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  <front>
    <journal-meta>
      <journal-id journal-id-type="nlm-ta">Rev Bras Enferm</journal-id>
      <journal-id journal-id-type="publisher-id">reben</journal-id>
      <journal-title-group>
        <journal-title>Revista Brasileira de Enfermagem</journal-title>
        <abbrev-journal-title abbrev-type="publisher">Rev. Bras. Enferm.</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">0034-7167</issn>
      <issn pub-type="epub">1984-0446</issn>
      <publisher>
        <publisher-name>Associa&#231;&#227;o Brasileira de Enfermagem</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id specific-use="scielo-v3" pub-id-type="publisher-id">MTbZQd7S7LmX8n43NrHZRBB</article-id>
      <article-id specific-use="scielo-v2" pub-id-type="publisher-id">S0034-71672022000500178</article-id>
      <article-id pub-id-type="other">00178</article-id>
      <article-id pub-id-type="doi">10.1590/0034-7167-2021-0822</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>ORIGINAL ARTICLE</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Validation of Ludic-Quest to the playfulness of health games: gameplay and emotions on the field</article-title>
        <trans-title-group xml:lang="es">
          <trans-title>Validaci&#243;n de Ludic-Quest a la ludicidad de los juegos de salud: jugabilidad y emociones en el campo</trans-title>
        </trans-title-group>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-7941-0816</contrib-id>
          <name>
            <surname>Pires</surname>
            <given-names>Maria Raquel Gomes Maia</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">I</xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-9113-0729</contrib-id>
          <name>
            <surname>Almeida</surname>
            <given-names>Alexandre Nascimento de</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">I</xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-2675-8085</contrib-id>
          <name>
            <surname>Gottems</surname>
            <given-names>Leila Bernarda Donato</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">II</xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-4984-4541</contrib-id>
          <name>
            <surname>Mundim</surname>
            <given-names>Gabriela Duarte Almeida</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">I</xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-8784-9589</contrib-id>
          <name>
            <surname>Oliveira</surname>
            <given-names>Rebeca Nunes Guedes de</given-names>
          </name>
          <xref ref-type="aff" rid="aff3">III</xref>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <label>I</label>
        <institution content-type="orgname">Universidade de Bras&#237;lia</institution>
        <addr-line>
          <city>Bras&#237;lia</city>
          <state>Distrito Federal</state>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">Universidade de Bras&#237;lia. Bras&#237;lia, Distrito Federal, Brazil.</institution>
      </aff>
      <aff id="aff2">
        <label>II</label>
        <institution content-type="orgname">Universidade Cat&#243;lica de Bras&#237;lia</institution>
        <addr-line>
          <city>Bras&#237;lia</city>
          <state>Distrito Federal</state>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">Universidade Cat&#243;lica de Bras&#237;lia. Bras&#237;lia, Distrito Federal, Brazil.</institution>
      </aff>
      <aff id="aff3">
        <label>III</label>
        <institution content-type="orgname">Universidade de S&#227;o Caetano do Sul</institution>
        <addr-line>
          <city>S&#227;o Caetano do Sul</city>
          <state>S&#227;o Paulo</state>
        </addr-line>
        <country country="BR">Brazil</country>
        <institution content-type="original">Universidade de S&#227;o Caetano do Sul. S&#227;o Caetano do Sul, S&#227;o Paulo, Brazil.</institution>
      </aff>
      <author-notes>
        <corresp id="c1"><bold>Corresponding author:</bold> Maria Raquel Gomes Maia Pires E-mail: <email>maiap@unb.br</email> </corresp>
        <fn fn-type="edited-by">
          <p>EDITOR IN CHIEF: Antonio Jos&#233; de Almeida Filho</p>
        </fn>
        <fn fn-type="edited-by">
          <p>ASSOCIATE EDITOR: Hugo Fernandes</p>
        </fn>
      </author-notes>
      <pub-date date-type="pub" publication-format="electronic">
        <day>09</day>
        <month>05</month>
        <year>2022</year>
      </pub-date>
      <pub-date date-type="collection" publication-format="electronic">
        <year>2022</year>
      </pub-date>
      <volume>75</volume>
      <issue>04</issue>
      <elocation-id>e20210822</elocation-id>
      <history>
        <date date-type="received">
          <day>27</day>
          <month>11</month>
          <year>2021</year>
        </date>
        <date date-type="accepted">
          <day>21</day>
          <month>01</month>
          <year>2022</year>
        </date>
      </history>
      <permissions>
        <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/" xml:lang="en">
          <license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
        </license>
      </permissions>
      <abstract>
        <title>ABSTRACT</title>
        <sec>
          <title>Objective:</title>
          <p>to validate Ludic-quest construct and reliability to assess game playfulness, through latent factors in gameplay, perception of learning and emotions in the game.</p>
        </sec>
        <sec>
          <title>Methods:</title>
          <p>a cross-sectional study to validate the instrument&#8217;s psychometric properties. 247 people responded to the questionnaire after a match in the game <italic>Violetas</italic>. Exploratory Factor Analysis, using KMO (&gt;0.7), Bertlett (p=0.005), Varimax and factor loading (&gt;0.6). Reliability by Cronbach&#8217;s alpha (&gt;0.6).</p>
        </sec>
        <sec>
          <title>Results:</title>
          <p>in gameplay/learning, KMO=0.859, Bertlett significant. The eigenvalue indicated four factors (reflections; immersion; challenges; aesthetics), 10 retained variables. In the factor analysis of emotions: KMO=0.817; Bartlett p=0.000. Extraction of four factors (pleasure; <italic>ostraenie</italic>; tension; fun), 10 retained variables. The 20 validated variables contain reliability (Cronbach&#8217;s alpha=0.716).</p>
        </sec>
        <sec>
          <title>Conclusions:</title>
          <p>the eight validated factors centralize playfulness in health game production, composing a reliable playfulness assessment instrument for use in research.</p>
        </sec>
      </abstract>
      <trans-abstract xml:lang="es">
        <title>RESUMEN</title>
        <sec>
          <title>Objetivo:</title>
          <p>validar el constructo y la confiabilidad del instrumento Ludic-Quest para evaluar la l&#250;dica de los juegos, a trav&#233;s de factores latentes en la jugabilidad, percepci&#243;n del aprendizaje y emociones en el juego.</p>
        </sec>
        <sec>
          <title>M&#233;todos:</title>
          <p>estudio transversal para validar las propiedades psicom&#233;tricas del instrumento. 247 personas contestaron el cuestionario despu&#233;s de un partido de Violetas. An&#225;lisis Factorial Exploratorio, utilizando KMO (&gt;0,7), Bertlett (p=0,005), Varimax y carga factorial (&gt;0,6). Confiabilidad por Alfa de Cronbach (&gt;0.6).</p>
        </sec>
        <sec>
          <title>Resultados:</title>
          <p>en jugabilidad/aprendizaje, KMO=0,859, Bertlett significativo. El valor propio indic&#243; cuatro factores (reflexiones; inmersi&#243;n; desaf&#237;os; est&#233;tica) y 10 variables retenidas. En el an&#225;lisis factorial de las emociones: KMO=0,817; Bartlett p=0,000. Extracci&#243;n de cuatro factores (placer; ostraenie; tensi&#243;n; diversi&#243;n) y 10 variables retenidas. Las 20 variables validadas contienen confiabilidad (Alfa de Cronbach=0,716).</p>
        </sec>
        <sec>
          <title>Conclusiones:</title>
          <p>los ocho factores validados centralizan la ludicidad en la producci&#243;n de juegos de salud, componiendo un instrumento de evaluaci&#243;n de la ludicidad confiable para uso en investigaci&#243;n.</p>
        </sec>
      </trans-abstract>
      <kwd-group xml:lang="en">
        <title>Descriptors:</title>
        <kwd>VALIDATION STUDY</kwd>
        <kwd>FACTOR ANALYSIS</kwd>
        <kwd>PLAY</kwd>
        <kwd>LEARNING</kwd>
        <kwd>EMOTIONS</kwd>
      </kwd-group>
      <kwd-group xml:lang="es">
        <title>Descriptores:</title>
        <kwd>Estudio de Validaci&#243;n</kwd>
        <kwd>An&#225;lisis Factorial</kwd>
        <kwd>Juego</kwd>
        <kwd>Aprendizaje</kwd>
        <kwd>Emociones</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec sec-type="intro">
      <title>INTRODUCTION</title>
      <p>Research in games has been consolidated in recent years with the expansion of journals and the improvement of the scientific field. Reviews confirm the interdisciplinarity and diversity of approaches, which include epistemic and methodological debates<sup>(<xref ref-type="bibr" rid="B1">1</xref>-<xref ref-type="bibr" rid="B2">2</xref>)</sup>. In the health area, Serious Games for Health (SGH) emphasize the game as an educational tool, in different applications (patient compliance, behavior changes, motivations for learning). These studies, however, remain unrelated to the prioritization of play&#8217;s disruptive character, as they aim at purposes that are foreign to the game features. In general, SGH distance themselves from investigations about gameplay and imaginative emotions in matches, by investing in protocols with controllable variables, which restrain the playful aspects<sup>(<xref ref-type="bibr" rid="B3">3</xref>-<xref ref-type="bibr" rid="B6">6</xref>)</sup>.</p>
      <p>Certainly, the experiments that imprison the game&#8217;s libertarian power incur limitations in the generalization of results<sup>(<xref ref-type="bibr" rid="B3">3</xref>-<xref ref-type="bibr" rid="B4">4</xref>)</sup>. In the same way, the instruments that help in the development of games are scarce, partial and imprecise - the majority focused on participants&#8217; behavioral or cognitive effects, although it considers participants&#8217; gameplay (artifices that guarantee the playful dynamics) and experience<sup>(<xref ref-type="bibr" rid="B5">5</xref>-<xref ref-type="bibr" rid="B8">8</xref>)</sup>. These researches could not be different, since playful&#8217;s unforeseen characteristics tend to escape scientific standardization, in insurgent free enjoyment. It is not by chance that conceptions about the game are equally ambiguous. A review of 60 terms arrived at the multiplicity of undefinitions, classifiable into<sup>(<xref ref-type="bibr" rid="B9">9</xref>)</sup>: i - what are the rules; ii - what is its function; iii - if they are artifacts, activities or both; iv - if they are disconnected or in tune with the &#8216;real&#8217;; v - what are the players; vi - if they are unproductive or generate something; vii - what is the role of competition; viii - if there are goals or purposes; ix - whether there are relevant phenomena; x- what purposes do they serve.</p>
      <p>Furthermore, in order to remain free, unsubmissive, unproductive, inscribed in its own rules, producer of imaginary universes and delimited in space and time, the game tends to circumvent the method. Among its characteristics, voluntary activity is included, not serious and outside everyday life, self-regulated, fictitious, disinterested in the ordinary and capable of absorbing participants in an intense way. In culture, the game transits between the sacred and the profane amidst the party, the ritual, the laughter. In it, dispute and mystery suspend the fixed references of representation of everyday life, subverting it in favor of imaginative freedom<sup>(<xref ref-type="bibr" rid="B10">10</xref>-<xref ref-type="bibr" rid="B13">13</xref>)</sup>.</p>
      <p>Paradoxically, the more playfulness distances itself from the evidence, the more the educational chances expand, through the denial of resigned obedience. For the sake of the insurrection of playful in thinking, we then should switch the focus of investigations in health. Instead of asking about how the game contributes to clinical or learning purposes in participants, we should investigate how to rescue their inventive restlessness. This twist in the search mode seeks to enhance the game&#8217;s own artifices, freeing it from other purposes as much as possible. Through playfulness, it is more interesting to delve into the resources, languages, regulations, ruptures, estrangements and experiences inherent to playing. In other words, we privilege the playful dynamics&#8217; formal procedures (gameplay) and the affections provoked by them (emotions), to intensify the game. We position ourselves, therefore, as a movement of critical resistance, immersed and dialogical to the epistemic field<sup>(<xref ref-type="bibr" rid="B10">10</xref>-<xref ref-type="bibr" rid="B16">16</xref>)</sup>.</p>
