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Dissemination, Use and Impact of a Community-based, Conversational Advance Care Planning Intervention: Ripple Effects of the Swedish DöBra cards
Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Karolinska Institutet, Dept of Learning, Informatics, Management and Ethics, Stockholm, Sweden.ORCID iD: 0000-0002-0050-4853
Karolinska Institutet, Dept of Learning, Informatics, Management and Ethics, Stockholm, Sweden.
Karolinska Institutet, Dept of Learning, Informatics, Management and Ethics, Stockholm, Sweden; SLSO, Stockholm Health Services, Stockholm, Sweden; University of Southampton, Southampton, United Kingdom.
2021 (English)In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 35, no 1_suppl, article id J-27Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: There is growing interest in community-based advance care planning (ACP) interventions, but few studies investigate the societal impact of such initiatives. A Swedish adaptation of the GoWish cards, the DöBra cards, were used as a tool in the SweACP participatory action research project with older people in the community, without imminent End-of-Life (EoL) care needs. Due to popular demand, the DöBra cards were later made available to the general public as a social innovation.

Aim: To explore how the publicly available DöBra cards have been disseminated and used without researchers’ engagement, to provide a basis for understanding their impact in a wider community setting.

Methods: Using a Ripple Effects Mapping approach, we followed three chains of dissemination of the DöBra cards originating in a patient organization, a national interest organization for older people, and in a health care organization. Data were collected through interviews with 20 participants and analyzed with directed content analysis.

Results: A variety of strategies for use were noted, as the DöBra cards were adapted to fit needs in different personal, professional, and organizational settings. The cards were found to act as both a means to raise awareness about EoL issues in different contexts, as well as an end in themselves, e.g. by facilitating ACP conversations for people with serious disease. Resistance, from various instances, to use or promotion of the DöBra cards was however also found. Impact included personal development as well as strengthened personal and professional relationships, with potential to affect EoL care provision.

Conclusions: The broad dissemination of the DöBra cards in a variety of contexts beyond those controlled by researchers, has led to capacity building in dealing with EoL issues in the community, as the topic of dying and death has been brought to agendas in new contexts.

Place, publisher, year, edition, pages
Sage Publications, 2021. Vol. 35, no 1_suppl, article id J-27
National Category
Nursing
Research subject
Nursing
Identifiers
URN: urn:nbn:se:ltu:diva-89369OAI: oai:DiVA.org:ltu-89369DiVA, id: diva2:1639573
Conference
17th World Congress Of The European Association For Palliative Care (EAPC), Online, October 6-8, 2021
Note

Godkänd;2023;Nivå 0;2023-02-03 (hanlid);

Title of host publication: Abstracts from the 17th World Congress of the EAPC 2021

Available from: 2022-02-21 Created: 2022-02-21 Last updated: 2023-02-14Bibliographically approved

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