Using Cards to Facilitate Conversations About Wishes and Priorities of Patients in Palliative Care.
Ulrika Olsson Möller, Christa Pranter, Carina Lundh Hagelin and 4 others
PMID 31770159WHAT IT FOUND
Palliative care patients said cards helped them put wishes and priorities into words and choose what to discuss.
Sorting was workable for many, but too hard for the most frail.
Key findings
01Patients said the cards helped them put wishes and priorities into words and made conversations about them possible.
02Most participants could sort the cards, but the most ill and frail found it too strenuous to hold, remember, and manage the cards.
03Giving cards in advance let patients exclude topics they did not want to discuss, and some preferred family rather than health professionals as conversation partners.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a qualitative study of patients' experiences, so it does not test whether the cards improve care, communication, or patient outcomes. Most participants were Swedish-born and had cancer, so the findings may not apply to other cultures, diagnoses, or settings. Only 40 patients were interviewed, and one who agreed could not take part because health deteriorated. Most interviews relied on field notes rather than recordings after the first 10, which may affect detail and consistency. The cards required physical and mental energy, and the most ill and frail participants found sorting too hard, so this version may not suit them. Timing of conversations was not settled; participants differed on discussing wishes now or closer to death. The study reports experiences, not measured patient outcomes or routine care changes.
Declared interests
The authors declared no conflicts of interest. The article is listed as having non-U.S. government research support, but no specific funder is named.
The easy way to misread this
Do not conclude the cards improve patient outcomes. The study reports patients' experiences of using them, and the most frail participants found sorting too strenuous.