{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T08:09:35Z","timestamp":1781942975405,"version":"3.54.5"},"reference-count":84,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Information"],"abstract":"<jats:p>A serious game is a type of game that is designed for a primary purpose other than entertainment. Instead, serious games are intended to achieve specific goals, such as education, training, or health promotion. The goal of serious games is to engage players in a way that is both enjoyable and effective in achieving the intended learning or behavior change outcomes. Recently, several systematic reviews on the development and application of serious games and on the application of gamification techniques have been published, which indicate high activity and ongoing progress in this area of research. Such an extensive body of review papers raises the need to analyze and extract the current state and the prevailing trends of the serious games and gamification (SGG) domain by analyzing and summarizing the systematic review articles. This study presents a systematic meta-review, i.e., a review of the 53 survey papers on the domain of serious games and gamification. The systematic review follows the PRISMA guidelines, while constructive and cross-sectional methods are used to analyze and present the results. Finally, this study identifies the future trends and challenges for the domain. As a result, the meta-review helps the reader to quickly assess the present status of SGG and serves as a reference for finding further information on each technology utilized in SGG. Using the criterion of the citations, the meta-review analysis provides insight into the quantity and academic relevance of the published SGG articles. Moreover, 53 articles published in journals were selected as important surveys in the research field. The study found that serious games and gamification techniques are increasingly being used for a wide range of health conditions and the focus is shifting towards the use of mobile and digital platforms, virtual reality, and machine learning to personalize and adapt interventions. The existing research gaps include the lack of standardization in development and evaluation, insufficient understanding of underlying mechanisms of action, limited understanding of integration into existing healthcare systems, limited understanding of specific game mechanics and design elements for promoting health behaviors, and limited research on scalability, adoption, and long-term effects. These research gaps highlight the need for further research to fully understand the potential and limitations of serious games and gamification for health and how to effectively apply them.<\/jats:p>","DOI":"10.3390\/info14020105","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T01:32:05Z","timestamp":1675819925000},"page":"105","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":235,"title":["Serious Games and Gamification in Healthcare: A Meta-Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9990-1084","authenticated-orcid":false,"given":"Robertas","family":"Dama\u0161evi\u010dius","sequence":"first","affiliation":[{"name":"Department of Software Engineering, Kaunas University of Technology, 44249 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2809-2213","authenticated-orcid":false,"given":"Rytis","family":"Maskeli\u016bnas","sequence":"additional","affiliation":[{"name":"Department of Multimedia Engineering, Kaunas University of Technology, 44249 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2858-328X","authenticated-orcid":false,"given":"Tomas","family":"Bla\u017eauskas","sequence":"additional","affiliation":[{"name":"Department of Software Engineering, Kaunas University of Technology, 44249 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Deterding, S., Dixon, D., Khaled, R., and Nacke, L. (2011, January 28\u201330). From Game Design Elements to Gamefulness: Defining. Proceedings of the International Academic MindTrek Conference: Envisioning Future Media Environments, MindTrek, Tampere, Finland.","DOI":"10.1145\/2181037.2181040"},{"key":"ref_2","unstructured":"Smed, J., and Hakonen, H. (2003). TUCS Technical Report Number 553, Turku Centre for Computer Science."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Udeozor, C., Toyoda, R., Russo Abeg\u00e3o, F., and Glassey, J. (2022). Digital games in engineering education: Systematic review and future trends. Eur. J. Eng. Educ., 1\u201319.","DOI":"10.1080\/03043797.2022.2093168"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"358152","DOI":"10.1155\/2014\/358152","article-title":"An overview of serious games","volume":"2014","author":"Laamarti","year":"2014","journal-title":"Int. J. Comput. Games Technol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/j.compedu.2012.03.004","article-title":"A systematic literature review of empirical evidence on computer games and serious games","volume":"59","author":"Connolly","year":"2012","journal-title":"Comput. Educ."