Heart failure is a chronic and debilitating condition that affects an estimated 6.5 million adults in the U.S., and the numbers are rising with the aging of the population. Most individuals with heart failure experience deficits in physical functioning, social isolation, decreased quality of life and exhibit psychological challenges, specifically anxiety and depression. Considering the negative consequences of heart failure, it is imperative to explore opportunities to improve the physical and psychological outcomes in this highly vulnerable population. Exercise training is recommended for the management of heart failure. The latest guidelines on the treatment of heart failure recommend regular and structured physical activity. Exercise through video or virtual reality games also known as exergames has grown in popularity among older adults at home or in assisted living facilities to increase physical activity and improve psychological well-being.
This dissertation describes four papers that address the impact of exergaming on psychological well-being and symptom burden in patients with heart failure and examine perceptions related to facilitators and barriers to exergaming. The first paper is a secondary analysis that examined the impact of perceived control on depression in patient with heart failure (Chapter 1). The second paper is a systematic review that analyzed the effect of exergaming on health-related quality of life in older adults (Chapter 2). The third paper is a qualitative study describing the barriers and facilitators to exergaming using the Nintendo™ Wii Sports platform (Chapter 3). The fourth paper describes a pilot study to evaluate the impact of exergaming in anxiety and depression, health-related quality of life, and symptom burden among patients with heart failure (Chapter 4). These papers contribute to the growing body of research involving patients with heart failure and demonstrate that 1) perceived control is associated with functional status and depression; 2) addressing barriers and facilitators to exergaming may potentially improve acceptance of exergaming in this population; and 3) exergaming has the potential to enhance psychological well-being and reduce symptom burden in patients with heart failure. Additional research is warranted with a larger sample size to explore the true effects of exergaming in improving the psychological well-being and symptom burden in patients with heart failure.