      <p>By privileging the autonomy of play, we include the enterprise limits: the creation of games with themes of interest to health restricts the freedom we claim. That is, the promotion of games aimed at the problems of collectivities presupposes the same coercion of playful to other purposes that we criticize. Aware of the aporia, we only intend to bet on the game&#8217;s elements to win its thematic content, in a calculation that favors playfulness. We invest, in an unusual way, in measuring instruments that privilege the power of gameplay to intensify the instant, singular, elusive and revealing emotions in players, keeping the finals open<sup>(<xref ref-type="bibr" rid="B9">9</xref>-<xref ref-type="bibr" rid="B15">15</xref>)</sup>.</p>
      <p>The confirmation of latent factors to playfulness becomes necessary in the methodological instrumentation of research focused on the validation of games with social approaches to health, in population studies. The reduction of variables to a set capable of explaining the playful phenomenon favors the elaboration of multiple scales, with valuable uses in the assessment of a game. In this sense, we discuss in this article the Ludic-quest instrument construct validation in the assessment of the playfulness of games in health, focusing on gameplay (mechanics to forge the playful field) and on imaginative emotions (affections provoked by the game)<sup>(<xref ref-type="bibr" rid="B9">9</xref>-<xref ref-type="bibr" rid="B17">17</xref>)</sup>. The question of this article is: what are the latent factors and valid items regarding the construct in the assessment of the playfulness of games that thematize violence in health?</p>
      <p>The study integrates research that assessed the playfulness of <italic>Violetas: cinema &amp; a&#231;&#227;o no enfrentamento da viol&#234;ncia contra a mulher</italic>, modern-style board game, in which players are characters in a network of confrontation with the mission of cooperatively containing the violence that spreads through Brazilian cities named after women. To win, participants need to act strategically to surround the violence on the board, in addition to answering questions to win four tokens (light, voice, welcome, networks)<sup>(<xref ref-type="bibr" rid="B18">18</xref>)</sup>.</p>
    </sec>
    <sec>
      <title>OBJECTIVE</title>
      <p>To validate gameplay, perception of learning and emotions in matches as expressions of playfulness, through latent factors, and analyze the reliability of Ludic-quest.</p>
    </sec>
    <sec sec-type="methods">
      <title>METHODS</title>
      <sec>
        <title>Ethical aspects</title>
        <p>The research follows the guidelines of the Brazilian National Health Council (CNS - <italic>Conselho Nacional de Sa&#250;de</italic>), being approved by the Ethics Committee of the Faculty of Health Sciences of the <italic>Universidade de Bras&#237;lia</italic>. All participants signed the Informed Consent Form (ICF).</p>
      </sec>
      <sec>
        <title>Study design</title>
        <p>This is a cross-sectional observational study, supported by STROBE, with validation of the psychometric properties of Ludic-quest in the assessment of the playfulness of games with themes of violence in the health area. The research took place in public and private higher education institutions (HEIs) classrooms in Bras&#237;lia, Distrito Federal, from October 2018 to June 2019, with recruitment of participants by prior scheduling of matches of <italic>Violetas</italic>. Players were followed up during the game, with clarifications to guarantee the playful atmosphere. We performed construct validation based on the variables included in the dimensions of gameplay and emotions in matches. We verified the instrument reliability, i.e., the consistency with which Ludic-quest measures and reproduces playfulness attributes, through Cronbach&#8217;s alpha<sup>(<xref ref-type="bibr" rid="B17">17</xref>,<xref ref-type="bibr" rid="B19">19</xref>)</sup>.</p>
      </sec>
      <sec>
        <title>Participants</title>
        <p>The sample consisted of 247 people, including students (n=236; 95%), professionals (n=3; 1.2%) and graduate students (n=8; 3.2%). Eligibility criteria, sources and selection methods were: inclusion of undergraduate students and/or professionals from the network to combat violence against women personified in <italic>Violetas</italic> (law enforcement officers; members of public policy/health professionals; activists in the women&#8217;s movement; educator(s) and/or researchers(es), who freely agreed to play a match. Women (n=203; 82.2%) and men (n=44; 17.8%) in the areas of nursing (n=191; 77.3%), social work (n=31; 12.5%) and humanities (n=25; 10%; public health, anthropology, social sciences, political science, history) participated. Most were aged between 18 and 30 years (n=224; 90.6%) or above (between 30 and 49 years; n=28; 11.3%). They and they answered the questionnaire after a match of <italic>Violetas: cinema &amp; a&#231;&#227;o no enfrentamento da viol&#234;ncia contra a mulher</italic><sup>(<xref ref-type="bibr" rid="B18">18</xref>)</sup>.</p>
      </sec>
      <sec>
        <title>Instrument</title>
        <p>The construction and validation of Ludic-quest content took place in previous stages, in line with the technological production of three board games. The items were prepared based on a literature review and the application of a preliminary version in test groups. This was followed by the closing of items and content validation through analysis by judges with reliability calculation by the Kappa coefficient, Content Validity Index (CVI) and Reliability Index (Reliability, Interrater Agreement (IRA)) analysis. This version of Ludic-quest with valid content resulted in 53 items for assessing the playfulness of health games, applicable using a five-point Likert scale<sup>(<xref ref-type="bibr" rid="B20">20</xref>)</sup>.</p>
        <p>In a second moment, to give parsimony and centrality to the playful in the assessment of <italic>Violetas</italic>, we prioritized 33 of the 53 items of the instrument with valid content, distributed in the dimensions learning, gameplay and emotions. The criteria for this selection were: i - interdisciplinary theoretical framework; ii - variables validated or recognized in the game production literature; iii - gameplay heuristics; iv - results of research using the Ludic Self-Reinvention methodology. We performed a statistical analysis of the variables of each of the three dimensions, as follows: we compared the three groups of variables (learning, gameplay, emotions) two by two, using the nonparametric Mann-Whitney U test. We verified that there is no difference between the learning and gameplay variables (same group), but these are significantly different from those included in the emotions dimension (another group)<sup>(<xref ref-type="bibr" rid="B15">15</xref>,<xref ref-type="bibr" rid="B18">18</xref>)</sup>.</p>
        <p>In the present Ludic-quest construct validation, we used this version with 33 items, distributed in the reconfigured dimensions after the Mann-Whitney U test<sup>(<xref ref-type="bibr" rid="B18">18</xref>)</sup>, namely: a - gameplay/learning (17 variables); b - imaginative emotions in matches (16 variables). The combination of gameplay and the perception of learning in the instrument - under the dimension rewritten as gameplay/learning - is in line with the premise of playful centrality argued for Ludic-quest. Due to space limitations, we will present only valid variables regarding the construct, after Exploratory Factor Analysis procedures.</p>
      </sec>
      <sec>
        <title>Data analysis procedures</title>
        <p>In the database construction, we used Excel for Windows&#8217; statistical package, double-entered, followed by database checking and unification. We transferred the file to IMB-SPSS, version 22, for statistical analysis. We performed Exploratory Factor Analysis (EFA), a multivariate inferential method indicated to find the underlying structure of a data matrix, through latent factors that represent a set of variables<sup>(<xref ref-type="bibr" rid="B19">19</xref>,<xref ref-type="bibr" rid="B21">21</xref>)</sup>.</p>
        <p>We conducted a factor analysis of the 33 Ludic-quest variables in two stages, respecting the significant differences between the gameplay/learning groups (17 variables) and emotions (16 variables). We aim to extract valid factors and items for each of these dimensions of playfulness, in order to identify latent conceptions. We start from the following conceptual bases: a - gameplay/learning: mechanical devices of the game that produce interactive immersion, challenges and aesthetic seduction on players, enhancers of reflections on learning; b - imaginative emotions: affective sensations provoked by the game in participants, with ambiguities between pleasure, fun, estrangement and tension<sup>(<xref ref-type="bibr" rid="B7">7</xref>,<xref ref-type="bibr" rid="B14">14</xref>,<xref ref-type="bibr" rid="B18">18</xref>,<xref ref-type="bibr" rid="B22">22</xref>)</sup>.</p>
        <p>To verify the assumptions for EFA, we used the following methods to observe the matrix adequacy for factoring: the Kaiser-Meyer-Olkin criterion (KMO, value above 0.7) and the Bertlett test (p=0.005). Factor retention was defined from the eigenvalue (Kaiser-Guttman) and eigenvalue &gt; 1. Factor rotation by the Varimax orthogonal method was indicated for variable reduction. To calculate the sample, we assumed the rule of 6 questionnaires per item. The factor loading above 0.6 was considered adequate for variable retention. However, the literature recommends loads with values above 0.5 or a minimum above 0.3, which allowed us flexibility. After each dimension&#8217;s EFA, we unified the validated items from Ludic-quest. We analyzed the instrument&#8217;s reliability by Cronbach&#8217;s alpha, with a parameter of 0.6, indicated for exploratory research<sup>(<xref ref-type="bibr" rid="B17">17</xref>,<xref ref-type="bibr" rid="B19">19</xref>,<xref ref-type="bibr" rid="B21">21</xref>)</sup>.</p>
      </sec>
    </sec>
    <sec sec-type="results">
      <title>RESULTS</title>
      <p>In the gameplay/learning EFA, the KMO index was 0.859, with a Bertlett test of p=0.000. The eigenvalue theory (Kaiser-Guttman) indicated four factors to the extraction, with the eigenvalues: F1:4,664; F2:1.424; F3:1.351; F4:1.109 (50.28% of explained variance). From thematic analysis of retained variables, we named the factors, namely: F1 - Reflections; F2 - Immersion; F3 - Challenges; F4 - Aesthetics. Nine variables above 0.6 and one above 0.4 were included (<xref ref-type="table" rid="t1">Table 1</xref>).</p>
      <table-wrap id="t1">
        <label>Table 1</label>
        <caption>
          <title>Factor analysis of gameplay as an expression of the playfulness of games that thematize violence in the health area, according to factors and items, Brasilia, Federal District, Brazil, September, 2021</title>
        </caption>
        <table>
          <thead>
            <tr>
              <th align="left">Gameplay/Learning<sup>a</sup></th>
              <th align="center">Reflection</th>
              <th align="center">Challenge</th>
              <th align="center">Immersion</th>
              <th align="center">Aesthetics</th>
              <th align="center">h<sup><xref ref-type="bibr" rid="B2">2</xref></sup></th>
            </tr>
          </thead>
          <tbody>
            <tr>
              <td align="left">I learned amazing things from the game</td>
              <td align="center">0.697</td>
              <td align="left"/>
              <td align="left"/>
              <td align="left"/>
              <td align="center">0.523</td>
            </tr>
            <tr>
              <td align="left">After this match, my interest in the content increased</td>
              <td align="center">0.694</td>
              <td align="left"/>
              <td align="left"/>
              <td align="left"/>
              <td align="center">0.608</td>
            </tr>
            <tr>
              <td align="left">During the match, I reflected on the challenges we face in life</td>
              <td align="center">0.683</td>
              <td align="left"/>
              <td align="left"/>
              <td align="left"/>
              <td align="center">0.612</td>
            </tr>
            <tr>
              <td align="left">The game favored my learning</td>
              <td align="center">0.681</td>
              <td align="left"/>
              <td align="left"/>
              <td align="left"/>
              <td align="center">0.611</td>
            </tr>
            <tr>
              <td align="left">I had difficulty concentrating on the text of the cards</td>
              <td align="left"/>
              <td align="center">-0.718</td>
              <td align="left"/>
              <td align="left"/>
              <td align="center">0.545</td>
            </tr>
            <tr>
              <td align="left">The difficulty of the cards compromised my learning</td>
              <td align="left"/>
              <td align="center">-0.702</td>
              <td align="left"/>
              <td align="left"/>
              <td align="center">0.535</td>
            </tr>
            <tr>
              <td align="left">I actively interacted with my teammates during the game<sup>b</sup></td>
              <td align="left"/>
              <td align="center">0.478</td>
              <td align="left"/>
              <td align="left"/>
              <td align="center">0.367</td>
            </tr>
            <tr>
              <td align="left">I did not pay attention to what was happening around me while playing</td>
              <td align="left"/>
              <td align="left"/>
              <td align="center">0.645</td>
              <td align="left"/>
              <td align="center">0.444</td>
            </tr>
            <tr>
              <td align="left">I felt more in the game environment than in the real world</td>
              <td align="left"/>
              <td align="left"/>
              <td align="center">0.630</td>
              <td align="left"/>
              <td align="center">0.596</td>
            </tr>
            <tr>
              <td align="left">The game design caught my attention</td>
              <td align="left"/>
              <td align="left"/>
              <td align="left"/>
              <td align="center">0.778</td>
              <td align="center">0.621</td>
            </tr>
            <tr>
              <td align="left">Cronbach&#8217;s alpha<sup>c</sup></td>
              <td align="center">0.725</td>
              <td align="center">0.546</td>
              <td align="center">0.321</td>
              <td align="center">---</td>
              <td align="center">---</td>
            </tr>
          </tbody>
        </table>
        <table-wrap-foot>
          <attrib>
            <italic>a- The table shows only variables with factor loadings above 0.6 retained in the factors. KMO 0.859; p=0.000. Percentage of variance explained by the model 50.28%. Varimax rotation. h<sup><xref ref-type="bibr" rid="B2">2</xref>=</sup>Commonalities.</italic>
          </attrib>
          <attrib>
            <italic>b- Variable with factor loading below 0.60, included in the model in line with the gameplay heuristics and with the minimum acceptable factor loading<sup>(<xref ref-type="bibr" rid="B21">21</xref>)</sup>.</italic>
          </attrib>
          <attrib>
            <italic>c- Cronbach&#8217;s alpha of all variables retained in the model: 0.502.</italic>
          </attrib>
        </table-wrap-foot>
      </table-wrap>
      <p>In imaginative emotions in matches, factor analysis showed a KMO test of 0.817 and Bartlett p=0.000. The eigenvalue (Kaiser-Guttman) predicted four factors, with the eigenvalues: F1: 4.400; F2: 1.858; F3: 1.184; F4: 1.089 (53.3% of explained variance). In the analysis of the 10 items included in the factors, we named: F1: Pleasure; F2: <italic>Ostranenie</italic> (defamiliarization, estrangement); F3: Tension; F4: Fun (<xref ref-type="table" rid="t2">Table 2</xref>).</p>
      <table-wrap id="t2">
        <label>Table 2</label>
        <caption>
          <title>Factor analysis of imaginative emotions as an expression of the playfulness of games that thematize violence in the health area, according to factors and items, Brasilia, Federal District, Brazil, August, 2021</title>
        </caption>
        <table>
          <thead>
            <tr>
              <th align="left" valign="top">Emotions in the game<sup>d</sup></th>
              <th align="center" valign="top">Pleasure</th>
              <th align="center" valign="top">Tension</th>
              <th valign="top">
                <italic>Ostranenie</italic>
                <sup>e</sup>
              </th>
              <th align="center" valign="top">Fun</th>
              <th align="center" valign="top">h<sup><xref ref-type="bibr" rid="B2">2</xref></sup></th>
            </tr>
          </thead>
          <tbody>
            <tr>
              <td align="left" valign="top">I had fun playing the game</td>
              <td align="center" valign="top">0.792</td>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.690</td>
            </tr>
            <tr>
              <td align="left" valign="top">I liked the game</td>
              <td align="center" valign="top">0.749</td>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.597</td>
            </tr>
            <tr>
              <td align="left" valign="top">The game kept me motivated to continue in the game</td>
              <td align="center" valign="top">0.721</td>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.661</td>
            </tr>
            <tr>
              <td align="left" valign="top">I was fulfilled with the achievements in the game</td>
              <td align="center" valign="top">0.689</td>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.521</td>
            </tr>
            <tr>
              <td align="left" valign="top">The game made me tense</td>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.823</td>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.748</td>
            </tr>
            <tr>
              <td align="left" valign="top">The game made me anxious</td>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.741</td>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.620</td>
            </tr>
            <tr>
              <td align="left" valign="top">I felt a mixture of relaxation and tension in the game</td>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.623</td>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.452</td>
            </tr>
            <tr>
              <td align="left" valign="top">The challenges of the game discouraged me in the match</td>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.652</td>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.588</td>
            </tr>
            <tr>
              <td align="left" valign="top">I felt incapable for not knowing how to answer the questions</td>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.663</td>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.442</td>
            </tr>
            <tr>
              <td align="left" valign="top">I was relaxed during the match</td>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="left" valign="top"/>
              <td align="center" valign="top">0.776</td>
              <td align="center" valign="top">0.499</td>
            </tr>
            <tr>
              <td align="left" valign="top">Cronbach&#8217;s alpha<sup>f</sup></td>
              <td align="center" valign="top">0.614</td>
              <td align="center" valign="top">0.638</td>
              <td align="center" valign="top">0.349</td>
              <td align="center" valign="top">-----</td>
              <td align="center" valign="top">----</td>
            </tr>
          </tbody>
        </table>
        <table-wrap-foot>
          <attrib>
            <italic>d- The table shows only variables with factor loadings above 0.6 retained in the factors. KMO 0.817; p=0.000. Variance explained by the model 53.31%. Varimax rotation. h<sup>2</sup>=Commonalities.</italic>
          </attrib>
          <attrib>
            <italic>e- Ostraenie (translations): singularization, estrangement, defamiliarization. f- Cronbach&#8217;s alpha of all variables retained in the model: 0.614.</italic>
          </attrib>
        </table-wrap-foot>
      </table-wrap>
      <p>Finally, the twenty variables distributed in the eight factors (reflection, challenge, immersion, aesthetics, pleasure, tension, <italic>ostranenie</italic>, fun) of playfulness showed good internal reliability, with Cronbach&#8217;s alpha of 0.716 (<xref ref-type="table" rid="t3">Table 3</xref>).</p>
      <table-wrap id="t3">
        <label>Table 3</label>
        <caption>
          <title>Ludic-quest instrument to assess the playfulness of games that thematize violence in the health area, with valid and reliable items, September, Brasilia, Federal District, Brazil, 2021</title>
        </caption>
        <table>
          <thead>
            <tr>
              <th align="left" valign="top">Items validated for construct</th>
              <th align="center" valign="top">Cronbach&#8217;s alpha</th>
            </tr>
          </thead>
          <tbody>
            <tr>
              <td align="left" valign="top">I learned amazing things from the game<break/>After this match, my interest in the content increased<break/>During the match, I reflected on the challenges we face in life<break/>The game favored my learning<break/>I had difficulty concentrating on the text of the cards<break/>The difficulty of the cards compromised my learning<break/>I actively interacted with my teammates during the match<break/>I did not pay attention to what was happening around me while playing <break/>I felt more in the game environment than in the real world<break/>The game design caught my attention<break/>I had fun playing the game<break/>I liked the game<break/>The game kept me motivated to continue in the game<break/>I was fulfilled with the achievements in the game<break/>The game made me tense<break/>The game made me anxious<break/>I felt a mixture of relaxation and tension in the game<break/>The challenges of the game discouraged me in the match<break/>I felt incapable for not knowing how to answer the questions<break/>I was relaxed during the match</td>
              <td align="center">0.716</td>
            </tr>
          </tbody>
        </table>
      </table-wrap>
    </sec>
    <sec sec-type="discussion">
      <title>DISCUSSION</title>
      <p>The Ludic-quest, in the assessment of the playfulness of games that thematize violence in the health area, fills a gap in the construction of valid and reliable instruments in population studies, given the identified scarcity<sup>(<xref ref-type="bibr" rid="B1">1</xref>-<xref ref-type="bibr" rid="B8">8</xref>)</sup>. Regardless of typology (whether digital or non-digital) or trend adopted when creating a game, the results identify factors underlying a phenomenon that is difficult to measure, the playful, placing it at the center of the epistemic field. The inversion in the way of producing research on games with social approaches to health, with an emphasis on gameplay and the game&#8217;s emotions, innovates, by problematizing the playful&#8217;s imaginative richness, sometimes subsumed in serious causal outcomes<sup>(<xref ref-type="bibr" rid="B10">10</xref>-<xref ref-type="bibr" rid="B16">16</xref>)</sup>.</p>
      <p>The specifics of the sample and the game type deserve comment. The fact that the respondents are predominantly women, young people and health undergraduate students emphasizes gender as an aspect to demarcate. In this sense, given the historical discrimination that women suffer - not only in the community of players (men, whites, heterosexuals), but also in the restricted space of design - the repercussions of this violence need greater visibility, especially in the unequal opportunities of access to the game. In the case of <italic>Violetas</italic>, gender issues compromise the girls&#8217; familiarity and learning with modern-style board games. In addition to being not widespread in Brazil&#8217;s playful culture, strategy games require a certain amount of time to grasp the gameplay, which implies greater contact with the public, hegemonically dominated by boys. Another point to be highlighted concerns the carrying out of the research with a single game - <italic>Violetas</italic> - and the specificity of confronting violence against women, which compromises the generalization of the results. Identifying a theme with the female bias of the sample favored participants&#8217; compliance with the game and playfulness, requiring other investigative approaches. Therefore, in advance, we suggest future research with population segments and with games of different social approaches - from sociodemographic and gender markers - in order to produce new validity and reliability to Ludic-quest<sup>(<xref ref-type="bibr" rid="B18">18</xref>,<xref ref-type="bibr" rid="B23">23</xref>-<xref ref-type="bibr" rid="B24">24</xref>)</sup>.</p>
      <p>In the validation techniques, the variables contained in the gameplay/learning and in the emotions were adequate to EFA, with a good KMO Test and a significant Bartlett. The eigenvalue was relevant to the extraction of factors in each dimension, with latent conceptions that denote the self-reference of playfulness, according to the literature. In gameplay/learning, the factors reflections, challenges, immersion and aesthetics are playful characteristics to be forged. Among the emotions that the game mobilizes in a game, the diffuse sensations of pleasure, tension, <italic>ostranenie</italic> (defamiliarization, estrangement) and fun stand out<sup>(<xref ref-type="bibr" rid="B7">7</xref>-<xref ref-type="bibr" rid="B8">8</xref>,<xref ref-type="bibr" rid="B14">14</xref>,<xref ref-type="bibr" rid="B22">22</xref>,<xref ref-type="bibr" rid="B25">25</xref>)</sup>.</p>
      <p>In scientific reviews, there is no consensus on which factors to use in assessing a game, although similar approaches exist<sup>(<xref ref-type="bibr" rid="B7">7</xref>-<xref ref-type="bibr" rid="B8">8</xref>)</sup>. Learning - whether that learned in a game or referring to external content - is a widely accepted factor in the assessment of a game. In Ludic-quest, we call reflection the factor of perceived learning, for better expressing the meaning of critical-imaginative education. We see that this reflection is expressed more or less intensely, respectively, in the following variables: I learned amazing things from the game; I reflected on the challenges; my interest in the content has increased; the game favored my learning.</p>
