{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:04:26Z","timestamp":1777655066135,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Games for Health Journal"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p\/>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Persistent pain affects many middle-aged and older patients with ovarian cancer. Serious games offer non-pharmacological relief, but their effectiveness and immersion monitoring in this population remain underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the efficacy of a biofeedback-driven serious game with dynamic difficulty in reducing pain and enhancing immersion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A two-arm, single-blinded randomized controlled trial was conducted with 52 participants randomized into an intervention group (biofeedback-driven dynamic-difficulty game) or a control group (fixed-difficulty game). Both groups engaged in a 15-minute gameplay session. The primary outcome was pain intensity, where the secondary outcomes were pain-related anxiety, immersion level, and user experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Both groups showed significant reductions in pain intensity and pain-related anxiety from baseline (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.05). No significant between-group differences were observed in these outcomes. The intervention group, however, exhibited a significantly higher average immersion level compared to the control group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.01; d = 1.08; \u03b2 = 0.11 [\u22120.38, 0.60]) . Participants in the intervention group also rated the game as more innovative, interesting, supportive, efficient, and exciting, though slightly more difficult to use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The biofeedback-based serious game effectively enhances immersion and may support pain and anxiety reduction in older ovarian cancer patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/g4h.2024.0128","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T04:42:58Z","timestamp":1749098578000},"page":"465-472","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Biofeedback-Based Serious Game for Pain Alleviation in Middle-Aged and Older Patients with Ovarian Cancer: A Randomized Controlled Trial"],"prefix":"10.1177","volume":"14","author":[{"given":"Fangyuan","family":"Chang","sequence":"first","affiliation":[{"name":"School of Design, Shanghai Jiao Tong University, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, Affiliated Cancer Hospital for University of Electronic Science and Technology of China, Chengdu, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuping","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Abdominal Medical Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, Affiliated Cancer Hospital for University of Electronic Science and Technology of China, Chengdu, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changying","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, Affiliated Cancer Hospital for University of Electronic Science and Technology of China, Chengdu, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongqing","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, Affiliated Cancer Hospital for University of Electronic Science and Technology of China, Chengdu, China."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"NCI SEER Database. 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