Exploring the Topics Discussed During a Conversation Card Game About Death and Dying: A Content Analysis

Lauren Jodi Van Scoy, Jean M. Reading, Allison M. Scott, Cynthia Chuang, Benjamin H. Levi, Michael J. Green

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Context Substantive discussions between loved ones are necessary for effective advance care planning. Although multiple tools are currently in use for promoting conversations, the content and clinical relevance of the conversations they stimulate is unknown. Objective To describe the content and clinical relevance of conversations that occur during a nonfacilitated end-of-life conversation game. Methods Using convenience sampling, we scheduled adult volunteers to participate in an end-of-life conversation game (2–6 individuals per game; n = 68). Participants discussed 20 questions about death, dying, or end-of-life issues. Games lasted up to two hours and were audio-recorded, transcribed, and analyzed using a conventional qualitative content analysis approach to identify emerging themes. Results Participants (n = 68) were primarily Caucasian (94%), females (68%), with mean age of 51.3 years (SD 0.7). Seventeen games were analyzed. Four primary themes emerged during game conversations: 1) the importance of people, relationships, and the roles played during end-of-life decision making, 2) values, beliefs, and preferences related to end-of-life care and the dying period, 3) considerations about preparing for the aftermath of one's death, and 4) the relevance of stories or experiences for informing one's own end-of-life preferences. Conclusions Topics discussed during a nonfacilitated end-of-life conversation game are substantive and address important issues for advance care planning.

Original languageEnglish
Pages (from-to)655-662
Number of pages8
JournalJournal of Pain and Symptom Management
Issue number5
StatePublished - Nov 1 2016

Bibliographical note

Funding Information:
The authors would like to thank Jessica Kraft and Michael Klemick for their assistance with coding of the study data, Brooke Skelley for her transcription services, and Margaret Hopkins for her assistance with project development and article review. This study was funded in part by the Social Science Research Institute at Penn State University, the Milton S. Hershey Penn State College of Medicine , Department of Medicine. Dr. Van Scoy receives funding from the Parker B. Francis Foundation of the American Thoracic Society.

Publisher Copyright:
© 2016 American Academy of Hospice and Palliative Medicine


  • Advance directives
  • communication
  • end-of-life care
  • medical decision making
  • palliative care
  • terminal care

ASJC Scopus subject areas

  • Nursing (all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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