      <p>Surprise with the new, with astonishment, with the unforeseen and with uncertainty are characteristics of education arising from the playful, in the link with the aesthetic. In other words, at the moment when we are taken to what was not there before, in this ephemeral, necessary for critical formation, the unexplorable thinking of poetic fruition inhabits<sup>(<xref ref-type="bibr" rid="B26">26</xref>)</sup>. In a way, the variables that show admiration for the unusual indicate satisfaction in reflection (I learned surprising things in the game; I reflected on the challenges). On the other hand, those that indicate the game&#8217;s contribution to the apprehension of themes correspond to the disciplinary aspects of learning (the game favored my learning; my interest in the content increased)<sup>(<xref ref-type="bibr" rid="B3">3</xref>,<xref ref-type="bibr" rid="B5">5</xref>,<xref ref-type="bibr" rid="B7">7</xref>)</sup>. Therefore, reflection factor indicate the educational tendencies in a game, whether inherent or outside the playful field.</p>
      <p>The immersion and challenges factors are intrinsic to the game mechanics, in the creation of the playful dynamics. In immersion, the feeling of being in another place, the loss of time, the opening of other senses, time reinvented or inaugurated in a fictional world give centrality to the playful. Likewise, the immersion of participants is permeated by challenges that make up and are awakened by the game itself, in its relational and emotional sense. Alongside this fictional reality, in Ludic-quest, immersion can be measured by variables: I did not pay attention to what was happening around me while playing; I felt more in the game environment than in the real world<sup>(<xref ref-type="bibr" rid="B8">8</xref>-<xref ref-type="bibr" rid="B14">14</xref>,<xref ref-type="bibr" rid="B22">22</xref>,<xref ref-type="bibr" rid="B25">25</xref>)</sup>.</p>
      <p>Contrary to what it may seem, difficulty is a prioritized component of gameplay. Research proposes a typology for the challenges in a game, namely: a - mechanical difficulties (impact on players&#8217; performance and skills); b - interpretive difficulties (barriers to comprehensibility); c - affective difficulties (ambiguous and insoluble emotions aroused). In this agonizing arena, in Ludic-quest, the obstacles of a game can be verified by the items: the difficulty of the cards compromised my learning; I had difficulty in the text of the cards; I actively interacted during the match. Since interaction is an inherent challenge to gameplay, we included this variable in the factorial model, in line with the literature<sup>(<xref ref-type="bibr" rid="B22">22</xref>,<xref ref-type="bibr" rid="B25">25</xref>,<xref ref-type="bibr" rid="B27">27</xref>)</sup>.</p>
      <p>Although the dimensions of gameplay and emotions experienced in the match form statistically distinct groups, we argue for the inseparability of play. Whatever mechanics are formally constructed to invent a game, it only happens when activated by players&#8217; emotions in that short space temporally delimited by freely accepted rules. For the classic definition of the design area, the game is nothing more than an artificially generated interaction, as it only happens when its regulatory system is agreed among players<sup>(<xref ref-type="bibr" rid="B25">25</xref>)</sup>. That said, despite the division of variables into different dimensions in EFA procedures, we assume that they all indicate the same construct, the playful, now described in the underlying aspects.</p>
      <p>In the factors latent to the emotions experienced in the match, the playful&#8217;s indissociability and fugacity stand out, expressed by the ambiguity of the variables. Thus, in the sensations experienced by players on the playful field, the game intertwining with art subsists. As indicative of this flirtation, in Ludic-quest, aesthetics and fun factors - one in each dimension - retained a single variable, escaping the rule of commonalities shared with others, in the same factor<sup>(<xref ref-type="bibr" rid="B21">21</xref>)</sup>. Apparently, aesthetic seduction and fruition in a game refuse the common, recognition or any causal nexus, although they are intertwined in the evidence. In other words, subtly, sometimes these variables mix affective performances (aesthetic sensation, in which there is playability; fun, in synesthetic emotion), sometimes they are singularized in free fictional game<sup>(<xref ref-type="bibr" rid="B22">22</xref>,<xref ref-type="bibr" rid="B25">25</xref>-<xref ref-type="bibr" rid="B28">28</xref>)</sup>.</p>
      <p>The game&#8217;s poetic forms have long been discussed by classics, which remind us<sup>(<xref ref-type="bibr" rid="B13">13</xref>)</sup>: i - poetry originates in ritual, entertainment and art, therefore, in the invention of riddles, guesswork and competition; ii - poetry originates in play; iii - poetic language is essentially a play with words; iv - the ritual is performed with singing, dancing and playing; v - music, theater and dance are recreational forms; vi - both play and art are outside practical life, necessity, utility, duty, or truth. In today&#8217;s virtual world, the dialogue between art and the game also forms the basis of video games&#8217; sophisticated aesthetics. Despite the reifying risk of technology on imaginative thinking, we dialogue with these productions, with the exception of safeguarding the game&#8217;s autonomy<sup>(<xref ref-type="bibr" rid="B15">15</xref>-<xref ref-type="bibr" rid="B16">16</xref>)</sup>. We also have reservations about the light appropriation of literary criticism, present in some researches. In the reinterpretation of Russian formalism or the theory of aesthetic effect, for instance, aspects such as the limits of meaning of language are improperly incorporated<sup>(<xref ref-type="bibr" rid="B14">14</xref>,<xref ref-type="bibr" rid="B28">28</xref>-<xref ref-type="bibr" rid="B29">29</xref>)</sup>.</p>
      <p>Returning to the sensations of playfulness, we know that the difficulty arouses tense desires of conquest in a game, in frank stimulating dispute. To spice up the emotions in a match, interactive defamiliarization production - based on the literary conception of <italic>ostranenie</italic> - makes up a technique to complicate the game and slow down participants&#8217; acquisition of skills. In dialogue with Russian formalism, the so-called poetic gameplay in video game production uses artistic language to generate astonishment with the unexpected, with the other made strange, with the exasperating. After all, we know that the work of art&#8217;s sensations emerge from the unexpected novelty, not from usual. The use of these artifices to make the playful universe incomprehensible intends to provoke in players reflections on the game&#8217;s formal aspects (its mechanics, language, design, aesthetics, fictionality, rhythm), generating affective discomforts. Such purposeful handlings encourage the participant to dive into the autonomy of the playful, perhaps in their emotional encounter with art, without external references to the fictional world<sup>(<xref ref-type="bibr" rid="B14">14</xref>,<xref ref-type="bibr" rid="B29">29</xref>-<xref ref-type="bibr" rid="B30">30</xref>)</sup>.</p>
      <p>In Ludic-quest, the affections provoked by <italic>ostraenie</italic> designate one of the factors extracted in the dimension emotions in the match. We kept the original term, an accidental neologism of the Russian language, for two reasons: i - in line with the recommendation of literary criticism, due to the difficulties in translation; ii - to suggest emotions of estrangement in the reader, self-referring to its meaning. Furthermore, the rescue of negativity proposed here claims that reflective thinking rejects the immediate, with demands for an interpretive effort on the user, although not always pleasant<sup>(<xref ref-type="bibr" rid="B30">30</xref>)</sup>. In this strange and persuasive playful environment, the other factors and variables that assess emotions in a game express similar lability, manifesting in sensations of pleasure. (I had fun playing the match; I liked the game; I was motivated; I was fulfilled in the achievements), tension (I was tense; anxious; I felt a mixture of relaxation and tension), next to <italic>ostranenie</italic> (the challenges discouraged me; I found me unable)<sup>(<xref ref-type="bibr" rid="B14">14</xref>,<xref ref-type="bibr" rid="B22">22</xref>,<xref ref-type="bibr" rid="B27">27</xref>-<xref ref-type="bibr" rid="B29">29</xref>)</sup>.</p>
      <p>In Cronbach&#8217;s alpha values, the twenty Ludic-quest variables showed good internal reliability. In the factors, reliability is maintained for reflections, pleasure, tension and also for the variables of emotions in the match.</p>
      <sec>
        <title>Study limitations</title>
        <p>Cronbach&#8217;s alpha values indicate a certain limitation in the scalar use of Ludic-quest in the assessment of the playfulness of games that thematize violence in the health area, requiring further studies. The predominant female gender in the sample and carrying out the research with a single game also limit the extrapolation of results. The findings in general corroborate the universe of investigations on games, which indicate caution in generalizing<sup>(<xref ref-type="bibr" rid="B1">1</xref>-<xref ref-type="bibr" rid="B8">8</xref>)</sup>.</p>
      </sec>
      <sec>
        <title>Contributions to nursing</title>
        <p>The boldness of this study consists in the inversion of the interdisciplinary way of producing research on games in health and nursing, with an emphasis on gameplay and on the emotions of the game. The innovation of this way of asking is to problematize the imaginative richness of the playful in the scope of measurement instrument production, sometimes subsumed in causal outcomes. In other words, Ludic-quest assesses and subsidizes reflections on the playful in games with complex social themes, such as violence, expanding interpretative perspectives. Consequently, critical-imaginative thinking promotion by health and nursing professionals, inscribed in this epistemic turnaround, favors the axiological prioritization of citizenship within the scope of public policies, especially those dealing with violence against women.</p>
      </sec>
    </sec>
    <sec sec-type="conclusions">
      <title>CONCLUSIONS</title>
      <p>In this article, we ask what are the latent factors and the valid items regarding the construct in the assessment of the playfulness of games that thematize violence in the health area. In response, the eight validated factors (reflections, immersion, challenges, aesthetics, pleasure, tension, <italic>ostraenie</italic>, fun) indicate playfulness centrality for game production with social approaches in health, composing a reliable assessment instrument of twenty items for use in research. In turn, the rebellion of some variables to the methods of validating playfulness seems to keep gameplay and emotions on the field so that there can be more play.</p>
    </sec>
    <sec sec-type="supplementary-material">
      <title>SUPPLEMENTARY MATERIAL</title>
      <p>
        <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.48331/scielodata.AZMS8G">https://doi.org/10.48331/scielodata.AZMS8G</ext-link>
      </p>
    </sec>
  </body>
  <back>
    <fn-group>
      <fn fn-type="supported-by">
        <p>
          <bold>FUNDING</bold>
        </p>
        <p>The article was supported by FAPESP (Process 2018/07389-4) and CNPq (Processes 405302/2012-6 and 425350/2018-5.</p>
      </fn>
    </fn-group>
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  <sub-article article-type="translation" id="s1" xml:lang="pt">
    <front-stub>
      <article-id pub-id-type="doi">10.1590/0034-7167-2021-0822</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>ARTIGO ORIGINAL</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Valida&#231;&#227;o do <italic>Ludic-Quest</italic> &#224; ludicidade de jogos na sa&#250;de: jogabilidade e emo&#231;&#245;es em campo</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-7941-0816</contrib-id>
          <name>
            <surname>Pires</surname>
            <given-names>Maria Raquel Gomes Maia</given-names>
          </name>
          <xref ref-type="aff" rid="aff4">I</xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-9113-0729</contrib-id>
          <name>
            <surname>Almeida</surname>
            <given-names>Alexandre Nascimento de</given-names>
          </name>
          <xref ref-type="aff" rid="aff4">I</xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-2675-8085</contrib-id>
          <name>
            <surname>Gottems</surname>
            <given-names>Leila Bernarda Donato</given-names>
          </name>
          <xref ref-type="aff" rid="aff5">II</xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-4984-4541</contrib-id>
          <name>
            <surname>Mundim</surname>
            <given-names>Gabriela Duarte Almeida</given-names>
          </name>
          <xref ref-type="aff" rid="aff4">I</xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-8784-9589</contrib-id>
          <name>
            <surname>Oliveira</surname>
            <given-names>Rebeca Nunes Guedes de</given-names>
          </name>
          <xref ref-type="aff" rid="aff6">III</xref>
        </contrib>
      </contrib-group>
      <aff id="aff4">
        <label>I</label>
        <institution content-type="orgname">Universidade de Bras&#237;lia</institution>
        <addr-line>
          <city>Bras&#237;lia</city>
          <state>Distrito Federal</state>
        </addr-line>
        <country country="BR">Brasil</country>
        <institution content-type="original">Universidade de Bras&#237;lia. Bras&#237;lia, Distrito Federal, Brasil.</institution>
      </aff>
      <aff id="aff5">
        <label>II</label>
        <institution content-type="orgname">Universidade Cat&#243;lica de Bras&#237;lia</institution>
        <addr-line>
          <city>Bras&#237;lia</city>
          <state>Distrito Federal</state>
        </addr-line>
        <country country="BR">Brasil</country>
        <institution content-type="original">Universidade Cat&#243;lica de Bras&#237;lia. Bras&#237;lia, Distrito Federal, Brasil.</institution>
      </aff>
      <aff id="aff6">
        <label>III</label>
        <institution content-type="orgname">Universidade de S&#227;o Caetano do Sul</institution>
        <addr-line>
          <city>S&#227;o Caetano do Sul</city>
          <state>S&#227;o Paulo</state>
        </addr-line>
        <country country="BR">Brasil</country>
        <institution content-type="original">Universidade de S&#227;o Caetano do Sul. S&#227;o Caetano do Sul, S&#227;o Paulo, Brasil.</institution>
      </aff>
      <author-notes>
        <corresp id="c2"><bold>Autor Correspondente:</bold> Maria Raquel Gomes Maia Pires E-mail: <email>maiap@unb.br</email> </corresp>
        <fn fn-type="edited-by">
          <p>EDITOR CHEFE: Antonio Jos&#233; de Almeida Filho</p>
        </fn>
        <fn fn-type="edited-by">
          <p>EDITOR ASSOCIADO: Hugo Fernandes</p>
        </fn>
      </author-notes>
      <abstract>
        <title>RESUMO</title>
        <sec>
          <title>Objetivo:</title>
          <p>validar o constructo e a confiabilidade do instrumento <italic>Ludic-Quest</italic> para avalia&#231;&#227;o da ludicidade de jogos, por meio de fatores latentes &#224; jogabilidade, percep&#231;&#227;o da aprendizagem e &#224;s emo&#231;&#245;es na partida.</p>
        </sec>
        <sec>
          <title>M&#233;todos:</title>
          <p>estudo transversal de valida&#231;&#227;o das propriedades psicom&#233;tricas do instrumento. 247 pessoas responderam ao question&#225;rio ap&#243;s uma partida do jogo <italic>Violetas</italic>. An&#225;lise Fatorial Explorat&#243;ria, com uso do KMO (&gt;0,7), Bertlett (p=0,005), Varimax e carga fatorial (&gt;0,6). Confiabilidade pelo Alfa de Cronbach (&gt;0,6).</p>
        </sec>
        <sec>
          <title>Resultados:</title>
          <p>na jogabilidade/aprendizagem, KMO=0,859, Bertlett significativo. O autovalor indicou quatro fatores (reflex&#245;es; imers&#227;o; desafios; est&#233;tica) e 10 vari&#225;veis retidas. Na an&#225;lise fatorial das emo&#231;&#245;es: KMO=0,817; Bartlett p=0,000. Extra&#231;&#227;o de quatro fatores (prazer; <italic>ostran&#234;nie</italic>; tens&#227;o; divers&#227;o) e 10 vari&#225;veis retidas. As 20 vari&#225;veis validadas cont&#234;m confiabilidade (Alfa de Cronbach=0,716). <bold>Conclus&#245;es:</bold> os oito fatores validados centralizam o l&#250;dico na produ&#231;&#227;o de jogos na sa&#250;de, compondo um instrumento de avalia&#231;&#227;o da ludicidade confi&#225;vel &#224; utiliza&#231;&#227;o em pesquisas.</p>
        </sec>
      </abstract>
      <kwd-group xml:lang="pt">
        <title>Descritores:</title>
        <kwd>Estudos de Valida&#231;&#227;o</kwd>
        <kwd>An&#225;lise Fatorial</kwd>
        <kwd>Jogo</kwd>
        <kwd>Aprendizagem</kwd>
        <kwd>Emo&#231;&#245;es</kwd>
      </kwd-group>
    </front-stub>
    <body>
      <sec sec-type="intro">
        <title>INTRODU&#199;&#195;O</title>
        <p>A pesquisa na &#225;rea de jogos se consolidou nos &#250;ltimos anos com a expans&#227;o de peri&#243;dicos e o aperfei&#231;oamento do campo cient&#237;fico. Revis&#245;es constatam a interdisciplinaridade e a diversidade dos enfoques, que incluem os debates epist&#234;micos e metodol&#243;gicos<sup>(<xref ref-type="bibr" rid="B1">1</xref>-<xref ref-type="bibr" rid="B2">2</xref>)</sup>. Na &#225;rea da sa&#250;de, os chamados <italic>Serious Games for Health</italic> (SGH) colocam &#234;nfase no jogo como ferramenta educativa, em aplica&#231;&#245;es diversas (ades&#245;es de pacientes, mudan&#231;as de comportamentos, motiva&#231;&#245;es &#224; aprendizagem). Esses estudos, entretanto, permanecem alheios &#224; prioriza&#231;&#227;o do car&#225;ter disruptivo do l&#250;dico, ao objetivarem finalidades estranhas &#224;s particularidades do jogo. Em geral, os SGH se distanciam de investiga&#231;&#245;es sobre a jogabilidade e as emo&#231;&#245;es imaginativas nas partidas, ao investirem em protocolos com vari&#225;veis control&#225;veis, os quais co&#237;bem os aspectos brincantes do l&#250;dico<sup>(<xref ref-type="bibr" rid="B3">3</xref>-<xref ref-type="bibr" rid="B6">6</xref>)</sup>.</p>
        <p>Decerto, os experimentos que aprisionam a pot&#234;ncia libert&#225;ria do jogo incorrem em limita&#231;&#245;es na generaliza&#231;&#227;o dos resultados<sup>(<xref ref-type="bibr" rid="B3">3</xref>-<xref ref-type="bibr" rid="B4">4</xref>)</sup>. Da mesma forma, s&#227;o escassos, parciais e imprecisos os instrumentos que auxiliam no desenvolvimento de jogos - a maioria voltada aos efeitos comportamentais ou cognitivos das(os) participantes, embora considere a jogabilidade (artif&#237;cios que garantem a din&#226;mica l&#250;dica) e a experi&#234;ncia das(os) participantes<sup>(<xref ref-type="bibr" rid="B5">5</xref>-<xref ref-type="bibr" rid="B8">8</xref>)</sup>. Essas pesquisas n&#227;o poderiam ser diferentes, uma vez que as caracter&#237;sticas imprevistas do l&#250;dico tendem a escapar da padroniza&#231;&#227;o cient&#237;fica, em livre gozo insurgente. N&#227;o por acaso, s&#227;o igualmente amb&#237;guas as concep&#231;&#245;es sobre o jogo. Uma revis&#227;o de 60 termos chegou &#224; multiplicidade de indefini&#231;&#245;es, classific&#225;veis em<sup>(<xref ref-type="bibr" rid="B9">9</xref>)</sup>: i - o que s&#227;o as regras; ii - qual sua fun&#231;&#227;o; iii - se s&#227;o artefatos, atividades ou ambos; iv - se s&#227;o desconectados ou sintonizados com o &#8216;real&#8217;; v - o que s&#227;o as(os) jogadoras(es); vi - se s&#227;o improdutivos ou geram algo; vii - qual o papel da competi&#231;&#227;o; viii - se h&#225; metas ou finalidades; ix - se h&#225; fen&#244;menos relevantes; x- a que prop&#243;sitos servem.</p>
        <p>Outrossim, para se manter livre, insubmisso, improdutivo, inscrito nas pr&#243;prias regras, produtor de universos imagin&#225;rios e delimitado espa&#231;o-temporalmente, o jogo tende a driblar o m&#233;todo. Entre suas caracter&#237;sticas, incluem-se: atividade volunt&#225;ria, n&#227;o s&#233;ria e exterior ao cotidiano; autorregulado, fict&#237;cio, desinteressado do ordin&#225;rio e capaz de absorver a(o) participante de maneira intensa. Na cultura, o jogo transita entre o sagrado e o profano em meio &#224; festa, ao ritual, ao riso. Nele, a disputa e o mist&#233;rio suspendem os referenciais fixos de representa&#231;&#227;o do cotidiano, subvertendo-a em favor da liberdade imaginativa<sup>(<xref ref-type="bibr" rid="B10">10</xref>-<xref ref-type="bibr" rid="B13">13</xref>)</sup>.</p>
        <p>Paradoxalmente, quanto mais a ludicidade se distancia da evid&#234;ncia, mais se alargam as chances educativas, pela nega&#231;&#227;o &#224; obedi&#234;ncia resignada. Em prol da insurrei&#231;&#227;o do l&#250;dico no pensar, invertamos, ent&#227;o, o foco das investiga&#231;&#245;es na sa&#250;de. Ao inv&#233;s de perguntarmos sobre como o jogo contribui para as finalidades cl&#237;nicas ou de aprendizagem nas(nos) participantes, investiguemos como resgatar sua inquietude inventiva. Essa tor&#231;&#227;o no modo de pesquisar busca potencializar os pr&#243;prios artif&#237;cios do jogo, desvencilhando-o de finalidades outras, o mais poss&#237;vel. Pelas vias da ludicidade, interessa mais aprofundar os recursos, as linguagens, as regula&#231;&#245;es, as rupturas, os estranhamentos e as experi&#234;ncias inerentes ao jogar. Ou seja, privilegiamos os procedimentos formais da din&#226;mica l&#250;dica (jogabilidade) e os afetos por eles provocados (emo&#231;&#245;es), para intensificar o jogo. Posicionamo-nos, assim, como um movimento de resist&#234;ncia cr&#237;tica, imerso e dial&#243;gico ao campo epist&#234;mico<sup>(<xref ref-type="bibr" rid="B10">10</xref>-<xref ref-type="bibr" rid="B16">16</xref>)</sup>.</p>
        <p>Ao privilegiarmos a autonomia do l&#250;dico, inclu&#237;mos os limites da empreitada: a cria&#231;&#227;o de jogos com temas de interesse &#224; sa&#250;de co&#237;be a liberdade que reivindicamos. Isto &#233;, o fomento de jogos voltados aos problemas de coletividades pressup&#245;e a mesma coer&#231;&#227;o do l&#250;dico a finalidades outras que criticamos. Cientes da aporia, pretendemos t&#227;o somente apostar nos elementos do jogo para vencer seu conte&#250;do tem&#225;tico, em um c&#225;lculo que favore&#231;a a ludicidade. Investimos, de forma inusitada, em instrumentos de medida que privilegiem o poder da jogabilidade em intensificar as emo&#231;&#245;es instant&#226;neas, singulares, inapreens&#237;veis e reveladoras nas(nos) jogadoras(es), mantendo finais em aberto<sup>(<xref ref-type="bibr" rid="B9">9</xref>-<xref ref-type="bibr" rid="B15">15</xref>)</sup>.</p>
        <p>A confirma&#231;&#227;o de fatores latentes &#224; ludicidade se torna necess&#225;ria na instrumentaliza&#231;&#227;o metodol&#243;gica de pesquisas com foco na valida&#231;&#227;o de jogos com abordagens sociais na sa&#250;de, em estudos populacionais. A redu&#231;&#227;o de vari&#225;veis a um conjunto capaz de explicar o fen&#244;meno do l&#250;dico favorece a elabora&#231;&#227;o de escalas m&#250;ltiplas, com usos valiosos na avalia&#231;&#227;o de um jogo. Nesse sentido, discutimos neste artigo a valida&#231;&#227;o de constructo do instrumento <italic>Ludic-Quest</italic> na avalia&#231;&#227;o da ludicidade de jogos na sa&#250;de, com foco na jogabilidade (mec&#226;nica para forjar o campo l&#250;dico) e nas emo&#231;&#245;es imaginativas (afetos provocados pelo jogo)<sup>(<xref ref-type="bibr" rid="B9">9</xref>-<xref ref-type="bibr" rid="B17">17</xref>)</sup>. A quest&#227;o do artigo &#233;: quais os fatores latentes e os itens v&#225;lidos quanto ao constructo na avalia&#231;&#227;o da ludicidade de jogos que tematizam a viol&#234;ncia na &#225;rea da sa&#250;de?</p>
        <p>O estudo integra pesquisa que avaliou a ludicidade do <italic>Violetas: cinema &amp; a&#231;&#227;o no enfrentamento da viol&#234;ncia contra a mulher</italic>, jogo de tabuleiro de estilo moderno, em que as(os) jogadoras(es) s&#227;o personagens de uma rede de enfrentamento com a miss&#227;o de conter cooperativamente a viol&#234;ncia que se espalha por cidades brasileiras com nome de mulheres. Para vencer, as(os) participantes precisam agir estrategicamente para cercar a viol&#234;ncia sobre o tabuleiro, al&#233;m de responder a perguntas para conquistar quatro <italic>tokens</italic> (luz, voz, acolhida, redes)<sup>(<xref ref-type="bibr" rid="B18">18</xref>)</sup>.</p>
      </sec>
      <sec>
        <title>OBJETIVO</title>
        <p>Validar a jogabilidade, a percep&#231;&#227;o da aprendizagem e as emo&#231;&#245;es nas partidas como express&#245;es da ludicidade, por meio de fatores latentes, e analisar a confiabilidade do <italic>Ludic-Quest</italic>.</p>
      </sec>
      <sec sec-type="methods">
        <title>M&#201;TODOS</title>
        <sec>
          <title>Aspectos &#233;ticos</title>
          <p>A pesquisa segue as diretrizes do Conselho Nacional de Sa&#250;de (CNS), sendo aprovada pelo Comit&#234; de &#201;tica da Faculdade de Ci&#234;ncias da Sa&#250;de da Universidade de Bras&#237;lia. Todas(os) as(os) participantes assinaram o Termo de Consentimento Livre e Esclarecido (TCLE).</p>
        </sec>
        <sec>
          <title>Desenho do estudo</title>
          <p>Estudo observacional seccional, sustentado pela ferramenta STROBE, com valida&#231;&#227;o das propriedades psicom&#233;tricas do instrumento <italic>Ludic-Quest</italic> na avalia&#231;&#227;o da ludicidade de jogos com tem&#225;ticas da viol&#234;ncia na &#225;rea da sa&#250;de. A pesquisa aconteceu em salas de aula das Institui&#231;&#245;es de Ensino Superior (IES) p&#250;blicas e privadas de Bras&#237;lia, Distrito Federal, no per&#237;odo de outubro de 2018 a junho de 2019, com recrutamento das(os) participantes por agendamentos pr&#233;vios das partidas do jogo <italic>Violetas</italic>. As(os) jogadoras(es) foram acompanhadas durante o jogo, com esclarecimentos para garantir a ambi&#234;ncia l&#250;dica. Realizamos a valida&#231;&#227;o de constructo com base nas vari&#225;veis inclu&#237;das nas dimens&#245;es da jogabilidade e das emo&#231;&#245;es nas partidas. Verificamos a confiabilidade do instrumento, isto &#233;, a consist&#234;ncia com que o <italic>Ludic-Quest</italic> afere e reproduz os atributos da ludicidade, por meio do Alfa de Cronbach<sup>(<xref ref-type="bibr" rid="B17">17</xref>,<xref ref-type="bibr" rid="B19">19</xref>)</sup>.</p>
