End-of-Life Conversation Game for Cancer
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Milton S. Hershey Medical Center
Disqualifiers: Advance directive, No recent treatment, others
Approved in 3 Jurisdictions
Trial Summary
What is the purpose of this trial?The goal of this clinical trial is to explore feasibility, acceptability, and effectiveness of end-of-life conversation game "Hello" as a tool to help individuals with various solid cancer types (including: breast, gastro-intestinal, lung, melanoma, head and neck, and/or genito-urinary cancers) treated at Penn State Health clinics and their loved ones perform advance care planning (ACP). The main questions it aims to answer are:
What modifications and/or adaptations are necessary to Hello for use in cancer populations?
What impact does participation in Hello event have on health care usage (e.g., number of hospitalizations, ICU admissions, emergency department visits, etc.)? How feasible is it to randomize participants to play either Hello for Cancer or Table Topics?
Participants will:
* Complete pre-game questionnaires
* Play either Hello or Table Topics game
* Complete post-game questionnaires
* Participate in a focus group
* Complete a telephone follow up interview 1-4 months after their event
This study is a continuation of NCT06028152.
Do I have to stop taking my current medications for this trial?
The trial information does not specify whether you need to stop taking your current medications. It seems unlikely, as the study focuses on playing a conversation game rather than medical treatment.
What data supports the effectiveness of the Hello for Cancer game treatment?
Research shows that using games to discuss end-of-life care can help patients think about their values and goals in a comfortable way, making it easier to talk with healthcare providers. Games like the Go Wish card game have been found to be feasible and effective in helping patients communicate their end-of-life care preferences.
12345How does the End-of-Life Conversation Game for Cancer differ from other treatments for cancer?
The End-of-Life Conversation Game for Cancer is unique because it uses a card game format to facilitate sensitive discussions about end-of-life care, which is different from traditional medical treatments that focus on physical symptoms. This approach helps patients and families express their feelings and experiences, addressing emotional and psychosocial needs in a supportive setting.
26789Eligibility Criteria
This trial is for individuals with various solid cancers such as breast, lung, and colorectal cancer. Participants will be from Penn State Health clinics who are interested in advance care planning. They should be willing to answer questionnaires, play a game designed to facilitate end-of-life conversations, join a focus group discussion, and do a follow-up interview.Inclusion Criteria
Patient with Cancer: Receives care at Penn State Health or is the chosen caregiver for a participant treated at Penn State Health
I can speak and read English or Spanish.
My caregiver can speak and read English or Spanish.
+4 more
Exclusion Criteria
Patient with Cancer: Has not received treatment for their cancer at a Penn State Health facility in the past year
Patient with Cancer: Unable to consent to participate in study
Caregiver/Loved one: Unable to consent to participate in study
+1 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Intervention
Participants play either the Hello for Cancer game or the Table Topics game, complete pre- and post-game questionnaires, and participate in focus groups.
1 day
1 visit (in-person)
Follow-up
Participants complete a telephone follow-up interview to assess ACP behaviors and satisfaction with the intervention.
1-4 months
Long-term Follow-up
The patient's medical chart is reviewed for up to two years to capture healthcare utilization and documentation of ACP discussions.
Up to 2 years
Participant Groups
The study tests the 'Hello for Cancer' game against the 'Table Topics' game to see if they help in advance care planning. It checks how these games affect healthcare usage like hospital stays or emergency visits and explores necessary changes for using Hello in cancer populations.
2Treatment groups
Experimental Treatment
Placebo Group
Group I: Hello for Cancer gameExperimental Treatment1 Intervention
For this arm, individuals will play the modified Hello game (Hello for Cancer). This game was modified to be better suited for individuals with cancer and their loved ones, and those modifications are now being tested. This game will include questions related to a variety of topics around an individual's cancer experience and medical decision making related to their cancer diagnosis.
After playing the game, individuals will be asked to reflect on the game questions and provide feedback to inform further modifications.
Group II: Table Topics gamePlacebo Group1 Intervention
For this arm, individuals will play commercially available Table Topics game during the research event. This game asks a variety of conversation starting questions, not particularly related to medical decision making.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Penn State Cancer InstituteHershey, PA
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Who Is Running the Clinical Trial?
Milton S. Hershey Medical CenterLead Sponsor
References
Feasibility of discussing end-of-life care goals with inpatients using a structured, conversational approach: the go wish card game. [2010]Establishing goals of care is important in advance care planning. However, such discussions require a significant time investment on the part of trained personnel and may be overwhelming for the patient. The Go Wish card game was designed to allow patients to consider the importance of common issues at the end of life in a nonconfrontational setting. By sorting through their values in private, patients may present to their provider ready to have a focused conversation about end-of-life care. We evaluated the feasibility of using the Go Wish card game with seriously ill patients in the hospital. Of 133 inpatients approached, 33 (25%) were able to complete the game. The "top 10" values were scored based on frequency and adjusted for rank. The value selected of highest importance by the most subjects was "to be free from pain." Other highly ranked values concerned spirituality, maintaining a sense of self, symptom management, and establishing a strong relationship with health care professionals. Average time to review the patient's rank list after the patient sorted their values in private was 21.8 minutes (range: 6-45 minutes). The rankings from the Go Wish game are similar to those from other surveys of seriously ill patients. Our results suggest that it is feasible to use the Go Wish card game even in the chaotic inpatient setting to obtain an accurate portrayal of the patient's goals of care in a time-efficient manner.
