專體育學刊，24（1），128–142。[Chang, T.-J., Liu, M.-F., Chang, W.-D., Wu, H.-W., & Chen, S.-Y. (2022). Effect of game-based exercise on physical function and exercise motivation of the pre-frail elderly in Miaoli community: A pilot study. Sports & Exercise Research, 24(1), 128–142.] https://doi.org/10.5297/ser.202203_24(1).0009
   連結：
5. Adipat, S., Laksana, K., Busayanon, K., Asawasowan, A., & Adipat, B. (2021). Engaging students in the learning process with game-based learning: The fundamental concepts. International Journal of Technology in Education, 4(3), 542–552. https://doi.org/10.46328/ijte.169
   連結：
6. Bai, S., Hew, K. F., & Huang, B. (2020). Does gamification improve student learning outcome? Evidence from a meta-analysis and synthesis of qualitative data in educational contexts. Educational Research Review, 30, Article 100322. https://doi.org/10.1016/j.edurev.2020.100322
   連結：
7. Brand, R., & Cheval, B. (2019). Theories to explain exercise motivation and physical inactivity: Ways of expanding our current theoretical perspective. Frontiers in Psychology, 10, Article 1147. https://doi.org/10.3389/fpsyg.2019.01147
   連結：
8. Dichev, C., & Dicheva, D. (2017). Gamifying education: What is known, what is believed and what remains uncertain: A critical review. International Journal of Educational Technology in Higher Education, 14(1), Article 9. https://doi.org/10.1186/s41239-017-0042-5
   連結：
9. Freed, S. A., Sprague, B. N., Stephan, A. T., Doyle, C. E., Tian, J., Phillips, C. B., & Ross, L. A. (2021). Feasibility and enjoyment of exercise video games in older adults. Frontiers in Public Health, 9, Article 751289. https://doi.org/10.3389/fpubh.2021.751289
   連結：
10. Gee, J. P. (2003). What video games have to teach us about learning and literacy. Palgrave Macmillan.
    連結：
11. Hakami, S. M., Omar, M. T., Alsaad, S. M., Vennu, V. S., Hattan, L. I., & Bindawas, S. M. (2023). Association between non-communicable diseases and physical activity level in older adults visiting primary health care centers in Jizan, Saudi Arabia. Saudi Medical Journal, 44(6), 580–587. https://doi.org/10.15537/smj.2023.44.6.20230076
    連結：
12. Jackman, P. C., Cooke, S., George, T., Blackwell, J., & Middleton, G. (2023). Physical activity experiences of community-dwelling older adults with physical disabilities: A scoping review of qualitative research. Disability and Rehabilitation. Advance online publication. https://doi.org/10.1080/09638288.2023.2253536
    連結：
13. Lee, I.-M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., Katzmarzyk, P. T., & Lancet Physical Activity Series Working Group. (2012). Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. The Lancet, 380(9838), 219–229. https://doi.org/10.1016/S0140-6736(12)61031-9
    連結：
14. Lim, Y. S., Ho, B., & Goh, Y.-S. (2023). Effectiveness of game-based exercise interventions on modifiable cardiovascular risk factors of individuals with type two diabetes mellitus: A systematic review and meta-analysis. Worldviews on Evidence-Based Nursing, 20(4), 377–400. https://doi.org/10.1111/wvn.12615
    連結：
15. Lyons, E. J. (2015). Cultivating engagement and enjoyment in exergames using feedback, challenge, and rewards. Games for Health Journal, 4(1), 12–18. https://doi.org/10.1089/g4h.2014.0072
    連結：
16. Mazeas, A., Duclos, M., Pereira, B., & Chalabaev, A. (2022). Evaluating the effectiveness of gamification on physical activity: Systematic review and meta-analysis of randomized controlled trials. Journal of Medical Internet Research, 24(1), Article e26779. https://doi.org/10.2196/26779
    連結：
17. Mouton, A., Gillet, N., Mouton, F., Van Kann, D., Bruyère, O., Cloes, M., & Buckinx, F. (2017). Effects of a giant exercising board game intervention on ambulatory physical activity among nursing home residents: A preliminary study. Clinical Interventions in Aging, 12, 847–858. https://doi.org/10.2147/CIA.S134760
    連結：
18. Najafi, Z., Kooshyar, H., Mazloom, R., & Azhari, A. (2018). The effect of fun physical activities on sarcopenia progression among elderly residents in nursing homes: A randomized controlled trial. Journal of Caring Sciences, 7(3), 137–142. https://doi.org/10.15171/jcs.2018.022
    連結：
19. Pradhan, S. (2019). The use of commercially available games for a combined physical and cognitive challenge during exercise for individuals with Parkinson’s disease –A case series report. Physiotherapy Theory and Practice, 35(4), 355–362. https://doi.org/10.1080/09593985.2018.1444118
    連結：
20. Tsai, C.-C., Chen, P.-Y., Tsai, M.-Y., Wu, C.-S., & Chen, M.-F. (2024). The effect of a bone-preserving board game program on the knowledge, attitudes and preventive behaviors of osteoporosis in older adults. Geriatric Nursing, 56(1), 212–217. https://doi.org/10.1016/j.gerinurse.2024.02.007
    連結：
21. Tsai, C.-C., Lee, H.-L., Wu, C.-S., Chen, P.-Y., Chen, T.-W., & Chen, M.-F. (2023). The efficacy of a mindfulness-based exercise program in older residents of a long-term care facility in Taiwan. Geriatric Nursing, 50(3), 227–233. https://doi.org/10.1016/j.gerinurse.2023.01.021
    連結：
22. Vilafranca Cartagena, M., Tort-Nasarre, G., & Rubinat Arnaldo, E. (2021). Barriers and facilitators for physical activity in adults with type 2 diabetes mellitus: A scoping review. International Journal of Environmental Research and Public Health, 18(10), Article 5359. https://doi.org/10.3390/ijerph18105359
    連結：
23. Williams, D. M., & Bohlen, L. C. (2019). Motivation for exercise: Reflective desire versus hedonic dread. In M. H. Anshel, S. J. Petruzzello, & E. E. Labbé (Eds.), APA handbook of sport and exercise psychology: Exercise psychology (pp. 363–385). American Psychological Association. https://doi.org/10.1037/0000124-019
    連結：
24. 侯惠澤（2016）．遊戲式學習．親子天下。[Hou, H.-T. (2016). Game-based learning. Parenting.]
25. 國民健康署（2022）．民國一百零八年台灣地區中老年身心社會生活狀況長期追蹤調查成果報告。[Health Promotion Administration, Taiwan, ROC. (2022). 2019 Taiwan longitudinal study on aging: Survey report.] https://www.hpa.gov.tw/Pages/ashx/File.ashx?FilePath=~/File/Attach/1282/File_18237.pdf
26. 陳一涵、胡凱揚（2019）．療癒性休閒之身體活動介入對老年人成功老化之影響．嶺東體育暨休閒學刊，（17），21–33。[Chen, I.-H., & Hu, K.-Y. (2019). The effect of therapeutic recreation in physical activity on successful aging for the elderly. Journal of Physical Education and Leisure, Ling Tung University, (17), 21–33.]
27. Werbach, K., & Hunter, D. (2020). For the win: The power of gamification and game thinking in business, education, government, and social impact (Rev. ed.). Wharton School Press.
28. World Health Organization. (2022, October 5). Physical activity. https://www.who.int/news-room/fact-sheets/detail/physical-activity