Virtual simulation on breastfeeding and nipple-areolar lesions: prototype development and validation

Medeiros, Lays Pinheiro de; Sena, Julliana Fernandes de; Rodrigues, Maria Izabel Rezende; Nascimento, Rafael Moreira do; Fonseca, Luciana Mara Monti; Costa, Isabelle Katherinne Fernandes

doi:10.37689/acta-ape/2023AO025022

Lays Pinheiro de Medeiros

contributed to the study design, data analysis and interpretation, relevant intellectual critical review and approval of the final version to be published

Department of Nursing, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.

https://orcid.org/0000-0002-1753-5330

Julliana Fernandes de Sena

contributed to the study design, data analysis and interpretation, relevant intellectual critical review and approval of the final version to be published

Department of Nursing, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.

https://orcid.org/0000-0002-8968-1521

Maria Izabel Rezende Rodrigues

contributed to the study design, data analysis and interpretation, relevant intellectual critical review and approval of the final version to be published

Department of Nursing, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.

https://orcid.org/0000-0001-9834-6226

Rafael Moreira do Nascimento

contributed to the study design, data analysis and interpretation, relevant intellectual critical review and approval of the final version to be published

Department of Nursing, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.

https://orcid.org/0000-0001-5874-844X

Luciana Mara Monti Fonseca

contributed to the study design, data analysis and interpretation, relevant intellectual critical review and approval of the final version to be published

Department of Maternal and Child Nursing and Public Health, Universidade de Sao Paulo, Ribeirao Preto, SP, Brazil.

https://orcid.org/0000-0002-5831-8789

Isabelle Katherinne Fernandes Costa

contributed to the study design, data analysis and interpretation, relevant intellectual critical review and approval of the final version to be published

Department of Nursing, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.

https://orcid.org/0000-0002-1476-8702

Corresponding author: Maria Izabel Rezende Rodrigues Email: izabel.rodrigues.703@gmail.com

Associate Editor (Peer review process): Rosely Erlach Goldman (https://orcid.org/0000-0003-4011-1875) Escola Paulista de Enfermagem, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil

Conflicts of interest: article extracted from the doctoral thesis “Development of the Serious Game prototype as an educational resource on nipple-areolar lesions resulting from breastfeeding”. Author: Lays Pinheiro de Medeiros. Advisor: Isabelle Katherinne Fernandes Costa. Postgraduate Program in Nursing. Universidade Federal do Rio Grande do Norte. 2021.

Variables	Expert judges n (%)	Mean (years)
Female gender	6(100)
Training in nursing	6(100)
Age group		54.6
Professional experience in the field
IBCLC certification*	4(66.6)
Baby Friendly Hospital	1(16.7)
Human milk bank	1(16.7)
Nursing training time		31
Certification
Specialization	3(50)
Master’s degree	3(50)
Theme in complementary training
Breastfeeding	3(50)
Obstetrics	1(16.7)
Pediatrics and neonatology	1(16.7)
Others	1(16.7)

Content	Didactic resource	Theoretical basis	Identification in figure 2
Inadequate breastfeeding technique	Photo-like real image Video-like real image	Amir, L.H. Managing common breastfeeding problems in the community. BMJ, v. 348, p. 31-34, 2014.	1.2
Historic	Fictitious medical record	Barbosa DM, Caliman MZ, Alvarenga SC, Lima EFA, Leite FMC, Caniçali Primo C. Assessment of factors associated with nipple trauma. Rev Fun Care Online. 2018.	3
Anamnesis	Narrative in dialog format	Barbosa DM, Caliman MZ, Alvarenga SC, Lima EFA, Leite FMC, Caniçali Primo C. Assessment of factors associated with nipple trauma. Rev Fun Care Online. 2018.	4
Relevant clinical parameters	Multiple choice question	Tiruye, G., Mesfin, F., Geda, B. et al. Breastfeeding technique and associated factors among breastfeeding mothers in Harar city, Eastern Ethiopia. Int Breastfeed J 13, 5 (2018).	5
Key points of latch evaluation and positioning	Text Video-like real image	Brazil. Ministry of Health. Food guide for Brazilian children under 2 years old, Secretariat of Primary Health Care, Department of Health Promotion. Brasília, 2019.	6
Influence of the latch on the occurrence of nipple-areolar lesion	Animation type video	Coca KP, Gamba MA, Silva RS, Abrão ACFV. Does the breastfeeding position determine the onset of nipple trauma? Revista da Escola de Enfermagem - USP. 2009;43(2):446-452.	7
Influence of the latch on the ejection of breast milk	Video-like real image	Brazil. Ministry of Health. Food guide for Brazilian children under 2 years old, Secretariat of Primary Health Care, Department of Health Promotion. Brasília, 2019.	8
“c” technique to assist in breastfeeding	Video-like real image	Ministry of Health. Food guide for Brazilian children under 2 years old, Secretariat of Primary Health Care, Department of Health Promotion. Brasília, 2019.	9
Breastfeeding advice	Text	Bueno LGS, Teruya KM. Breastfeeding counseling and its practice. Jornal de Pediatria. v. 80, n. 5(supl), 2004	10
Variety in the clinical presentations of nipple-areolar lesions	Text and real photo type image	Nakamura M, et al. Nipple Skin Trauma in Breastfeeding Women During Postpartum Week One. Breastfeed Med, v. 13, n. 7, p. 479-484, 2011.	11
Most appropriate conduct for the case	Multiple choice question	Berens P, Eglash A, Malloy M, Steube A M, and the Academy of Breastfeeding Medicine. ABM Clinical Protocol #26: Persistent Pain with Breastfeeding. Breastfeeding Medicine. Volume 11, Number 2, 2016. Brazil. Ministry of Health. Food guide for Brazilian children under 2 years old, Secretariat of Primary Health Care, Department of Health Promotion. Brasília, 2019. Dennis CL, Jackson K, Watson J. Interventions for treating painful nipples among breastfeeding women. Cochrane Database of Systematic Reviews 2014, Issue 12.	12

GameFlow instrument items	n(%)
What is your contact with technological resources (computers, tablets, smartphones, etc.)?
I use it daily	9(100)
What is your contact with digital games (video games, tablets, smartphones, etc.)?
I rarely play	3(33.4)
I never play	2(22.2)
I play occasionally	2(22.2)
I play daily	2(22.2)

Educational Software Evaluation Items	*Average score (Content) average score (Tec/Ped)

Does the game hold my attention?	6.85(4)
Am I distracted from tasks I should be focusing on?	6.57(5.3)
Do I enjoy the game without getting bored or anxious?	6.57(4)
Is difficulty adequate?	6.57(6)
Will my skills increase as the game progresses?	6.42(6.3)
Am I motivated by improving my skills?	6.57(5)
Do I have a sense of menu control?	6.71(5.3)
Does the game allow me to recover from mistakes made?	7(5)
Do I feel like I can use any strategies?	6.57(4.3)
Do I know the next step in the game?	6.14(5.3)
Are general objectives presented at the beginning of the game?	6.57(6.6)
Do I understand the goals of learning through the game?	7(7)
Do I get feedback on my game progress?	7(7)
Do I receive information about my status, such as level or score?	7(6)
Do I lose track of time while playing?	6.14(3.3)
Do I forget things around me while playing?	6.28(3.3)
Do I forget about everyday problems while playing?	6(3)
Am I involved with the game?	6.85(4.6)
Does the game improve my knowledge?	7(5.6)
Do I try to apply the knowledge in the game?	7(6.6)
Do I want to know more about the featured content?	6.85(5.6)

[1] Corresponding author: Maria Izabel Rezende Rodrigues Email: izabel.rodrigues.703@gmail.com

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Virtual simulation on breastfeeding and nipple-areolar lesions: prototype development and validation

Abstract

Objective

Methods

Results

Conclusion