TABLE 6.

Significant event categories and cases.

Thematic analysis	Real case report examples
Physical state: the session has a direct or indirect impact on patients’ physical state. n = 7 cases The patient shows: - Better resistance to fever [n = 3]. - Improved pain control [n = 2]. - Increased fine mobility in patients with neurological impairment [n = 2].	“Superman, 7 years old, was very ill and has neurological problems that prevent him from moving and speaking normally. HabitApp managed to motivate him to take pictures by working on the fine mobility of his fingers and to try to speak during the session, imitating animal sounds. His doctor and mom were very surprised to see HabitApp encouraging and activating him” “Princess Leia, 10 years old, has undergone numerous surgical operations and was in severe pain during the sessions. The nurses had given her as much pain medication as possible and could not alleviate her. Using HabitApp she managed to relax and was distracted from her pain and also stopped demanding more medication from the nurses” “Cat-woman, 9 years old, had a high fever; the medicine could not get it down and she had been lying in bed all day, while her mother was putting wet towels on her head to try to reduce the fever. She and her mother were very happy when they discovered HabitApp, she got out of bed and started exploring for animals, laughing together with her mother. The fever went down within 10 min after the session started. Mom and nurses were very surprised”
Emotional state: the session had a significant impact on mood state, achieving positive states n = 10 cases	“Wonder-woman, 6 years old, was feverish and didn’t want to do anything else over several days. Hospital teachers had tried to encourage her through activities but she did not want to do anything. When she discovered HabitApp she asked to have more sessions, she was very interested and smiling and taking many pictures. In addition, after the session she wished to go to the hospital school. Teachers and nurses were surprised” “Iron-man, 12 years old, was very sad, for many days he did not want to do anything, and also was annoyed and irritated for treatment-induced distress. He found the session with HabitApp stimulating and showed expressively positive affection, unlike the previous days. During the session he relaxed and expressed emotions and worries he had experienced during the hospital stay to his caregiver”
Social interaction: the session had a significant impact on interpersonal communication. n = 14 - Between the patient and caregiver [n = 7]. - Between patient and health medical staff [n = 7].	“Hulk, 7 years old, used his personal tablet device extensively when he was hospitalized, which alarmed his mother because he was not interested in any other activity and did not have proper communication with anyone. She believed he was addicted to it. When he discovered HabitApp, he stopped using his tablet immediately and began to use the tool, interacting with his mother and constantly talking to her” “Thor, 9 years old, had intense nausea and vomiting caused by the treatment. He did not want to see or talk to anyone at the hospital and had fairly defensive and aggressive behavior. During the HabitApp session, his nausea and vomiting were reduced, rapidly forgotten, and he had a totally different attitude toward the healthcare staff, being rather friendly and polite and responding to nurses’ comments” “Both Deadpool, 5 years old from Algeria and his mother spoke Spanish with difficulty, so they did not have much interaction with the health staff. Using HabitApp, they remembered anecdotes from their country, telling them to the health staff, which created a relaxed and communicative atmosphere. The nurses were surprised by the more communicative and friendly change of attitude”
Hospital routines: the sessions had an impact on the performance of daily routines in the hospital. n = 7 Using HabitApp was very useful: - To relax patients during painful or frightening interventions, such as venepuncture [n = 2]. - To promote the intake necessary for their recovery [n = 3]. - To help them take medication [n = 7]. - To motivate them to wake up in the morning as well as to clean themselves [n = 1].	“Lara-croft, 9 years old, was very weak and very affected by the aggressive treatment, had extreme weight loss and developed an aversion to food. Using HabitApp relaxed her and simultaneously helped her to start eating. Doctors reported a significant change in her medical history regarding food” “Cat-woman, 9 years old, was very concerned because she had to go to the operating theater. Her grandmother and her doctor informed us how nervous she was. HabitApp managed to catch her attention and distract her concern. The health team and her caregiver told us that this change in her attitude had been surprising. The caregiver spent much time watching the animals and invited some nurses to observe them” “Batman, 3 years old, was very bored and eager to be alone in the transplant room. His father was exhausted and did not have any ideas to amuse his son. HabitApp was a powerful tool for the father, who got his son into a fun and relaxing playful and educational activity that was interesting for both of us” “Spider-Man, 4 years old, was going home, but first the nurses had to remove the port-a-cath. Spiderman was really nervous and crying. Watching giraffes on HabitApp managed to reduce his crying, and decrease his anxiety while the nurses did the intervention”
N total = 37 cases of significant events