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Maskeli\u016bnas, R., Kulikajevas, A., Bla\u017eauskas, T., Dama\u0161evi\u010dius, R., and Swacha, J. (2020). An interactive serious mobile game for supporting the learning of programming in javascript in the context of eco-friendly city management. Computers, 9.","DOI":"10.3390\/computers9040102"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Swacha, J., Maskeli\u016bnas, R., Dama\u0161evi\u010dius, R., Kulikajevas, A., Bla\u017eauskas, T., Muszy\u0144ska, K., Miluniec, A., and Kowalska, M. (2021). Introducing sustainable development topics into computer science education: Design and evaluation of the eco jsity game. Sustainability, 13.","DOI":"10.3390\/su13084244"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e19280","DOI":"10.2196\/19280","article-title":"Archetypes of gamification: Analysis of mhealth apps","volume":"8","author":"Toussaint","year":"2020","journal-title":"JMIR mhealth uhealth"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Maskeliunas, R., Dama\u0161evi\u010dius, R., Lethin, C., Paulauskas, A., Esposito, A., Catena, M., and Aschettino, V. (2019). Serious game iDO: Towards better education in dementia care. Information, 10.","DOI":"10.3390\/info10110355"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Vasiljevas, M., Dama\u0161evi\u010dius, R., Po\u0142ap, D., and Wo\u017aniak, M. (2019, January 16\u201320). Gamification of eye exercises for evaluating eye fatigue. Proceedings of the Artificial Intelligence and Soft Computing: 18th International Conference, ICAISC 2019, Zakopane, Poland.","DOI":"10.1007\/978-3-030-20915-5_10"},{"key":"ref_11","unstructured":"Wood, L.C., and Reiners, T. (2015). Encyclopedia of Information Science and Technology, IGI Global. [3rd ed.]."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Manzano-Le\u00f3n, A., Camacho-Lazarraga, P., Guerrero, M.A., Guerrero-Puerta, L., Aguilar-Parra, J.M., Trigueros, R., and Alias, A. (2021). Between level up and game over: A systematic literature review of gamification in education. Sustainability, 13.","DOI":"10.3390\/su13042247"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1108\/JBIM-01-2019-0005","article-title":"The role of the predictive gamification to increase the sales performance: A novel business approach","volume":"35","author":"Rocha","year":"2020","journal-title":"J. Bus. Ind. Mark."},{"key":"ref_14","first-page":"59","article-title":"Enhancing the tourist attraction visiting process with gamification: Key concepts","volume":"9","author":"Swacha","year":"2017","journal-title":"Eng. Manag. Prod. Serv."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"100994","DOI":"10.1016\/j.elerap.2020.100994","article-title":"Work gamification: Effects on enjoyment, productivity and the role of leadership","volume":"43","author":"Gerdenitsch","year":"2020","journal-title":"Electron. Commer. Res. Appl."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Swacha, J. (2021). State of research on gamification in education: A bibliometric survey. Educ. Sci., 11.","DOI":"10.3390\/educsci11020069"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1007\/s00779-013-0747-y","article-title":"Augmented reality in education: A meta-review and cross-media analysis","volume":"18","author":"Radu","year":"2014","journal-title":"Pers. Ubiquitous Comput."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1089\/g4h.2013.0086","article-title":"Promoting children\u2019s health with digital games: A review of reviews","volume":"3","author":"Parisod","year":"2014","journal-title":"Games Health J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1186\/s13643-017-0582-8","article-title":"Overviews of systematic reviews: Great promise, greater challenge","volume":"6","author":"McKenzie","year":"2017","journal-title":"Syst. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/XEB.0000000000000055","article-title":"Summarizing systematic reviews: Methodological development conduct and reporting of an umbrella review approach","volume":"13","author":"Aromataris","year":"2015","journal-title":"Int. J. Evid. Based Healthc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e16096","DOI":"10.2196\/16096","article-title":"Investigating serious games that incorporate medication use for patients: Systematic literature review","volume":"8","author":"Abraham","year":"2020","journal-title":"JMIR Serious Games"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1089\/g4h.2018.0129","article-title":"Interaction modalities used on serious games for upper limb rehabilitation: A systematic review","volume":"8","author":"Hu","year":"2019","journal-title":"Games Health J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e25831","DOI":"10.2196\/25831","article-title":"Software engineering frameworks used for serious games development in physical rehabilitation: Systematic review","volume":"9","year":"2021","journal-title":"JMIR Serious Games"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"65","DOI":"10.5195\/ijt.2020.6326","article-title":"Serious games for stroke telerehabilitation of upper limb-a review for future research","volume":"12","author":"Amorim","year":"2020","journal-title":"Int. J. Telerehabilitation"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"103909","DOI":"10.1016\/j.ijmedinf.2019.06.016","article-title":"Vision-based serious games and virtual reality systems for motor rehabilitation: A review geared toward a research methodology","volume":"131","author":"Ayed","year":"2019","journal-title":"Int. J. Med. Inform."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.chb.2018.11.030","article-title":"Gamification and serious games: A literature meta-analysis and integrative model","volume":"92","author":"Baptista","year":"2019","journal-title":"Comput. Hum. Behav."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1108\/JET-12-2019-076","article-title":"Serious games in physical rehabilitation","volume":"13","author":"Bossavit","year":"2019","journal-title":"J. Enabling Technol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"103823","DOI":"10.1016\/j.foodqual.2019.103823","article-title":"Can games change children\u2019s eating behaviour? A review of gamification and serious games","volume":"80","author":"Chow","year":"2020","journal-title":"Food Qual. Prefer."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1007\/s10566-020-09566-1","article-title":"How effective are serious games for promoting mental health and health behavioral change in children and adolescents? A systematic review and meta-analysis","volume":"49","author":"David","year":"2020","journal-title":"Child Youth Care Forum"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1007\/s42600-021-00162-3","article-title":"A systematic review of serious games used for rehabilitation of individuals with Parkinson\u2019s disease","volume":"37","author":"Mendes","year":"2021","journal-title":"Res. Biomed. Eng."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1089\/g4h.2017.0058","article-title":"The use of user-centered participatory design in serious games for anxiety and depression","volume":"6","author":"Dekker","year":"2017","journal-title":"Games Health J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1093\/jamia\/ocaa013","article-title":"Serious games for smoking prevention and cessation: A systematic review of game elements and game effects","volume":"27","author":"Derksen","year":"2020","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Dias, J.D., Domingues, A.N., Tibes, C.M., Zem-Mascarenhas, S.H., and Fonseca, L.M.M. (2018). Serious games as an educational strategy to control childhood obesity: A systematic literature review. Rev. Lat. Am. Enferm., 26.","DOI":"10.1590\/1518-8345.2509.3036"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Dias, J.D., Tibes, C.M.S., Fonseca, L.M.M., and Zem-Mascarenhas, S.H. (2017). Use of serious games for coping with childhood obesity: Integrative literature review. Texto Contexto Enferm., 26.","DOI":"10.1590\/0104-07072017003010015"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s12984-021-00889-1","article-title":"Serious games for upper limb rehabilitation after stroke: A meta-analysis","volume":"18","author":"Doumas","year":"2021","journal-title":"J. NeuroEngineering Rehabil."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1097\/EJA.0000000000000675","article-title":"Serious game versus online course for pretraining medical students before a simulation-based mastery learning course on cardiopulmonary resuscitation","volume":"34","author":"Drummond","year":"2017","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/pai.12690","article-title":"A systematic review of serious games in asthma education","volume":"28","author":"Drummond","year":"2017","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1089\/g4h.2016.0068","article-title":"Serious games for psychotherapy: A systematic review","volume":"6","author":"Eichenberg","year":"2017","journal-title":"Games Health J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"100396","DOI":"10.1016\/j.entcom.2020.100396","article-title":"Serious games for people with mental disorders: State of the art of practices to maintain engagement and accessibility","volume":"37","author":"Francillette","year":"2021","journal-title":"Entertain. Comput."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1109\/TCIAIG.2015.2512592","article-title":"Review of the use of AI techniques in serious games: Decision making and machine learning","volume":"9","author":"Zapirain","year":"2017","journal-title":"IEEE Trans. Comput. Intell. AI Games"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12984-019-0492-1","article-title":"Recent advances in rehabilitation for parkinson\u2019s disease with exergames: A systematic review","volume":"16","author":"Folkerts","year":"2019","journal-title":"J. NeuroEngineering Rehabil."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e28079","DOI":"10.2196\/28079","article-title":"Serious games are not serious enough for myoelectric prosthetics","volume":"9","author":"Garske","year":"2021","journal-title":"JMIR Serious Games"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"F98","DOI":"10.1136\/archdischild-2019-317011","article-title":"Serious games, a game changer in teaching neonatal resuscitation? A review","volume":"105","author":"Ghoman","year":"2020","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Ghoman, S.K., and Schm\u00f6lzer, G.M. (2020). The retain simulation-based serious game\u2014A review of the literature. Healthcare, 8.","DOI":"10.3389\/fped.2020.00014"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1438718","DOI":"10.1080\/10872981.2018.1438718","article-title":"A systematic review of serious games in medical education: Quality of evidence and pedagogical strategy","volume":"23","author":"Gorbanev","year":"2018","journal-title":"Med. Educ. Online"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1055\/s-0039-1677904","article-title":"Serious games in health professions education: Review of trends and learning efficacy","volume":"28","author":"Haoran","year":"2019","journal-title":"Yearb. Med. Inform."