A serious game for engaging older adults in end-of-life care discussion: A mixed method study

• Published in: Patient education and counseling Vol. 113; p. 107787
• Main Authors: Liu, Li, Chan, Helen Yue-lai, Ho, Tad Chun-kwan, Chow, Rita Suk-kuen, Li, Miranda Man-yee, Cheung, Eddie Wai-sum, Gu, Can, Wang, Yao
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.08.2023
• Subjects: Advance Care Planning; Aged; End-of-life care; Game; Humans; Mixed method study; Older adult; Terminal Care; Game; End-of-life care; Mixed method study; Older adult
• ISSN: 0738-3991; 1873-5134; 1873-5134
• DOI: 10.1016/j.pec.2023.107787

To examine the acceptability of a board game newly developed through a co-design process for promoting end-of-life care discussion among Chinese older adults. A multi-centre mixed method study, including a one group pre-test post-test study and focus group interviews, was conducted. Thirty older adults participated in a one-hour game session in a small group format. Acceptability was assessed by attrition rate and satisfaction with the game. Participants’ experiences with the game were explored qualitatively. Within-subject changes in self-efficacy and readiness for advance care planning (ACP) behaviours were also examined. The players generally had positive experiences with the game, giving a low attrition rate. A significantly higher level of self-efficacy in sharing end-of-life care preferences with surrogates was reported after the game session (p = 0.008). There was a slight increase in the proportion of players indicated that they would complete ACP behaviours in the coming months immediately after the intervention. A serious game is acceptable by Chinese older adults to raise discussions regarding end-of-life matters. A game can be an ice-breaking tool to increase self-efficacy towards communicating end-of-life care preferences with surrogates, but follow-up support is needed to facilitate the uptake of ACP behaviours.