        </sec>
        <sec>
          <title>Participantes</title>
          <p>Amostra foi formada por 247 pessoas, entre estudantes (n = 236; 95%), profissionais (n = 3; 1,2%) e p&#243;s-graduados (n = 8; 3,2%). Os crit&#233;rios de elegibilidade, as fontes e os m&#233;todos de sele&#231;&#227;o foram: inclus&#227;o de graduandas(os) e/ou profissionais da rede de enfrentamento da viol&#234;ncia contra a mulher personificada no <italic>Violetas</italic> (operadoras(es) de direito; integrantes de pol&#237;tica p&#250;blica/profissional de sa&#250;de; militantes no movimento de mulheres; educadoras(es) e/ou pesquisadoras(es)), que livremente aceitaram jogar uma partida. Participaram mulheres (n = 203; 82,2%) e homens (n = 44; 17,8%) das &#225;reas de enfermagem (n = 191; 77,3%), servi&#231;o social (n = 31; 12,5%) e humanas (n = 25; 10%; sa&#250;de coletiva, antropologia, ci&#234;ncias sociais, ci&#234;ncia pol&#237;tica, hist&#243;ria). A maioria estava na faixa et&#225;ria de 18 a 30 anos (n = 224; 90,6%) ou acima (entre 30 e 49 anos; n = 28; 11,3%). Elas e eles responderam ao question&#225;rio ap&#243;s uma partida do <italic>Violetas: cinema &amp; a&#231;&#227;o no enfrentamento da viol&#234;ncia contra a mulher</italic><sup>(<xref ref-type="bibr" rid="B18">18</xref>)</sup>.</p>
        </sec>
        <sec>
          <title>Instrumento</title>
          <p>A constru&#231;&#227;o e valida&#231;&#227;o de conte&#250;do do <italic>Ludic-Quest</italic> ocorreu em etapas anteriores, consonante &#224; produ&#231;&#227;o tecnol&#243;gica de tr&#234;s jogos de tabuleiro. Os itens foram elaborados com base em revis&#227;o da literatura e na aplica&#231;&#227;o de vers&#227;o preliminar em grupos de testes. Seguiu-se o fechamento dos itens e a valida&#231;&#227;o de conte&#250;do, mediante a an&#225;lise de ju&#237;zes com c&#225;lculo de confiabilidade pelo coeficiente de Kappa, an&#225;lise do &#205;ndice de Validade de Conte&#250;do (IVC) e do &#205;ndice de Fidedignidade (<italic>Reliability, Interrater Agreement</italic> (IRA)). Essa vers&#227;o do <italic>Ludic-Quest</italic> com conte&#250;do v&#225;lido resultou em 53 itens para a avalia&#231;&#227;o da ludicidade de jogos na sa&#250;de, aplic&#225;vel mediante escala Likert de cinco pontos<sup>(<xref ref-type="bibr" rid="B20">20</xref>)</sup>.</p>
          <p>Em um segundo momento, para conferir parcim&#244;nia e centralidade ao l&#250;dico na avalia&#231;&#227;o do jogo <italic>Violetas</italic>, priorizamos 33 dos 53 itens do instrumento com conte&#250;do v&#225;lido, distribu&#237;dos nas dimens&#245;es aprendizagem, jogabilidade e emo&#231;&#245;es. Os crit&#233;rios para essa sele&#231;&#227;o foram: i - referencial te&#243;rico interdisciplinar; ii - vari&#225;veis validadas ou reconhecidas na literatura de produ&#231;&#227;o de jogos; iii - heur&#237;sticas de jogabilidade; iv - resultados de pesquisas com uso da metodologia do Recriar-se L&#250;dico. Fizemos a an&#225;lise estat&#237;stica das vari&#225;veis de cada uma das tr&#234;s dimens&#245;es da seguinte forma: comparamos os tr&#234;s grupos de vari&#225;veis (aprendizagem, jogabilidade, emo&#231;&#245;es) dois a dois, com uso do teste n&#227;o param&#233;trico U de Mann-Whitney. Verificamos que n&#227;o h&#225; diferen&#231;a entre as vari&#225;veis da aprendizagem e da jogabilidade (mesmo grupo), mas essas s&#227;o significativamente distintas das inclu&#237;das na dimens&#227;o emo&#231;&#245;es (outro grupo)<sup>(<xref ref-type="bibr" rid="B15">15</xref>,<xref ref-type="bibr" rid="B18">18</xref>)</sup>.</p>
          <p>Na presente valida&#231;&#227;o de constructo do <italic>Ludic-Quest</italic>, utilizamos, ent&#227;o, essa vers&#227;o do instrumento com 33 itens, distribu&#237;das nas dimens&#245;es reconfiguradas ap&#243;s o Teste de U de Mann-Whitney<sup>(<xref ref-type="bibr" rid="B18">18</xref>)</sup>, a saber: a - jogabilidade/aprendizagem (17 vari&#225;veis); b - emo&#231;&#245;es imaginativas nas partidas (16 vari&#225;veis). A combina&#231;&#227;o da jogabilidade e da percep&#231;&#227;o da aprendizagem no instrumento - sob a dimens&#227;o reescrita como jogabilidade/aprendizagem - coaduna com a premissa da centralidade do l&#250;dico argumentada para o <italic>Ludic-Quest</italic>. Por limita&#231;&#227;o de espa&#231;o, apresentaremos apenas as vari&#225;veis v&#225;lidas quanto ao constructo, ap&#243;s os procedimentos da An&#225;lise Fatorial Explorat&#243;ria.</p>
        </sec>
        <sec>
          <title>Procedimentos de an&#225;lise dos dados</title>
          <p>Na constru&#231;&#227;o do banco de dados, utilizamos o pacote estat&#237;stico do <italic>Excel for Windows</italic>, com dupla inser&#231;&#227;o, seguida de confer&#234;ncia e unifica&#231;&#227;o do banco. Transpusemos o arquivo para o <italic>software</italic> IMB-SPSS, vers&#227;o 22, para as an&#225;lises estat&#237;sticas. Realizamos a An&#225;lise Fatorial Explorat&#243;ria (AFE), m&#233;todo inferencial multivariado indicado para encontrar a estrutura subjacente de uma matriz de dados, por meio de fatores latentes que representam um conjunto de vari&#225;veis<sup>(<xref ref-type="bibr" rid="B19">19</xref>,<xref ref-type="bibr" rid="B21">21</xref>)</sup>.</p>
          <p>Conduzimos a an&#225;lise fatorial das 33 vari&#225;veis do <italic>Ludic-Quest</italic> em duas etapas, respeitando as diferen&#231;as significativas entre os grupos jogabilidade/aprendizagem (17 vari&#225;veis) e as emo&#231;&#245;es (16 vari&#225;veis). Objetivamos extrair fatores e itens v&#225;lidos para cada uma dessas dimens&#245;es da ludicidade, com vistas a identificar concep&#231;&#245;es latentes. Partimos das seguintes bases conceituais: a - jogabilidade/aprendizagem: artif&#237;cios mec&#226;nicos do jogo que produzem imers&#227;o interativa, desafios e sedu&#231;&#227;o est&#233;tica sobre as(os) jogadoras(es), potencializadores de reflex&#245;es &#224; aprendizagem; b - emo&#231;&#245;es imaginativas: sensa&#231;&#245;es afetivas provocadas pelo jogo nas(nos) participantes, com ambiguidades entre o prazer, a divers&#227;o, o estranhamento e a tens&#227;o<sup>(<xref ref-type="bibr" rid="B7">7</xref>,<xref ref-type="bibr" rid="B14">14</xref>,<xref ref-type="bibr" rid="B18">18</xref>,<xref ref-type="bibr" rid="B22">22</xref>)</sup>.</p>
          <p>Para verificarmos os pressupostos para a AFE, utilizamos os m&#233;todos para observar a adequa&#231;&#227;o das matrizes &#224; fatora&#231;&#227;o: o crit&#233;rio de Kaiser-Meyer-Olkin (KMO, valor acima de 0,7) e o Teste de Bertlett (<italic>p = 0,005</italic>). A reten&#231;&#227;o dos fatores foi definida a partir do autovalor (Kaiser-Guttman) e <italic>eigenvalue &gt; 1.</italic> Rota&#231;&#227;o dos fatores pelo m&#233;todo ortogonal <italic>Varimax</italic> foi indicado para redu&#231;&#227;o de vari&#225;veis. Para o c&#225;lculo da amostra, assumimos a regra de 6 question&#225;rios por item. A carga fatorial acima de 0,6 foi considerada adequada para a reten&#231;&#227;o das vari&#225;veis. Por&#233;m, a literatura recomenda cargas com valores acima de 0,5 ou um m&#237;nimo acima de 0,3, o que nos permitiu flexibilidade. Ap&#243;s a AFE de cada dimens&#227;o, unificamos os itens validados do <italic>Ludic-Quest</italic>. Analisamos confiabilidade do instrumento pelo Alfa de Cronbach, com par&#226;metro de 0,6, indicado &#224;s pesquisas explorat&#243;rias<sup>(<xref ref-type="bibr" rid="B17">17</xref>,<xref ref-type="bibr" rid="B19">19</xref>,<xref ref-type="bibr" rid="B21">21</xref>)</sup>.</p>
        </sec>
      </sec>
      <sec sec-type="results">
        <title>RESULTADOS</title>
        <p>Na AFE da jogabilidade/aprendizagem, o &#237;ndice KMO foi de 0,859, com Teste de Bertlett de <italic>p = 0,000</italic>. A teoria do autovalor (Kaiser-Guttman) indicou quatro fatores para extra&#231;&#227;o, com os <italic>eigenvalues</italic>: F1:4,664; F2:1,424; F3:1,351; F4:1,109 (50,28% da vari&#226;ncia explicada). A partir da an&#225;lise tem&#225;tica das vari&#225;veis retidas, nomeamos os fatores: F1 - Reflex&#245;es; F2 - Imers&#227;o; F3 - Desafios; F4 - Est&#233;tica. Nove vari&#225;veis acima de 0,6 e uma acima de 0,4 foram inclu&#237;das (<xref ref-type="table" rid="t4">Tabela 1</xref>).</p>
        <table-wrap id="t4">
          <label>Tabela 1</label>
          <caption>
            <title>An&#225;lise fatorial da jogabilidade como express&#227;o da ludicidade de jogos que tematizam a viol&#234;ncia na &#225;rea da sa&#250;de, segundo fatores e itens, Bras&#237;lia, Distrito Federal, Brasil, setembro, 2021</title>
          </caption>
          <table>
            <thead>
              <tr>
                <th align="left">Jogabilidade/aprendizagem<sup>a</sup></th>
                <th align="center">Reflex&#227;o</th>
                <th align="center">Desafio</th>
                <th align="center">Imers&#227;o</th>
                <th align="center">Est&#233;tica</th>
                <th align="center">h<sup><xref ref-type="bibr" rid="B2">2</xref></sup></th>
              </tr>
            </thead>
            <tbody>
              <tr>
                <td align="left">Aprendi coisas surpreendentes com o jogo</td>
                <td align="center">0,697</td>
                <td align="left"/>
                <td align="left"/>
                <td align="left"/>
                <td align="center">0,523</td>
              </tr>
              <tr>
                <td align="left">Depois desta partida, o meu interesse pelo conte&#250;do aumentou</td>
                <td align="center">0,694</td>
                <td align="left"/>
                <td align="left"/>
                <td align="left"/>
                <td align="center">0,608</td>
              </tr>
              <tr>
                <td align="left">Durante a partida, refleti sobre os desafios que enfrentamos na vida</td>
                <td align="center">0,683</td>
                <td align="left"/>
                <td align="left"/>
                <td align="left"/>
                <td align="center">0,612</td>
              </tr>
              <tr>
                <td align="left">O jogo favoreceu a minha aprendizagem</td>
                <td align="center">0,681</td>
                <td align="left"/>
                <td align="left"/>
                <td align="left"/>
                <td align="center">0,611</td>
              </tr>
              <tr>
                <td align="left">Tive dificuldades de me concentrar no texto das cartelas</td>
                <td align="left"/>
                <td align="center">-0,718</td>
                <td align="left"/>
                <td align="left"/>
                <td align="center">0,545</td>
              </tr>
              <tr>
                <td align="left">A dificuldade das cartelas comprometeu o meu aprendizado</td>
                <td align="left"/>
                <td align="center">-0,702</td>
                <td align="left"/>
                <td align="left"/>
                <td align="center">0,535</td>
              </tr>
              <tr>
                <td align="left">Interagi ativamente com meus colegas durante a partida<sup>b</sup></td>
                <td align="left"/>
                <td align="center">0,478</td>
                <td align="left"/>
                <td align="left"/>
                <td align="center">0,367</td>
              </tr>
              <tr>
                <td align="left">Eu me desliguei do que acontecia ao meu redor enquanto jogava</td>
                <td align="left"/>
                <td align="left"/>
                <td align="center">0,645</td>
                <td align="left"/>
                <td align="center">0,444</td>
              </tr>
              <tr>
                <td align="left">Senti-me mais no ambiente do jogo que no mundo real</td>
                <td align="left"/>
                <td align="left"/>
                <td align="center">0,630</td>
                <td align="left"/>
                <td align="center">0,596</td>
              </tr>
              <tr>
                <td align="left">O <italic>design</italic> do jogo chamou minha aten&#231;&#227;o</td>
                <td align="left"/>
                <td align="left"/>
                <td align="left"/>
                <td align="center">0,778</td>
                <td align="center">0,621</td>
              </tr>
              <tr>
                <td align="left">Alfa de Cronbach<sup>c</sup></td>
                <td align="center">0,725</td>
                <td align="center">0,546</td>
                <td align="center">0,321</td>
                <td align="center">---</td>
                <td align="center">---</td>
              </tr>
            </tbody>
          </table>
          <table-wrap-foot>
            <attrib>
              <italic>a - A tabela apresenta apenas as vari&#225;veis com cargas fatoriais acima de 0,6 retidas nos fatores; KMO 0,859; p = 0,000; percentual de vari&#226;ncia explicado pelo modelo 50,28%; Rota&#231;&#227;o Varimax; h<sup>2</sup> = Comunalidades.</italic>
            </attrib>
            <attrib>
              <italic>b - Vari&#225;vel com carga fatorial abaixo de 0,60, inclu&#237;da no modelo em conson&#226;ncia com as heur&#237;sticas da jogabilidade e com o m&#237;nimo aceit&#225;vel de carga fatorial<sup>(<xref ref-type="bibr" rid="B21">21</xref>)</sup>.</italic>
            </attrib>
            <attrib>
              <italic>c - Alfa de Cronbach de todas as vari&#225;veis retidas no modelo: 0,502.</italic>
            </attrib>
          </table-wrap-foot>
        </table-wrap>
        <p>Nas emo&#231;&#245;es imaginativas nas partidas, a an&#225;lise fatorial apresentou Teste KMO de 0,817 e Bartlett <italic>p = 0,000</italic>. O autovalor (Kaiser-Guttman) previu quatro fatores, com os <italic>eigenvalues</italic>: F1: 4,400; F2: 1,858; F3: 1,184; F4: 1,089 (53,3% da vari&#226;ncia explicada). Na an&#225;lise dos 10 itens inclu&#237;dos nos fatores, nominamos: F1 - Prazer; F2 - <italic>Ostran&#234;nie</italic> (desfamiliariza&#231;&#227;o, estranhamento); F3 - Tens&#227;o; F4 - Divers&#227;o (<xref ref-type="table" rid="t5">Tabela 2</xref>).</p>
        <table-wrap id="t5">
          <label>Tabela 2</label>
          <caption>
            <title>An&#225;lise fatorial das emo&#231;&#245;es imaginativas como express&#227;o da ludicidade de jogos que tematizam a viol&#234;ncia na &#225;rea da sa&#250;de, segundo fatores e itens, Bras&#237;lia, Distrito Federal, Brasil, agosto, 2021</title>
          </caption>
          <table>
            <thead>
              <tr>
                <th align="left" valign="top">Emo&#231;&#245;es na partida<sup>d</sup></th>
                <th align="center" valign="top">Prazer</th>
                <th align="center" valign="top">Tens&#227;o</th>
                <th valign="top">
                  <italic>Ostran&#234;nie</italic>
                  <sup>e</sup>
                </th>
                <th align="center" valign="top">Divers&#227;o</th>
                <th align="center" valign="top">h<sup><xref ref-type="bibr" rid="B2">2</xref></sup></th>
              </tr>
            </thead>
            <tbody>
              <tr>
                <td align="left" valign="top">Eu me diverti ao jogar a partida</td>
                <td align="center" valign="top">0,792</td>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,690</td>
              </tr>
              <tr>
                <td align="left" valign="top">Eu gostei do jogo</td>
                <td align="center" valign="top">0,749</td>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,597</td>
              </tr>
              <tr>
                <td align="left" valign="top">O jogo me manteve motivado a continuar na partida</td>
                <td align="center" valign="top">0,721</td>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,661</td>
              </tr>
              <tr>
                <td align="left" valign="top">Fiquei realizada(o) com as conquistas no jogo</td>
                <td align="center" valign="top">0,689</td>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,521</td>
              </tr>
              <tr>
                <td align="left" valign="top">O jogo me deixou tenso</td>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,823</td>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,748</td>
              </tr>
              <tr>
                <td align="left" valign="top">O jogo me deixou ansioso</td>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,741</td>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,620</td>
              </tr>
              <tr>
                <td align="left" valign="top">Senti um misto de descontra&#231;&#227;o e tens&#227;o no jogo</td>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,623</td>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,452</td>
              </tr>
              <tr>
                <td align="left" valign="top">Os desafios do jogo me desestimularam na partida</td>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,652</td>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,588</td>
              </tr>
              <tr>
                <td align="left" valign="top">Achei-me incapaz por n&#227;o saber responder as perguntas</td>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,663</td>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,442</td>
              </tr>
              <tr>
                <td align="left" valign="top">Fiquei descontra&#237;do durante a partida</td>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="left" valign="top"/>
                <td align="center" valign="top">0,776</td>
                <td align="center" valign="top">0,499</td>
              </tr>
              <tr>
                <td align="left" valign="top">Alfa de Cronbach<sup>f</sup></td>
                <td align="center" valign="top">0,614</td>
                <td align="center" valign="top">0,638</td>
                <td align="center" valign="top">0,349</td>
                <td align="center" valign="top">-----</td>
                <td align="center" valign="top">----</td>
              </tr>
            </tbody>
          </table>
          <table-wrap-foot>
            <attrib>
              <italic>d- A tabela apresenta apenas as vari&#225;veis com cargas fatoriais acima de 0,6 retidas nos fatores. KMO 0,817; p = 0,000. Vari&#226;ncia explicada pelo modelo 53,31%. Rota&#231;&#227;o Varimax. h<sup>2</sup> = Comunalidades.</italic>
            </attrib>
            <attrib>
              <italic>e- Ostran&#234;nie (tradu&#231;&#245;es): singulariza&#231;&#227;o, estranhamento, desfamiliariza&#231;&#227;o. f- Alfa de Cronbach de todas as vari&#225;veis retidas no modelo: 0,614.</italic>
            </attrib>
          </table-wrap-foot>
        </table-wrap>
        <p>Por fim, as vinte vari&#225;veis distribu&#237;das nos oito fatores (reflex&#227;o, desafio, imers&#227;o, est&#233;tica, prazer, tens&#227;o, <italic>ostran&#234;nie</italic>, divers&#227;o) da ludicidade demonstraram boa confiabilidade interna, com Alfa de Cronbach de 0,716 (<xref ref-type="table" rid="t6">Tabela 3</xref>).</p>
        <table-wrap id="t6">
          <label>Tabela 3</label>
          <caption>
            <title>Instrumento <italic>Ludic-Quest</italic> para avalia&#231;&#227;o da ludicidade de jogos que tematizam a viol&#234;ncia na &#225;rea da sa&#250;de, com itens v&#225;lidos e confi&#225;veis, setembro, Bras&#237;lia, Distrito Federal, Brasil, 2021</title>
          </caption>
          <table>
            <thead>
              <tr>
                <th align="left" valign="top">Itens validados quanto ao constructo</th>
                <th align="center" valign="top">Alfa de Cronbach</th>
              </tr>
            </thead>
            <tbody>
              <tr>
                <td align="left" valign="top">Aprendi coisas surpreendentes com o jogo<break/>Depois desta partida, o meu interesse pelo conte&#250;do aumentou<break/>Durante a partida, refleti sobre os desafios que enfrentamos na vida<break/>O jogo favoreceu a minha aprendizagem<break/>Tive dificuldades de me concentrar no texto das cartelas<break/>A dificuldade das cartelas comprometeu o meu aprendizado<break/>Interagi ativamente com meus colegas durante a partida<break/>Eu me desliguei do que acontecia ao meu redor enquanto jogava<break/>Senti-me mais no ambiente do jogo que no mundo real<break/>O <italic>design</italic> do jogo chamou minha aten&#231;&#227;o<break/>Eu me diverti ao jogar a partida<break/>Eu gostei do jogo<break/>O jogo me manteve motivado a continuar na partida<break/>Fiquei realizada(o) com as conquistas no jogo<break/>O jogo me deixou tenso<break/>O jogo me deixou ansioso<break/>Senti um misto de descontra&#231;&#227;o e tens&#227;o no jogo<break/>Os desafios do jogo me desestimularam na partida<break/>Achei-me incapaz por n&#227;o saber responder as perguntas<break/>Fiquei descontra&#237;do durante a partida</td>
                <td align="center">0,716</td>
              </tr>
            </tbody>
          </table>
        </table-wrap>
      </sec>
      <sec sec-type="discussion">
        <title>DISCUSS&#195;O</title>
        <p>O <italic>Ludic-Quest</italic>, na avalia&#231;&#227;o da ludicidade de jogos que tematizam a viol&#234;ncia na &#225;rea da sa&#250;de, preenche uma lacuna na constru&#231;&#227;o de instrumentos v&#225;lidos e confi&#225;veis em estudos populacionais, haja vista a escassez identificada<sup>(<xref ref-type="bibr" rid="B1">1</xref>-<xref ref-type="bibr" rid="B8">8</xref>)</sup>. Independentemente da tipologia (se digitais ou n&#227;o digitais) ou da tend&#234;ncia adotada na cria&#231;&#227;o de um jogo, os resultados identificam fatores subjacentes a um fen&#244;meno de dif&#237;cil mensura&#231;&#227;o, o l&#250;dico, colocando-o no centro do campo epist&#234;mico. A invers&#227;o no modo de produzir pesquisas sobre jogos com abordagens sociais na sa&#250;de, com &#234;nfase na jogabilidade e nas emo&#231;&#245;es da partida, inova, ao problematizar a riqueza imaginativa do l&#250;dico, por vezes subsumida em sisudos desfechos causais<sup>(<xref ref-type="bibr" rid="B10">10</xref>-<xref ref-type="bibr" rid="B16">16</xref>)</sup>.</p>
        <p>As especificidades da amostra e do tipo de jogo merecem coment&#225;rios. O fato de as respondentes serem preponderantemente mulheres, jovens e graduandas da sa&#250;de ressalta o g&#234;nero como aspecto a demarcar. Nesse sentido, haja vista a hist&#243;rica discrimina&#231;&#227;o que as mulheres sofrem - n&#227;o apenas na comunidade dos jogadores (homens, brancos, heterossexuais), mas tamb&#233;m no restrito espa&#231;o do <italic>design</italic> - as repercuss&#245;es dessa viol&#234;ncia precisam de maior visibilidade, especialmente nas oportunidades desiguais de acesso ao jogo. No caso do <italic>Violetas</italic>, as quest&#245;es de g&#234;nero comprometem a familiaridade e o aprendizado das meninas com jogos de tabuleiro do estilo moderno. Al&#233;m de serem pouco difundidos na cultura l&#250;dica do Brasil, os jogos de estrat&#233;gia requerem um certo tempo para a apreens&#227;o da jogabilidade, o que implica maior contato do p&#250;blico, hegemonicamente dominado pelos garotos. Outro ponto a ressaltar diz respeito &#224; realiza&#231;&#227;o da pesquisa com um &#250;nico jogo - o <italic>Violetas</italic> - e a especificidade do enfrentamento &#224; viol&#234;ncia contra a mulher, o que compromete a generaliza&#231;&#227;o dos resultados. A identifica&#231;&#227;o da tem&#225;tica com o vi&#233;s feminino da amostra favoreceu a ades&#227;o das participantes ao jogo e a ludicidade, requerendo outros recortes investigativos. Portanto, de antem&#227;o, sugerimos futuras pesquisas com segmentos populacionais e com jogos de enfoques sociais diversos - a partir de marcadores sociodemogr&#225;ficos e de g&#234;nero - no intuito de produzir novas validades e fidedignidades ao <italic>Ludic-Quest</italic><sup>(<xref ref-type="bibr" rid="B18">18</xref>,<xref ref-type="bibr" rid="B23">23</xref>-<xref ref-type="bibr" rid="B24">24</xref>)</sup>.</p>
        <p>Nas t&#233;cnicas de valida&#231;&#227;o, as vari&#225;veis contidas na jogabilidade/aprendizagem e nas emo&#231;&#245;es foram adequadas &#224; AFE, com bom Teste KMO e Bartlett significativo. O <italic>eigenvalue</italic> foi pertinente &#224; extra&#231;&#227;o dos fatores em cada dimens&#227;o, com concep&#231;&#245;es latentes que denotam a autorrefer&#234;ncia da ludicidade, conforme literatura. Na jogabilidade/aprendizagem, os fatores reflex&#245;es, desafios, imers&#227;o e est&#233;tica s&#227;o caracter&#237;sticas do l&#250;dico a serem forjadas. Entre as emo&#231;&#245;es que o jogo mobiliza em uma partida, destacam-se as sensa&#231;&#245;es difusas de prazer, de tens&#227;o, de <italic>ostran&#234;nie</italic> (desfamiliariza&#231;&#227;o, estranhamento) e de divers&#227;o<sup>(<xref ref-type="bibr" rid="B7">7</xref>-<xref ref-type="bibr" rid="B8">8</xref>,<xref ref-type="bibr" rid="B14">14</xref>,<xref ref-type="bibr" rid="B22">22</xref>,<xref ref-type="bibr" rid="B25">25</xref>)</sup>.</p>
        <p>Em revis&#245;es cient&#237;ficas, n&#227;o h&#225; consenso sobre quais fatores utilizar na avalia&#231;&#227;o de um jogo, embora existam abordagens similares<sup>(<xref ref-type="bibr" rid="B7">7</xref>-<xref ref-type="bibr" rid="B8">8</xref>)</sup>. A aprendizagem - seja aquela apreendida em uma partida ou a que se refere a conte&#250;dos externos - constitui um fator amplamente aceito na avalia&#231;&#227;o de um jogo. No <italic>Ludic-Quest</italic>, denominamos de reflex&#227;o o fator da aprendizagem percebida, por expressar melhor o sentido da educa&#231;&#227;o cr&#237;tico-imaginativa. Vemos que este refletir se expressa de maneira mais ou menos intensa, respectivamente, nas seguintes vari&#225;veis: aprendi coisas surpreendentes com o jogo; refleti sobre os desafios; meu interesse pelo conte&#250;do aumentou; o jogo favoreceu minha aprendizagem.</p>
        <p>A surpresa com o novo, com o espanto, com o imprevisto e com a incerteza s&#227;o caracter&#237;sticas &#224; educa&#231;&#227;o advinda do l&#250;dico, no enlace com o est&#233;tico. Em outros termos, no instante em que somos arrebatados para o que antes n&#227;o estava ali, nesse ef&#234;mero, necess&#225;rio &#224; forma&#231;&#227;o cr&#237;tica, habita o pensar inexplor&#225;vel da frui&#231;&#227;o po&#233;tica<sup>(<xref ref-type="bibr" rid="B26">26</xref>)</sup>. De certa forma, as vari&#225;veis que exibem admira&#231;&#227;o com o inusitado indicam satisfa&#231;&#227;o na reflex&#227;o (aprendi coisas surpreendentes no jogo; refleti sobre desafios). Por outro lado, aquelas que indicam a contribui&#231;&#227;o do jogo &#224; apreens&#227;o de temas correspondem aos aspectos disciplinares da aprendizagem (o jogo favoreceu meu aprendizado; meu interesse pelo conte&#250;do aumentou)<sup>(<xref ref-type="bibr" rid="B3">3</xref>,<xref ref-type="bibr" rid="B5">5</xref>,<xref ref-type="bibr" rid="B7">7</xref>)</sup>. Portanto, as vari&#225;veis do fator reflex&#227;o indicam as tend&#234;ncias educativas em um jogo, seja inerente ou fora do campo l&#250;dico.</p>
        <p>Os fatores da imers&#227;o e dos desafios s&#227;o intr&#237;nsecos &#224; mec&#226;nica do jogo, na cria&#231;&#227;o da din&#226;mica l&#250;dica. Na imers&#227;o, a sensa&#231;&#227;o de estar em outro lugar, a perda da no&#231;&#227;o do tempo, a inaugura&#231;&#227;o de outros sentidos, o tempo reinventado ou inaugurado em um mundo ficcionado conferem centralidade ao l&#250;dico. Da mesma forma, a imers&#227;o das(os) participantes &#233; permeada por desafios que comp&#245;em e s&#227;o despertados pelo pr&#243;prio jogo, em seu sentido relacional e emocionado. A par desse real ficcionado, no <italic>Ludic-Quest</italic>, a imers&#227;o pode ser aferida pelas vari&#225;veis: eu me desliguei do que acontecia ao meu redor enquanto jogava; senti-me mais no ambiente do jogo que no mundo real<sup>(<xref ref-type="bibr" rid="B8">8</xref>-<xref ref-type="bibr" rid="B14">14</xref>,<xref ref-type="bibr" rid="B22">22</xref>,<xref ref-type="bibr" rid="B25">25</xref>)</sup>.</p>
        <p>Ao contr&#225;rio do que possa parecer, a dificuldade &#233; componente priorizado na jogabilidade. Pesquisas prop&#245;em uma tipologia aos desafios em um jogo, sendo elas: a - dificuldades mec&#226;nicas (impactam no desempenho e nas habilidades das(os) jogadoras(es)); b - dificuldades interpretativas (barreiras &#224; compreensibilidade); c - dificuldades afetivas (emo&#231;&#245;es amb&#237;guas e insol&#250;veis despertadas). Nessa arena ag&#244;nica, no <italic>Ludic-Quest</italic>, os obst&#225;culos de um jogo podem ser verificados pelos itens: a dificuldade das cartelas comprometeu meu aprendizado; tive dificuldade no texto das cartelas; interagi ativamente durante a partida. Uma vez que a intera&#231;&#227;o &#233; um desafio inerente &#224; jogabilidade, inclu&#237;mos essa vari&#225;vel no modelo fatorial, em conson&#226;ncia com a literatura<sup>(<xref ref-type="bibr" rid="B22">22</xref>,<xref ref-type="bibr" rid="B25">25</xref>,<xref ref-type="bibr" rid="B27">27</xref>)</sup>.</p>
        <p>Embora as dimens&#245;es da jogabilidade e das emo&#231;&#245;es vividas na partida formem grupos estatisticamente distintos, argumentamos pela indissociabilidade no l&#250;dico. Seja qual for a mec&#226;nica formalmente constru&#237;da para inventar um jogo, ele s&#243; acontece quando ativado pelas emo&#231;&#245;es das(os) jogadoras(es) naquele curto espa&#231;o temporalmente delimitado por regras livremente aceitas. Para a cl&#225;ssica defini&#231;&#227;o da &#225;rea de <italic>designs</italic>, o jogo nada mais &#233; do que uma intera&#231;&#227;o artificialmente gerada, pois ele acontece apenas quando seu sistema de regula&#231;&#227;o &#233; consentido entre as(os) jogadoras(es)<sup>(<xref ref-type="bibr" rid="B25">25</xref>)</sup>. Isso posto, a despeito da divis&#227;o das vari&#225;veis em dimens&#245;es distintas nos procedimentos da AFE, pressupomos que todas indicam um mesmo constructo, o l&#250;dico, ora descrito nos aspectos subjacentes.</p>
        <p>Nos fatores latentes &#224;s emo&#231;&#245;es vividas na partida, a indissociabilidade e a fugacidade do l&#250;dico se sobressaem, expressas pela ambiguidade das vari&#225;veis. Assim, nas sensa&#231;&#245;es vivenciadas pelas(os) jogadoras(es) no campo l&#250;dico, subsiste o entrela&#231;amento do jogo com a arte. Como indicativos desse flerte, no <italic>Ludic-Quest</italic>, os fatores da est&#233;tica e da divers&#227;o - um em cada dimens&#227;o - retiveram uma &#250;nica vari&#225;vel, fugindo da regra de comunalidades partilhadas com outras, em um mesmo fator<sup>(<xref ref-type="bibr" rid="B21">21</xref>)</sup>. Ao que tudo indica, a sedu&#231;&#227;o est&#233;tica e a frui&#231;&#227;o em um jogo se recusam ao comum, ao reconhecimento ou a qualquer nexo causal, embora se imiscuam nas evid&#234;ncias. Ou seja, sutilmente, ora essas vari&#225;veis mesclam as <italic>performances</italic> afetivas (sensa&#231;&#227;o est&#233;tica, onde h&#225; jogabilidade; divers&#227;o, na emo&#231;&#227;o sinest&#233;sica), ora se singularizam em livre jogo ficcional<sup>(<xref ref-type="bibr" rid="B22">22</xref>,<xref ref-type="bibr" rid="B25">25</xref>-<xref ref-type="bibr" rid="B28">28</xref>)</sup>.</p>
        <p>As formas po&#233;ticas do jogo h&#225; muito s&#227;o discutidas por cl&#225;ssicos, que nos rememoram<sup>(<xref ref-type="bibr" rid="B13">13</xref>)</sup>: i - a poesia se origina no ritual, no divertimento e na arte, portanto, na inven&#231;&#227;o de enigmas, da adivinha&#231;&#227;o e da competi&#231;&#227;o; ii - a poesia tem origem no jogo; iii - a linguagem po&#233;tica &#233; essencialmente um jogar com as palavras; iv - o ritual &#233; feito com canto, dan&#231;a e jogo; v - a m&#250;sica, o teatro e a dan&#231;a s&#227;o formas l&#250;dicas; vi - tanto o jogo quanto a arte est&#227;o fora da vida pr&#225;tica, da necessidade, da utilidade, do dever ou da verdade. No atual mundo virtual, o di&#225;logo da arte com o jogo perfaz igualmente as bases da sofisticada est&#233;tica dos <italic>video games</italic>. Em que pese o risco reificante da tecnologia sobre o pensar imaginativo, dialogamos com essas produ&#231;&#245;es, com a ressalva de salvaguardar a autonomia do jogo<sup>(<xref ref-type="bibr" rid="B15">15</xref>-<xref ref-type="bibr" rid="B16">16</xref>)</sup>. Mantemos, tamb&#233;m, reservas quanto &#224; apropria&#231;&#227;o ligeira da cr&#237;tica liter&#225;ria, presente em algumas pesquisas. Na releitura do formalismo russo ou da teoria do efeito est&#233;tico, por exemplo, aspectos como os limites de significa&#231;&#227;o da linguagem s&#227;o impropriamente incorporados<sup>(<xref ref-type="bibr" rid="B14">14</xref>,<xref ref-type="bibr" rid="B28">28</xref>-<xref ref-type="bibr" rid="B29">29</xref>)</sup>.</p>
        <p>De volta &#224;s sensa&#231;&#245;es do l&#250;dico, sabemos que a dificuldade suscita desejos tensos de conquista em um jogo, em franca disputa estimulante. Para apimentar as emo&#231;&#245;es em uma partida, a produ&#231;&#227;o da desfamiliariza&#231;&#227;o interativa - baseada na concep&#231;&#227;o liter&#225;ria de <italic>ostran&#234;nie</italic> - perfaz uma t&#233;cnica para complicar o jogo e desacelerar a aquisi&#231;&#227;o de habilidades das(os) participantes. Em di&#225;logo com o formalismo russo, a denominada jogabilidade po&#233;tica na produ&#231;&#227;o de <italic>video games</italic> utiliza a linguagem art&#237;stica para gerar o espanto com o inesperado, com o outro tornado estranho, com o exasperante. Afinal, sabemos que as sensa&#231;&#245;es da obra de arte emergem da novidade imprevista, n&#227;o do habitual. O uso desses artif&#237;cios para tornar o universo l&#250;dico incompreens&#237;vel pretende provocar nas(nos) jogadoras(es) reflex&#245;es sobre os aspectos formais do jogo (sua mec&#226;nica, linguagem, <italic>design</italic>, est&#233;tica, ficcionalidade, ritmo), gerando desconfortos afetivos. Tais manejos propositais encorajam a(o) participante a mergulhar na autonomia do l&#250;dico, qui&#231;&#225; no seu encontro emocionado com a arte, sem refer&#234;ncias externas ao mundo ficcionado<sup>(<xref ref-type="bibr" rid="B14">14</xref>,<xref ref-type="bibr" rid="B29">29</xref>-<xref ref-type="bibr" rid="B30">30</xref>)</sup>.</p>
        <p>No <italic>Ludic-Quest</italic>, os afetos provocados pelo <italic>ostran&#234;nie</italic> designam um dos fatores extra&#237;dos na dimens&#227;o emo&#231;&#245;es na partida. Mantivemos o termo original, um neologismo acidental da l&#237;ngua russa, por dois motivos: i - conson&#226;ncia com a recomenda&#231;&#227;o da cr&#237;tica liter&#225;ria, pelas dificuldades na tradu&#231;&#227;o; ii - para sugerir emo&#231;&#245;es de estranhamento na leitora ou no leitor, autorreferente do seu sentido. Al&#233;m disso, o resgate da negatividade aqui proposto reivindica que o pensar reflexivo rejeite o imediato, com exig&#234;ncias de um esfor&#231;o interpretativo no fruidor, embora nem sempre agrad&#225;vel<sup>(<xref ref-type="bibr" rid="B30">30</xref>)</sup>. Nesse ambiente estranhado e persuasivo do l&#250;dico, os demais fatores e vari&#225;veis que avaliam as emo&#231;&#245;es em um jogo expressam semelhante labilidade, manifestando nas sensa&#231;&#245;es de prazer (eu me diverti ao jogar a partida; gostei do jogo; fiquei motivado; fiquei realizado nas conquistas), tens&#227;o (fiquei tenso; ansioso; senti um misto de descontra&#231;&#227;o e tens&#227;o), ao lado do <italic>ostran&#234;nie</italic> (os desafios me desestimularam; achei-me incapaz)<sup>(<xref ref-type="bibr" rid="B14">14</xref>,<xref ref-type="bibr" rid="B22">22</xref>,<xref ref-type="bibr" rid="B27">27</xref>-<xref ref-type="bibr" rid="B29">29</xref>)</sup>.</p>
        <p>Nos valores Alfa de Cronbach, as vinte vari&#225;veis do <italic>Ludic-Quest</italic> apresentaram boa confiabilidade interna. Nos fatores, a confiabilidade se mant&#233;m para as reflex&#245;es, o prazer, a tens&#227;o e tamb&#233;m para as vari&#225;veis das emo&#231;&#245;es na partida.</p>
        <sec>
          <title>Limita&#231;&#245;es do estudo</title>
          <p>Os valores do Alfa de Cronbach indicam certa limita&#231;&#227;o no uso escalonar do <italic>Ludic-Quest</italic> na avalia&#231;&#227;o da ludicidade de jogos que tematizam a viol&#234;ncia na &#225;rea da sa&#250;de, requerendo novos estudos. O g&#234;nero feminino preponderante da amostra e a realiza&#231;&#227;o da pesquisa com um &#250;nico jogo igualmente limitam a extrapola&#231;&#227;o dos resultados. Os achados, em geral, corroboram com o universo das investiga&#231;&#245;es sobre jogos, as quais indicam cautela na generaliza&#231;&#227;o<sup>(<xref ref-type="bibr" rid="B1">1</xref>-<xref ref-type="bibr" rid="B8">8</xref>)</sup>.</p>
        </sec>
        <sec>
          <title>Contribui&#231;&#245;es para a &#225;rea da enfermagem</title>
          <p>A ousadia do estudo consiste na invers&#227;o no modo interdisciplinar de produzir pesquisas sobre jogos na sa&#250;de e na enfermagem, com &#234;nfase na jogabilidade e nas emo&#231;&#245;es da partida. A inova&#231;&#227;o dessa maneira de perguntar consiste em problematizar a riqueza imaginativa do l&#250;dico no &#226;mbito da produ&#231;&#227;o de instrumentos de aferi&#231;&#227;o, por vezes subsumida nos desfechos causais. Em outras palavras, o <italic>Ludic-Quest</italic> avalia e subsidia reflex&#245;es sobre o l&#250;dico em jogos com tem&#225;ticas sociais complexas, como a viol&#234;ncia, ampliando as perspectivas interpretativas. Por consequ&#234;ncia, o fomento do pensar cr&#237;tico-imaginativo de profissionais de sa&#250;de e de enfermagem, inscrito nessa reviravolta epist&#234;mica, favorece a prioriza&#231;&#227;o axiol&#243;gica da cidadania no &#226;mbito das pol&#237;ticas p&#250;blicas, especialmente aquelas de enfrentamento da viol&#234;ncia contra a mulher.</p>
        </sec>
      </sec>
      <sec sec-type="conclusions">
        <title>CONCLUS&#213;ES</title>
        <p>Neste artigo, perguntamos quais os fatores latentes e os itens v&#225;lidos quanto ao constructo na avalia&#231;&#227;o da ludicidade de jogos que tematizam a viol&#234;ncia na &#225;rea da sa&#250;de. Em resposta, os oito fatores validados (reflex&#245;es, imers&#227;o, desafios, est&#233;tica, prazer, tens&#227;o, <italic>ostran&#234;nie</italic>, divers&#227;o) indicam a centralidade do l&#250;dico para produ&#231;&#227;o de jogos com abordagens sociais na &#225;rea da sa&#250;de, compondo um instrumento de avalia&#231;&#227;o confi&#225;vel de vinte itens para utiliza&#231;&#227;o em pesquisas. Por seu turno, a rebeli&#227;o de algumas vari&#225;veis aos m&#233;todos de valida&#231;&#227;o da ludicidade parece manter a jogabilidade e as emo&#231;&#245;es em campo, para que possa haver mais jogo.</p>
      </sec>
      <sec sec-type="supplementary-material">
        <title>MATERIAL SUPLEMENTAR</title>
        <p>
          <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.48331/scielodata.AZMS8G">https://doi.org/10.48331/scielodata.AZMS8G</ext-link>
        </p>
      </sec>
    </body>
    <back>
      <fn-group>
        <fn fn-type="supported-by">
          <p>
            <bold>FOMENTO</bold>
          </p>
          <p>O artigo foi financiado pela FAPESP (Processo 2018/07389-4) e CNPq (Processos 405302/2012-6 e 425350/2018-5.</p>
        </fn>
      </fn-group>
    </back>
  </sub-article>
</article>
