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

Abstract

Background: 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. Objective: 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. Methods: 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. Results: 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. Conclusions: 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.