# Let's talk about death, dying, and what matters most to you in life: Pretest and piloting of a translated and adapted conversation game

## TL;DR

This study tests a German version of a conversation game to help people of all ages discuss their preferences for medical care and life values.

## Contribution

Hey du is the first scientifically supported gamification approach in Germany for advance care planning.

## Key findings

- Hey du was found to be acceptable and comprehensible in both nursing school and family/friend group settings.
- Over 92% of participants felt the game helped them reflect on their care preferences and values.
- The game provides a safe way to discuss sensitive topics like death and dying.

## Abstract

This study aimed to pretest and pilot the German version of the Hello conversation game (German: Hey du) to assess its comprehensibility and acceptability. Like the original, Hey du is designed as a low-threshold method to empower people of almost all ages and health conditions to engage in advance care planning (ACP), particularly targeting young/healthy people for whom there are currently few or no ACP programmes.

The conversation game was systematically translated into German using the TRAPD process and cognitively pretested in 12 interviews. Subsequently, two observational studies were conducted: Hey du was used in 1) a nursing school (n = 16) and 2) with groups of family and friends (n = 50). After completing the game, participants were surveyed regarding the game's acceptability and comprehensibility.

The results of the cognitive pretest and the observational studies show that the conversation game was acceptable and comprehensible in both settings. Most of the participants (>92 %) reported that Hey du helped them come to terms with their own wishes and preferences for medical and nursing care and that they felt comfortable playing the game.

Hey du has the potential to motivate and empower people to deal with ACP.

Hey du is the first scientifically supported gamification approach in Germany to introduce ACP to people for whom no systematic ACP programs exist. The game provides a safe forum for people of almost all ages and health conditions to discuss their values regarding life, death, dying and what matters most.

•Gamification in advance care planning.•Hey du is a low-threshold way to introduce advance care planning.•Empowering people of almost all ages and health conditions to engage with ACP.•Hey du can help overcome the barriers often associated with advance care planning.

Gamification in advance care planning.

Hey du is a low-threshold way to introduce advance care planning.

Empowering people of almost all ages and health conditions to engage with ACP.

Hey du can help overcome the barriers often associated with advance care planning.