VA Greater Los Angeles Healthcare System, Los Angeles, California 90403, USA.
J Pain Symptom Manage. 2010 Apr;39(4):637-43. doi: 10.1016/j.jpainsymman.2009.08.011.
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 free 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.
确定关怀目标在预先护理计划中很重要。然而，此类讨论需要训练有素的人员投入大量时间，并且可能会让患者感到不知所措。Go Wish 卡牌游戏旨在允许患者在非对抗性的环境中考虑生命末期常见问题的重要性。通过私下整理自己的价值观，患者可能会在向医生提供信息时，已经准备好就临终关怀进行重点对话。我们评估了在医院使用 Go Wish 卡牌游戏对重病患者的可行性。在 133 名住院患者中，有 33 名（25%）能够完成游戏。根据频率和排名进行调整后，根据排名列出了“十大”价值观。被大多数患者选为最重要的价值观是“免受痛苦”。其他排名较高的价值观涉及精神性、保持自我意识、症状管理和与医疗保健专业人员建立牢固关系。在患者私下整理完价值观后，回顾患者排名列表的平均时间为 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结果相似。我们的研究结果表明，即使在混乱的住院环境中，使用 Go Wish 卡牌游戏也可以有效地以高效的方式获得患者关怀目标的准确描述。
