Effect of a Nurse‐Navigated Game‐Based Program on Transition Readiness and Psychosocial Outcomes in Adolescents With Osteosarcoma: A Cluster‐Nonrandomized Controlled Study

Vollständiger Abstract

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ABSTRACT Background Adolescents with osteosarcoma face clinical and psychosocial challenges during the transition from adolescence to adulthood. Aims This study examined the effects of a nurse‐navigated game‐based intervention (N 2 ‐GBI) on transition readiness in adolescents. Methods Participants in the control group received usual care, whereas the intervention group received the N 2 ‐GBI programme alongside usual care. Transition readiness was assessed using the Self‐Management and Transition to Adulthood with Rx = Treatment Questionnaire as the primary outcome. Secondary outcomes included cancer worry, transition expectation and patient activation, which were measured using the Cancer Worry Scale, Transition Expectation Scale, and Patient Activation Measure, respectively. Outcomes were assessed at baseline (T0), immediately after intervention (T1) and at 12‐week follow‐up (T2). Generalized estimating equations were used to estimate the intervention effects. Results A total of 59 adolescents were enrolled. The intervention and control groups comprised 32 and 27 adolescents, respectively, with mean ages of 15 and 13 years, respectively. A total of 19 and 15 participants were male in the intervention and control groups, respectively. Compared with the control group, the N 2 ‐GBI group showed significantly greater improvement in transition readiness at T1 ( β = 8.83, p < 0.001) and T2 ( β = 7.97, p = 0.001). The N 2 ‐GBI programme also significantly reduced cancer worry ( p = 0.009) and increased patient activation ( p = 0.001), but had no significant effect on transition expectation ( p = 0.056). Conclusions The N 2 ‐GBI programme improved transition readiness, reduced cancer worry, and increased patient activation among adolescents with osteosarcoma, but did not significantly improve transition expectation. This intervention may be a useful nurse‐led approach to transition preparation in pediatric oncology care. Future studies with larger sample sizes and prolonged follow‐up durations are needed.