A serious game for engaging older adults in end-of-life care discussion: A mixed method study. [2023]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.
"I was never one of those people who just jumped right in for me": patient perspectives on self-advocacy training for women with advanced cancer. [2023]Patients with advanced cancer experience many complicated situations that can make self-advocacy (defined as the ability speak up for yourself in the face of a challenge) difficult. Few self-advocacy interventions exist, and most are atheoretical with minimal patient engagement. The purpose of this study is to describe participant perspectives of a novel, self-advocacy serious game intervention called Strong Together.
Electronic game: A key effective technology to promote behavioral change in cancer patients. [2017]Cancer diagnosis is a very unpleasant and unbelievable experience. Appropriate management and treatment of these diseases require a high degree of patient engagement. Interactive health electronic games are engaging, fun, challenging, and experiential and have the potential to change the attitude and behavior, which can improve the player's health. The use of these digital tools, as one of the most attractive and entertaining modern technologies, canem power patients, provide suitable palliative care, promote health behavior change strategies, increase patient engagement, enhance healthy lifestyle habits, improve self.management, and finally improve the quality of life of the patients. Finally, the aim of this article was to describe electronic games and their effects on the promotion of behavior change in cancer patients. In addition, this article describes categories, characteristic features, and benefits of this digital media in the lifestyle modification of cancer patients.
Communication Interventions to Improve Goal-Concordant Care of Seriously Ill Patients: An Integrative Review. [2021]Effective communication between clinicians and seriously ill patients and their families about a patient's goals of care is essential to patient-centered, goal-concordant, end-of-life care. Effective goals-of-care communication between clinicians and patients is associated with improved patient and family outcomes, increased clinician satisfaction, and decreased health care costs. Unfortunately, clinicians often face barriers in goals-of-care communication and collaboration, including a lack of education, time constraints, and no standardized protocols. Without clear goals-of-care communication, patients may not be able to provide guidance to clinicians about their end-of-life preferences. The purpose of this integrative review was to examine the efficacy of goals-of-care communication interventions between patients, families, and clinicians in randomized controlled trials published between 2009 and 2018. Twenty-three studies met the inclusion criteria with an overall sample (N = 6376) of patients, family members, and clinicians. Results revealed of the 6 different intervention modes, patient decision aids and patient-clinician communication consistently increased comprehension and communication. Twelve of the studies had nurses facilitate or support the communication intervention. Because nurses are a critical, trusted nexus for communication about end-of-life care, focusing on nurse interventions may significantly improve clinical outcomes and the patient experience.
Patient card games in palliative care: integrative review. [2022]In the context of palliative care, a new approach has been documented that allows for sensitive end-of-life conversations to be established through a game of cards.
Acceptability and feasibility of a therapeutic board game for children and adolescents with cancer: the Italian version of Shop Talk. [2019]Shop Talk is a therapeutic board game for children and adolescents with cancer, aimed at helping them talk about their disease, life, and emotions in a creative way and in a secure setting. The scope of this study was to translate Shop Talk into Italian, evaluating its acceptability, feasibility, and emotional impact.
Developing a Card Game for Assessment and Intervention in the Person and the Family in Palliative Care: "Pallium Game". [2023]Communication between the multidisciplinary team, the person, and the family in palliative and end-of-life situations implies, in most situations, a high negative emotional burden. Therefore, innovative strategies are needed to reduce it. The goal of this study is to describe the various stages of development and validation of a collaborative card game for people in palliative care and their families. Phase one is an exploratory study, Phase two is a Delphi study, and Phase three is a multiple case study. Participants for phases 2 and 3 were recruited using a convenience sampling method. The results demonstrate in an organized and structured way the different phases required to build a collaborative card game. The use of the game was found to be useful and effective. Four categories emerged from the content analysis of the open-ended responses: usability, evaluation tool, communication and therapeutic relationship, and meaning when using the game. A collaborative game in palliative care helps to create a space for individuals and families to express feelings and experiences, meeting the myriad of physical, psychosocial, and spiritual needs. The "Pallium game" is a useful and impactful approach to discussing sensitive topics in palliative care.
The role of serious games in the iManageCancer project. [2020]Within the iManageCancer project, two serious games were developed, one for adults and one for children and adolescents. The adult's game was developed by the University of Bedfordshire (UK), the kid's game by Promotion Software GmbH (Germany). The aim was to support adult and young cancer patients with serious games to manage the impact of the disease on their psychological status, such as negative emotions, anxiety or depression, and motivate them to stay positive and to participate in social life [Patterson and Garwick (1994) Ann Behav Med16 131-142; Brennan et al. (2002) J Consul Clin Psychol70 1075-1085; Robinson et al. (2007) J Pediatr Psychol32 400-410]. Early demonstrators showed how important it is that players understand the meaning behind the game design. Improvements in the design of the games addressed that issue. Also, technical and use case issues were found that had a significant impact on the outcome. Both games interact with the iManageCancer platform, record game results and make them available for research. Two pilots are on the way and another evaluation cycle will follow.