Authors: (including presenting author): :
ZHANG SW(2); CHAN NHT(1); KAM KW(2); CHENG YS(2); AU YEUNG TL(2); CHAN MN(3)
Affiliation: :
(1)M&G, POH/TSWH (2)PRC, NTWC (3)HKSKHWC
Keyword 1: :
Life and Death Education
Keyword 2: :
Advance Decision on Life-sustaining Treatment Ordinance
Keyword 3: :
Medical Social Collaboration
Introduction: :
The recent Advance Decision on Life-sustaining Treatment Ordinance empowers patient autonomy in Hong Kong. Yet, existential anxiety often impedes essential end-of-life conversations, impacting holistic care. Structured experiential tools, such as a purpose-designed boardgame, can safely facilitate these discussions. This helps individuals prepare practically, cope emotionally, and live more intentionally while they are alive.
Objectives: :
The Pok Oi Hospital Community Network on Life and Death aimed to develop a Life and Death Boardgame “THE CHOICE” to promote open dialogue on life and death in the community and hospital settings.
Methodology: :
Seven medical-social-collaboration workgroup meetings were organized with 70 attendance of workgroup members for the development of the Boardgame. Key Narrative Therapy constructs were applied: Externalization (separating the person from "the problem" of death anxiety), Storytelling (re-authoring one's relationship to death through fictional scenarios), and Unique Outcomes (exploring alternate personal values and choices). The game translates these into a structured, contained and playful modality. The boardgame components include character cards, scenario cards, and scoring tokens. Players are "contestants" trapped in a locked room. Each round, a scenario card (e.g., a critical health decision) is drawn. Players will role in the assigned character, deliver a 1-minute rationale for their character's choice, followed by a mini-debate. The Host will then score on which character's decision was more justified; the character with highest score advances. The goal is to "escape" by accumulating scores. There are three categories of scenarios include daily life, disease management, and life-and-death decision. The host would start with daily life scenarios then proceed to deeper level of scenarios. A debriefing session was designed to reflect on one’s attitude toward life-and-death and consolidate their learning from the game.
Result & Outcome: :
A pilot symposium and workshop for over 300 helping professionals yielded highly positive feedback. All attendees reported increased awareness and willingness to engage in life-and-death education, noting the game’s relevant scenarios, capacity for perspective expansion, and psychologically safe structure. Designed for broad accessibility, the game is bilingual and includes a dedicated character and tailored questions for ethnic minorities, fostering inclusion and representation. Its successful use across a wide age range confirms its suitability for intergenerational and community settings. This project demonstrates significant potential to enhance psychosocial support by proactively addressing the existential anxiety of death. Future work should focus on a formal pilot study utilizing validated scales to empirically evaluate the game's impact on reducing death anxiety and improving end-of-life discussion readiness.
