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使用“愿望达成”游戏在癌症和慢性进行性疾病的预立医疗照护计划中提供个性化照护。

Personalized Care in Advance Care Planning with Cancer and Chronic Progressive Diseases Using the Go Wish Game.

作者信息

Alquati Sara, Perin Marta, Sacchi Simona, De Panfilis Ludovica, Tanzi Silvia

机构信息

Palliative Care Unit, Azienda USL-IRCCS di Reggio Emilia, 42121 Reggio Emilia, Italy.

Legal Medicine and Bioethics, Azienda USL-IRCCS di Reggio Emilia, 42121 Reggio Emilia, Italy.

出版信息

J Pers Med. 2025 Apr 30;15(5):180. doi: 10.3390/jpm15050180.

Abstract

The Go Wish Game (GWG) is a card game designed to ease Advance Care Planning (ACP) discussions. It helps patients to consider their values and priorities, and to share them with families and healthcare professionals (HPs). Despite a general appreciation of the GWG, mechanisms related to its implementation have been poorly investigated. : to determine optimal strategies for integration of the GWG into clinical practice and to investigate the experiences of a Palliative Care Unit (PCU) trained in the use of the GWG. : We performed a descriptive qualitative study. Data were collected through a focus group (FG) and we followed the thematic analysis. The PCU's team described their experience using the GWG focusing on 15 patients (9 oncological, 6 non-oncological) patients, managed by the PCU. : Our data revealed five main themes, along with their subthemes: (1) personalizing the GWG proposal; (2) the role of the caregiver; (3) organizational aspects; (4) meaning of the GWG in clinical practice, and (5) dealing with patient's priorities. Comparison of real-life cases has led to the identification of specific facilitators and barriers that can hinder or promote the use of the GWG for personalized medicine. : Findings suggest that certain aspects still require attention in GWG implementation, particularly regarding the training and competencies (communicative, relational, ethical) of the healthcare professionals, and the process leading to the proposal of the GWG to the patient.

摘要

“愿望清单游戏”(GWG)是一款旨在促进预立医疗计划(ACP)讨论的纸牌游戏。它帮助患者思考自身价值观和优先事项,并与家人及医疗保健专业人员(HP)分享。尽管人们普遍认可GWG,但与其实施相关的机制却鲜有研究。:确定将GWG整合到临床实践中的最佳策略,并调查一家接受过GWG使用培训的姑息治疗科(PCU)的经验。:我们进行了一项描述性定性研究。通过焦点小组(FG)收集数据,并采用主题分析法。PCU团队描述了他们使用GWG的经验,重点关注由PCU管理的15名患者(9名肿瘤患者,6名非肿瘤患者)。:我们的数据揭示了五个主要主题及其子主题:(1)使GWG提议个性化;(2)护理人员的角色;(3)组织方面;(4)GWG在临床实践中的意义,以及(5)处理患者的优先事项。对实际案例的比较导致识别出了可能阻碍或促进GWG用于个性化医疗的具体促进因素和障碍。:研究结果表明,在GWG实施中某些方面仍需关注,特别是医疗保健专业人员的培训和能力(沟通、关系、伦理),以及向患者提出GWG提议的过程。

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