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

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: A serious game is acceptable by Chinese older adults to raise discussions regarding end-of-life matters.

Practice Implications: 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.