利用对话游戏促进癌症患者及其护理伙伴之间的预先护理计划对话：一项试点研究。

Facilitating Advance Care Planning Conversations Among Patients With Cancer and Their Care Partners Utilizing a Conversation Game: A Pilot Study.

作者信息

Kimbel Kylee, Hayes Michael, Bucher Morgan, Calo William A, Garg Tullika, Joshi Monika, Kuntz Hannah, Murphy Terrence E, VanDyke Erika, Wasserman Emily, Van Scoy Lauren J

机构信息

Penn State College of Medicine, Hershey, Pennsylvania, USA.

Penn State Cancer Institute, Hershey, Pennsylvania, USA.

出版信息

Cancer Rep (Hoboken). 2025 Jun;8(6):e70250. doi: 10.1002/cnr2.70250.

DOI:10.1002/cnr2.70250

PMID:40528532

Abstract

BACKGROUND

Patients with cancer should engage in decision-making throughout the course of their illness and treatment. Current guidelines recommend early, frequent advance care planning (ACP) conversations among clinicians, patients, and care partners (CPs) and advance directive (AD) completion. However, only 55% of patients with cancer have completed such directives, suggesting the need for interventions to increase rates of ACP. The Hello game has been shown to be effective in promoting ACP in several populations but has not been tested in patients with cancer or their CP.

AIMS

To assess the acceptability of Hello and determine the modifications necessary for use in cancer populations.

METHODS AND RESULTS

This convergent mixed methods study involved seven dyads (7 patients with cancer and their 7 CPs to total n = 14); dyads played Hello in groups of 2-4. Post-game, dyads completed satisfaction and acceptability questionnaires and focus groups. Qualitative thematic analysis was performed; quantitative data was summarized. Patients' mean age was 56.4 years-43% were female, 57% had genitourinary cancer, and 43% had breast cancer. Three themes emerged from both patient and CP focus groups (n = 14 individuals): (1) Participants enjoyed the group dynamics and relating to peers when playing Hello; (2) Hello serves as a helpful conversation starter; (3) modifications could help tailor Hello for use in cancer context-particularly adding more questions about quality of life and mental health. The patient focus groups had an additional theme: (4) Patients with localized cancer may have a different experience with Hello when compared to those with advanced cancer.

CONCLUSION

Hello was well-received by dyads, and their feedback was used to tailor Hello for patients with cancer and their CPs. Next steps for this project include assessing the acceptability of the modified game.

TRIAL REGISTRATION

clinicaltrials.gov: NCT06028152.

摘要

背景

癌症患者在整个疾病和治疗过程中都应参与决策。当前指南建议临床医生、患者和护理伙伴（CP）尽早、频繁地进行预先护理计划（ACP）对话并完成预先指示（AD）。然而，只有55%的癌症患者完成了此类指示，这表明需要采取干预措施来提高ACP的完成率。“你好”游戏已被证明在促进多个群体的ACP方面有效，但尚未在癌症患者或其CP中进行测试。

目的

评估“你好”游戏的可接受性，并确定在癌症群体中使用所需的修改。

方法和结果

这项收敛性混合方法研究涉及七个二元组（7名癌症患者及其7名CP，共14人）；二元组以2至4人的小组形式玩“你好”游戏。游戏结束后，二元组完成满意度和可接受性问卷以及焦点小组讨论。进行了定性主题分析；对定量数据进行了总结。患者的平均年龄为56.4岁，43%为女性，57%患有泌尿生殖系统癌症，43%患有乳腺癌。患者和CP焦点小组（共14人）出现了三个主题：（1）参与者在玩“你好”游戏时喜欢小组互动并与同龄人交流；（2）“你好”游戏有助于开启有益的对话；（3）修改可以帮助调整“你好”游戏以适用于癌症患者——特别是增加更多关于生活质量和心理健康的问题。患者焦点小组还有一个额外的主题：（4）与晚期癌症患者相比，局限性癌症患者玩“你好”游戏的体验可能不同。