A Story‐Based Digital Game to Reduce Anxiety and Improve Treatment Adherence in Patients Receiving Hemodialysis: A Cluster‐Randomized Controlled Trial

INTRODUCTION: Patients receiving hemodialysis frequently experience anxiety and treatment non-adherence, which negatively impact clinical outcomes. Digital health interventions offer innovative opportunities to address these challenges during dialysis sessions. METHODS: This cluster-randomized controlled trial included 40 patients receiving chronic hemodialysis (intervention n = 20, control n = 20). The intervention group played a story-based digital game once during hemodialysis; controls received standard care. Outcomes were assessed using validated scales for anxiety, adherence, and dietary knowledge at baseline, 2 weeks, and 1 month. RESULTS: The intervention group demonstrated significant improvements in treatment adherence (p < 0.001), dietary knowledge (p = 0.002), and anxiety reduction (p < 0.001) compared with controls at both follow-ups. Participants reported high game engagement with minimal negative effects. No adverse events occurred. CONCLUSIONS: A single-session story-based digital game enhanced adherence, knowledge, and reduced anxiety in hemodialysis patients, demonstrating that brief, engaging digital tools can support dialysis care and promote behavioral change.