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.2196\/games.7216","article-title":"Gamification in stress management apps: A critical app review","volume":"5","author":"Hoffmann","year":"2017","journal-title":"JMIR Serious Games"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1089\/g4h.2018.0024","article-title":"Serious games for children with chronic diseases: A systematic review","volume":"7","author":"Holtz","year":"2018","journal-title":"Games Health J."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Jin, R., Pilozzi, A., and Huang, X. (2020). Current cognition tests, potential virtual reality applications, and serious games in cognitive assessment and non-pharmacological therapy for neurocognitive disorders. J. Clin. Med., 9.","DOI":"10.3390\/jcm9103287"},{"key":"ref_50","first-page":"26","article-title":"Serious game-based intervention for children with developmental disabilities","volume":"16","author":"Kokol","year":"2020","journal-title":"Curr. Pediatr. Rev."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.2196\/games.7880","article-title":"The role of transfer in designing games and simulations for health: Systematic review","volume":"5","author":"Kuipers","year":"2017","journal-title":"JMIR Serious Games"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3389\/fpsyt.2016.00209","article-title":"Serious games for mental health: Are they accessible, feasible, and effective? A systematic review and meta-analysis","volume":"7","author":"Lau","year":"2017","journal-title":"Front. Psychiatry"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1097\/SIH.0000000000000512","article-title":"Efficacy of serious games in healthcare professions education: A systematic review and meta-analysis","volume":"16","author":"Cossette","year":"2021","journal-title":"Simul. Healthc."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e019871","DOI":"10.1136\/bmjopen-2017-019871","article-title":"Effectiveness of serious games and impact of design elements on engagement and educational outcomes in healthcare professionals and students: A systematic review and meta-analysis protocol","volume":"8","author":"Cossette","year":"2018","journal-title":"BMJ Open"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e30482","DOI":"10.2196\/30482","article-title":"Awareness, prevention, detection, and therapy applications for depression and anxiety in serious games for children and adolescents: Systematic review","volume":"9","author":"Martinez","year":"2021","journal-title":"JMIR Serious Games"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/j.apmr.2017.10.018","article-title":"Systematic review on the effects of serious games and wearable technology used in rehabilitation of patients with traumatic bone and soft tissue injuries","volume":"99","author":"Meijer","year":"2018","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1109\/MCG.2018.021951633","article-title":"An analysis of VR technology used in immersive simulations with a serious game perspective","volume":"38","author":"Menin","year":"2018","journal-title":"IEEE Comput. Graph. Appl."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"3299","DOI":"10.1590\/1413-81232020258.11782018","article-title":"Serious games for children\u2019s oral hygiene education: An integrative review and application search","volume":"25","author":"Morais","year":"2020","journal-title":"Cienc. Saude Coletiva"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1080\/17483107.2020.1768309","article-title":"Exploring serious games for stroke rehabilitation: A scoping review","volume":"17","author":"Mubin","year":"2020","journal-title":"Disabil. Rehabil. Assist. Technol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3233\/THC-202333","article-title":"Serious games as rehabilitation tools in neurological conditions: A comprehensive review","volume":"29","author":"Ong","year":"2021","journal-title":"Technol. Health Care"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1080\/17483107.2017.1290702","article-title":"Serious games for upper limb rehabilitation: A systematic review","volume":"13","author":"Quaresma","year":"2018","journal-title":"Disabil. Rehabil. Assist. Technol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.jbi.2017.05.011","article-title":"A systematic review of gamification in e-health","volume":"71","author":"Sardi","year":"2017","journal-title":"J. Biomed. Inform."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e13459","DOI":"10.2196\/13459","article-title":"Health education serious games targeting health care providers, patients, and public health users: Scoping review","volume":"8","author":"Sharifzadeh","year":"2020","journal-title":"JMIR Serious Games"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e20190293","DOI":"10.1590\/1983-1447.2020.20190293","article-title":"The use of serious games as an innovative educational strategy for learning cardiopulmonary resuscitation: An integrative review","volume":"41","author":"Siqueira","year":"2020","journal-title":"Rev. Gauch. Enferm."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e19914","DOI":"10.2196\/19914","article-title":"Gamification in rehabilitation of patients with musculoskeletal diseases of the shoulder: Scoping review","volume":"8","author":"Steiner","year":"2020","journal-title":"JMIR Serious Games"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"101412","DOI":"10.1016\/j.rasd.2019.101412","article-title":"A systematic review and meta-analysis of social emotional computer based interventions for autistic individuals using the serious game framework","volume":"66","author":"Tang","year":"2019","journal-title":"Res. Autism Spectr. Disord."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e18687","DOI":"10.2196\/18687","article-title":"Mapping behavioral health serious game interventions for adults with chronic illness: Scoping review","volume":"8","author":"Thomas","year":"2020","journal-title":"JMIR Serious Games"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e11565","DOI":"10.2196\/11565","article-title":"Developing theory-driven, evidence-based serious games for health: Framework based on research community insights","volume":"7","author":"Verschueren","year":"2019","journal-title":"JMIR Serious Games"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e20066","DOI":"10.2196\/20066","article-title":"Serious game design and clinical improvement in physical rehabilitation: Systematic review","volume":"9","author":"Vieira","year":"2021","journal-title":"JMIR Serious Games"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1089\/g4h.2017.0108","article-title":"Videogames for emotion regulation: A systematic review","volume":"7","author":"Villani","year":"2018","journal-title":"Games Health J."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e30390","DOI":"10.2196\/30390","article-title":"Conceptual ambiguity surrounding gamification and serious games in health care: Literature review and development of game-based intervention reporting guidelines (gamING)","volume":"23","author":"Warsinsky","year":"2021","journal-title":"J. Med. Internet Res."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1089\/g4h.2020.0042","article-title":"Current state of serious games in dentistry: A scoping review","volume":"10","author":"Zaror","year":"2021","journal-title":"Games Health J."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"4797032","DOI":"10.1155\/2019\/4797032","article-title":"A meta-analysis of use of serious games in education over a decade","volume":"2019","author":"Zhonggen","year":"2019","journal-title":"Int. J. Comput. Games Technol."},{"key":"ref_74","unstructured":"American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Publishing, Inc.. [4th ed.]."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Cohen, J. (2013). Statistical Power Analysis for the Behavioral Sciences, Routledge.","DOI":"10.4324\/9780203771587"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"264","DOI":"10.7326\/0003-4819-151-4-200908180-00135","article-title":"Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement","volume":"151","author":"Moher","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-mental state\u201d: A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/0749-5978(91)90020-T","article-title":"The theory of planned behavior","volume":"50","author":"Ajzen","year":"1991","journal-title":"Organ. Behav. Hum. Decis. Process"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1038\/s41586-022-05543-x","article-title":"Papers and patents are becoming less disruptive over time","volume":"613","author":"Park","year":"2023","journal-title":"Nature"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"100402","DOI":"10.1016\/j.entcom.2020.100402","article-title":"Empowering vulnerable target groups with serious games and gamification","volume":"38","author":"Gerritsen","year":"2021","journal-title":"Entertain. Comput."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Arora, C., and Razavian, M. (2021). Ethics of Gamification in Health and Fitness-Tracking. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182111052"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Mavroeidi, A.-G., Kitsiou, A., Kalloniatis, C., and Gritzalis, S. (2019). Gamification vs. Privacy: Identifying and Analysing the Major Concerns. Future Internet, 11.","DOI":"10.3390\/fi11030067"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Nakatsu, R., Rauterberg, M., and Ciancarini, P. (2015). Handbook of Digital Games and Entertainment Technologies, Springer.","DOI":"10.1007\/978-981-4560-52-8"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/s10676-016-9401-5","article-title":"More than Just a Game: Ethical Issues in Gamification","volume":"18","author":"Kim","year":"2016","journal-title":"Ethics Inf. Technol."}],"container-title":["Information"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2078-2489\/14\/2\/105\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:27:18Z","timestamp":1760120838000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2078-2489\/14\/2\/105"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,7]]},"references-count":84,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["info14020105"],"URL":"https:\/\/doi.org\/10.3390\/info14020105","relation":{},"ISSN":["2078-2489"],"issn-type":[{"value":"2078-2489","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,7]]}}}