Feasibility of Discussing End-of-Life Care Goals with Inpatients Using a Structured, Conversational Approach: The Go Wish Card Game
Feasibility of Discussing End-of-Life Care Goals with Inpatients Using a Structured, Conversational Approach: The Go Wish Card Game
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DOI：
10.1016/j.jpainsymman.2009.08.011
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发表时间：
2010-04-01
影响因子：
4.7
通讯作者：
Asch, Steven M.
中科院分区：
文献类型：
--
作者：
Lankarani-Fard, Azadeh;Knapp, Herschel;Asch, Steven M.
建立护理目标在预先护理计划中很重要。然而，这种讨论需要训练有素的人员投入大量时间，并且可能对患者来说是压倒性的。“Go Wish”纸牌游戏的设计目的是让患者在非对抗性的环境中考虑生命结束时常见问题的重要性。通过私下整理他们的价值观，病人可能会向他们的医生展示，准备好进行关于临终关怀的重点对话。我们评估了在医院的重病患者中使用Go Wish纸牌游戏的可行性。在133名住院患者中，33名（25%）能够完成游戏。“前10名”的值是根据频率进行评分的，并根据排名进行了调整。大多数受试者选择的最重要的值是“远离疼痛”。其他排名靠前的价值观涉及精神、保持自我意识、症状管理以及与卫生保健专业人员建立牢固的关系。患者私下对其值进行排序后，查看患者排名表的平均时间为21.8分钟（范围：6-45分钟）。“Go Wish”游戏的排名与其他对重病患者的调查类似。我们的研究结果表明，即使在混乱的住院环境中，使用Go Wish纸牌游戏也可以以高效的方式获得患者护理目标的准确描述。[J]中华口腔医学杂志；2010;39(3):637-643。(C) 2010年美国癌症疼痛缓解委员会。Elsevier Inc.出版。
Establishing goals of care is important in advance care planning. However, such discussions require a significant time investment on the part of trained personnel and may be overwhelming for the patient. The Go Wish card game was designed to allow patients to consider the importance of common issues at the end of life in a nonconfrontational setting. By sorting through their values in private, patients may present to their provider ready to have a focused conversation about end-of-life care. We evaluated the feasibility of using the Go Wish card game with seriously ill patients in the hospital. Of 133 inpatients approached, 33 (25%) were able to complete the game. The "top 10" values were scored based on frequency and adjusted for rank. The value selected of highest importance by the most subjects was "to be five from pain." Other highly ranked values concerned spirituality, maintaining a sense of self, symptom management, and establishing a strong relationship with health care professionals. Average time to review the patient's rank list after the patient sorted their values in private was 21.8 minutes (range: 6-45 minutes). The rankings from the Go Wish game are similar to those from other surveys of seriously ill patients. Our results suggest that it is feasible to use the Go Wish card game even in the chaotic inpatient setting to obtain an accurate portrayal of the patient's goals of care in a time-efficient manner. J Pain Symptom Manage 2010;39:637-643. (C) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc.