Advance Care Planning in Dialysis Patients With a Conversation Game

Area of Science:

• Medical Humanities
• Health Services Research
• Patient Care

Background:

• Advance care planning (ACP) is crucial for patient-centered end-of-life care.
• Developing accessible tools to facilitate ACP discussions is essential, particularly for vulnerable patient populations.

Purpose of the Study:

• To assess the acceptability, feasibility, and effectiveness of a novel 3-step ACP intervention utilizing the conversation game 'Anticip'action'.
• To evaluate the intervention's impact on advance directive completion, surrogate designation, and patient engagement among dialysis patients.

Main Methods:

• A 3-step ACP intervention was implemented by trained dialysis nurses using the 'Anticip'action' game.
• Data on acceptability and feasibility were collected via questionnaires and notes.
• Effectiveness was measured by pre-post changes in advance directives, surrogate designation, ACP engagement, and documentation quality.

Main Results:

• The intervention demonstrated high acceptability and feasibility among nurses and patients.
• Significant increases were observed in advance directives (30%), designated surrogates (80%), and patient engagement (P ≤ 0.001).
• The quality of ACP documentation also significantly improved (P ≤ 0.001).

Conclusions:

• The 3-step ACP intervention using 'Anticip'action' is a viable and effective tool for enhancing advance care planning in clinical settings.
• The intervention shows good potential for implementation in routine dialysis care, improving patient involvement in end-of-life decisions.