The Preliminary Effect of Serious Gaming on Cognitive Representation of Nausea in Aging Adults With Cancer: A Randomized Controlled Trial

Background: Chemotherapy-induced nausea and vomiting (CINV) is one of the most feared side effects of chemotherapy, with more severe consequences in aging adults with cancer. Objective: This analysis examines the beliefs about managing nausea among aging adults enrolled in a longitudinal randomized controlled trial that evaluated a novel serious game for CINV self-management. Methods: One hundred fourteen participants were randomized to the attention control group or intervention group, followed up to 6 months. The Symptom Representation Questionnaire (SRQ) was used to measure the cognitive and emotional beliefs about nausea. We first evaluated the construct validity of SRQ using confirmatory factor analysis. Then, multilevel linear models were used to examine the intervention effects on SRQ. Results: Significant within-group changes over time were observed across all subscales in both groups. No significant group and time interaction was detected at this stage. However, subgroup analyses showed significant group and time interaction among high school and trade school subgroups, the Hispanic subgroup, patients having low nausea levels at final assessment, and those with decreased nausea after intervention. Conclusions: Intervention effects have not been detected. However, some groups may demonstrate greater responsiveness to interventions aimed at modifying cognitions related to CINV. Implications for Practice: Technology-based intervention has the potential to change individuals’ responses to CINV and facilitate effective self-management in the home setting among aging adults. What is Foundational: This study examines the preliminary intervention effects on the cognition of nausea among aging adults. With the current sample size, we only find intervention effects among some subgroups.