Bioethics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy.
J Palliat Med. 2022 Oct;25(10):1540-1550. doi: 10.1089/jpm.2022.0083. Epub 2022 Jul 21.
<b><i>Background:</i></b> The Go Wish Game (GWG) is a practical tool developed to ease advance care planning (ACP) conversations regarding end-of-life (EOL) issues. The game consists of a guide and 35 cards to help persons think about their personal values and priorities in the context of care and to discuss and share those concerns with families and health care professionals (HPs). <b><i>Objectives:</i></b> To promote ACP conversations in the Italian context, we developed an Italian version of the GWG by linguistic translation and cultural adaptation. <b><i>Design:</i></b> Cross-cultural adaptation process developed by Beaton et al. <b><i>Measurements:</i></b> We started with a back-and-forth translation to guarantee linguistic appropriateness. A prefinal Italian version was developed and then qualitatively evaluated by two focus groups (FGs) to assess content validity and cultural appropriateness. Participants' suggestions were discussed by the research groups and included in the final Italian version. <b><i>Data analysis:</i></b> The FGs' transcripts were analyzed by thematic analysis. <b><i>Sample:</i></b> One FG included HPs potentially involved in ACP, the second FG involved representative from local patient associations (RLPAs) with chronic, degenerative, and potentially terminal disease. Participants were purposefully selected. The two FGs involved eight HPs and five RLPAs, respectively. <b><i>Results:</i></b> Fewer explicit statements concerning EOL choices and a broader emphasis on the role of HPs in this discussion characterized the prefinal version. Our analysis identified three themes and five subthemes: (1) <i>improving translation</i>: linguistic redefinition and practical clarification; (2) <i>how to play the GWG</i>: needs and suggestions; and (3) <i>more than a game</i>. <b><i>Conclusion:</i></b> The Italian version developed in this study presents several cultural peculiarities. The rigorous translation and cultural adaptation process applied can enrich the existing literature by spreading a practical tool for initiating ACP in other languages and cultures. Further studies are needed to evaluate this tool's effectiveness in supporting ACP and training HPs to promote the ACP process.
<b><i>背景：</i></b> 愿望游戏（GWG）是一种实用工具，旨在促进关于生命末期（EOL）问题的预先护理计划（ACP）对话。该游戏包括一个指南和 35 张卡片，帮助人们在护理方面思考个人价值观和优先事项，并与家人和医疗保健专业人员（HPs）讨论和分享这些问题。<b><i>目的：</i></b> 为了在意大利推广 ACP 对话，我们通过语言翻译和文化适应性开发了 GWG 的意大利语版本。<b><i>设计：</i></b> 由 Beaton 等人开发的跨文化适应过程。<b><i>测量：</i></b> 我们从来回翻译开始，以确保语言的适当性。开发了一个预终版意大利语版本，然后由两个焦点小组（FGs）进行定性评估，以评估内容有效性和文化适宜性。研究小组讨论了参与者的建议，并将其纳入最终的意大利语版本。<b><i>数据分析：</i></b> 对焦点小组的转录进行了主题分析。<b><i>样本：</i></b> 一个焦点小组包括可能参与 ACP 的 HPs，第二个焦点小组包括来自当地患者协会（RLPAs）的代表，他们患有慢性、退行性和潜在的终末期疾病。参与者是有目的选择的。两个焦点小组分别涉及八名 HPs 和五名 RLPAs。<b><i>结果：</i></b> 预终版更加强调 HPs 在这一讨论中的作用，而较少明确陈述有关 EOL 选择的内容。我们的分析确定了三个主题和五个子主题：（1）<i>改进翻译</i>：语言重新定义和实际澄清；（2）<i>如何玩 GWG</i>：需求和建议；（3）<i>不仅仅是游戏</i>。<b><i>结论：</i></b> 本研究中开发的意大利语版本具有一些文化特点。应用的严格翻译和文化适应性过程可以通过传播在其他语言和文化中启动 ACP 的实用工具来丰富现有文献。需要进一步研究来评估该工具在支持 ACP 和培训 HPs 以促进 ACP 过程方面的有效性。
