Go Wish card game-exploring end-of-life wishes of patients in oncology palliative care: a qualitative study

Ann Palliat Med. 2024 Jan;13(1):31-41. doi: 10.21037/apm-23-381. Epub 2023 Dec 6.

Abstract

Background: Among the methods that promote quality of life and care, discussing and remembering end-of-life (EOL) wishes for future care may contribute to decision-making about care and the promotion of a good death. Our aim was to investigate the most significant EOL desires among Brazilian cancer patients receiving palliative care (PC).

Methods: This was an exploratory, descriptive, and qualitative study conducted in a Palliative Care Oncology Unit. Fifteen patients played the Go Wish card game (GWCG), choosing and categorizing cards into themes as very important, more or less important, and not important at all. The ten most important cards were discussed, and categories were defined for each card. Cards with the highest frequencies of choice were described. Patients were also asked, "What did playing the cards mean to you?". All data were analyzed using Bardin's content analysis and generated a word cloud to interpret the participants' narratives.

Results: Out of the 36 cards, card 19, "I want my family and friends close to me", was the most frequently chosen. Out of the 15 patients studied, only one reported that they initially did not enjoy playing the cards. In this study, the GWCG was effective in fulfilling 90% of the patients' wishes, and this was only possible with the support of the researchers, members of the multi-professional team, and patients' families.

Conclusions: The use of the GWCG in the oncology PC setting made an important contribution to open discussions about patients' values and preferences, as well as being an easy-to-use, understandable, and flexible tool. Prioritizing the fulfillment of patients' wishes was one of the main strengths of this study. Our study suggests working with these wishes as a framework for person-centered care.

Keywords: Go Wish card game (GWCG); Palliative care (PC); communication in terminal illness; end-of-life care (EOL care); end-of-life wishes (EOL wishes).

MeSH terms

  • Death
  • Humans
  • Medical Oncology
  • Palliative Care* / methods
  • Quality of Life
  • Terminal Care*