P-74 Advance care planning awareness: Using the go wish card game to assess the modern Japanese view of life and death

Kuramoto, Koichi; Harasawa, Keitaro; Moody, Sandra; Yoshida, Masanori; Okawa, K; Sera, Nobukatsu; Chiba, Kazuhiro; Sekine, Ryuichi

doi:10.1136/bmjspcare-2015-000978.204

Cited by 4 publications

(5 citation statements)

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“…Our sampling strategy also inhibits broad generalizations to other populations; however, we would argue that the present study offers an important contribution to knowledge about the reasoning and considerations leading to prioritized EoL preferences. While the GoWish cards have been used in several recent studies of different contexts and populations ( Banner et al, 2019 ; Delgado-Guay et al, 2016 ; Glennon et al, 2019 ; Kuramoto et al, 2015 ; Zachariah, Klein, Clifton-Hawkins, Andrews, & Gross, 2015 ), we have found few other studies reporting on how GoWish items have been reasoned about and negotiated by users. The study by Lee, Hinderer, and Alexander (2018) on EoL preferences for Chinese Americans is a rare exception, also involving community-dwelling older adults, as they briefly report on how participants commented card items.…”

Section: Discussionmentioning

confidence: 91%

Exploring Community-Dwelling Older Adults’ Considerations About Values and Preferences for Future End-of-Life Care: A Study from Sweden

2020

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Background and Objectives There is a substantial body of research on advance care planning (ACP), often originating from English-speaking countries and focused on health care settings. However, studies of content of ACP conversations in community settings remain scarce. We therefore explore community-dwelling, older adults’ reasoning about end-of-life (EoL) values and preferences in ACP conversations. Research Design and Methods In this participatory action research project, planned and conducted in collaboration with national community-based organizations, we interviewed 65 older adults without known EoL care needs, about their values and preferences for future EoL care. Conversations were stimulated by sorting and ranking statements in a Swedish version of GoWish cards, called the DöBra cards, and verbatim transcripts were analyzed inductively. Results While participants shared some common preferences about EoL care, there was great variation among individuals in how they reasoned. Although EoL preferences and prioritizations could be identical, different individuals explained these choices very differently. We exemplify this variation using data from four participants who discussed their respective EoL preferences by focusing on either physical, social, existential, or practical implications. Discussion and Implications A previously undocumented benefit of the GoWish/DöBra cards is how the flexibility of the card statements support substantial discussion of an individual’s EoL preferences and underlying values. Such in-depth descriptions of participants’ reasoning and considerations are important for understanding the very individual nature of prioritizing EoL preferences. We suggest future users of the DöBra/GoWish cards consider the underlying reasoning of individuals’ prioritizations to strengthen person-centeredness in EoL conversations and care provision.

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Section: Discussionmentioning

confidence: 91%

Exploring Community-Dwelling Older Adults’ Considerations About Values and Preferences for Future End-of-Life Care: A Study from Sweden

2020

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“…The GoWish cards have been used in research studies with community‐dwelling adults in several countries [10, 15, 27, 28] and as the DöBra cards with majority populations in Sweden [4, 9, 17, 18], however, we have seen no other studies that have reported an extensive use of wild cards as in the present study. This may be in part due to interviewers explicitly prompting interviewees about other potential preferences not covered by card items.…”

Section: Discussionmentioning

confidence: 81%

“…The card deck, which has been made publicly available, contains 37 pre-formulated statements with items that research indicated are often important at the EoL, as well as wild cards for users to formulate other, more individual preferences not covered by those statements [9]. While most research on use of the cards derives from English-speaking populations in North America [10][11][12][13], they are available in nine other languages including Swedish (www.gowish.org), with research also conducted with elderly in Japan [14]. We are aware of only one study using the cards in an Indigenous population, i.e.…”

Section: Introduction and Aimmentioning

confidence: 99%

Values and preferences for future end‐of‐life care among the indigenous Sámi

Kroik

Eneslätt

Tishelman

et al. 2021

Scandinavian Caring Sciences

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Intoduction: Research with Indigenous peoples internationally indicates the importance of socio-cultural contexts for end-of-life (EoL) preferences. However, knowledge about values and preferences for future EoL care among the Indigenous Sámi is limited. Aim:We investigated if and how a Swedish adaptation of the English-language GoWish cards, DöBra cards, supports reflection and discussion of values and preferences for future EoL care among the Sámi.Methods: This qualitative study is based on interviews with 31 self-defined Sámi adults who used DöBra cards at four events targeting the Sámi population, between August 2019 and February 2020. Using directed content analysis, we examined aspects of interviews addressing Sámi-specific and Sámi-relevant motivations for choices. Data about individuals' card rankings were collated and compiled on group level to examine variation in card choices.Findings: All 37 pre-formulated card statements were ranked as a top 10 priority by at least one person. The cards most frequently ranked in the top 10 were a wild card used to formulate an individual preference and thus not representing the same statement, and the pre-formulated card 'to have those I am close to around me'. Reactions to interviews varied, with some participants commenting on the taboo-laden nature of discussing EoL issues, although many commented positively about EoL conversations in general, and the benefit of using the DöBra cards in particular. We categorised reasoning about Sámi-specific and Sámi-relevant values and preferences under the themes: Attributes of contemporary Sámi culture, Spirituality, Setting for death, Maintaining identity, Preferences related to death, Dying and EoL care and After death. Conclusions:The DöBra cards were found to be easy-to-use, understandable and a flexible tool for initiating and supporting conversations about EoL values and preferences. The open formulations of cards, with wild cards, enable discussions about individual values and preferences, with potential to reflect life as a Sámi in Sweden.

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“…The DöBra cards are a translated and adapted version of the US GoWish cards, 20 previously used in community settings to stimulate conversations about EoL issues. 21 – 24 The DöBra cards include 37 preformulated statements of potential importance at the EoL, for example, ‘to be free of pain’, ‘not dying alone’, and ‘to pray’; there are also wild cards for users to freely formulate any other matters of importance. Users initially sort each card statement into one of three piles according to its priority—very important, somewhat important, and less important—and then rank the 10 most important cards from 1 to 10, with the first most important.…”

Section: Introductionmentioning

confidence: 99%

“…Users initially sort each card statement into one of three piles according to its priority—very important, somewhat important, and less important—and then rank the 10 most important cards from 1 to 10, with the first most important. This procedure has been used in previous international studies, 20 , 22 , 23 , 25 and provides a basis for reflection and discussion about EoL values and preferences.…”

Section: Introductionmentioning

confidence: 99%

Dissemination, use, and impact of a community-based, conversational advance care planning intervention: ripple effects of the Swedish DöBra cards

2021

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Introduction & Aim: Despite increasing interest in community-based advance care planning interventions, few studies investigate the societal impact of such initiatives. The DöBra cards, a Swedish adaptation of the GoWish cards, were first used for advance care planning conversations in a participatory action research project and later, due to popular demand, made available for purchase by the general public. We explore how the DöBra cards were disseminated and used publicly, to understand their impact in the community. Methods: We used Ripple Effects Mapping to follow three dissemination ripples, based on interviews with 20 participants, analyzed with directed content analysis. Findings: Key factors influencing dissemination of the DöBra cards included ‘champions’ with a mandate within their context or organization, policy documents including use of the cards, media coverage, and presentations of the cards in various settings. The DöBra cards were adapted for use individually and in groups in different private, professional, and organizational settings. Perceived benefits of the cards included acting as an icebreaker in initiating end-of-life conversations and having preformulated statements to reflect upon. Other positive experiences included discussions on different interpretations of card statements, thus opening new perspectives regarding end-of-life. The DöBra cards functioned both as means to raise end-of-life issues in different contexts, and as an end in themselves, for example, by facilitating advance care planning conversations for those with serious disease. Impact also included personal development and strengthening of private and professional relationships, with potential to affect end-of-life care. Conclusion: The broad dissemination of the DöBra cards influenced capacity-building in dealing with end-of-life issues in communities, as the topic of dying and death was brought to agendas in new contexts.

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P-74 Advance care planning awareness: Using the go wish card game to assess the modern Japanese view of life and death

Cited by 4 publications

References 0 publications

Exploring Community-Dwelling Older Adults’ Considerations About Values and Preferences for Future End-of-Life Care: A Study from Sweden

Exploring Community-Dwelling Older Adults’ Considerations About Values and Preferences for Future End-of-Life Care: A Study from Sweden

Values and preferences for future end‐of‐life care among the indigenous Sámi

Dissemination, use, and impact of a community-based, conversational advance care planning intervention: ripple effects of the Swedish DöBra cards

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