O-38 Narrative cases as a tool for reshaping acp in spain. « kayrÓs-conversaciones que ayudan » web and training experience

Abstract

Background « KAYROS-Conversaciones que ayudan » (KAYROS-helping conversations) is an Spanish public web for patients/families and healthcare professionals, launched in Summer 2014, as a result of a research and community work developed over the past 10 years in Madrid and Murcia, Spain: http://conversacioneskayros.es Aim “KAYROS-CQA” aims to facilitate ACP as a tool for professionals and patients/families to reduce the current gap between wishes and realities, taking advantages of current website possibilities. Methods “KAYROS-CQA” relies on, as one of its axis, in the development of narrative materials describing most common characteristic illness trajectories (cancer, advanced chronic disease, neurodegenerative decline, elderly frailty…). It then matches narrative with facilitated discussion of topics raised, whether experienced or witnessed. Results People can gain insight and it becomes easer deliberating and talking about goals, current status, expectations, plans of care, therefore contributing to increase motivation to engage in useful and significant ACP conversations and implement effective plans for the present as well as for the future. Discussion In Spain, mainstream approach despite qualified criticism has been one of distant AD information, as a right, and as a document for future (and speculative) care. Significant change of approach is been pushed forward in recent efforts with advanced chronic care trying to catch up and align with best international ACP practices. Conclusion “KAYROS-CQA” strongly supports narrative materials and cases as useful tools to facilitate ACP process (at the hospital and at home) to help reduce the gap between the ACP’s potential and its current reality in Spain.