Author: Anne-Lore Scherrens
Prof. dr. Joachim Cohen (Promotor Vrije Universiteit Brussel)
Prof. dr. Benedicte Deforche (Promotor Ghent University)
Prof. dr. Kim Beernaert (Copromotor Vrije Universiteit Brussel)
Prof. dr. Luc Deliens (Copromotor Ghent University)
Despite the beneficial effects of timely initiation of palliative care for people with cancer and their families, it is often initiated too late or not at all. An important reason for this, is that communication about palliative care is frequently avoided or postponed.
Efforts have been made to increase the proportion of people with cancer for whom palliative care is timely initiated.
However, palliative care research (and practice) is mainly approached as professional carers guiding care discussions and making care decisions. Insufficient attention is paid to the pertinent role that patients and family carers can play in the timely communication about palliative care and the initiation of it. Theory-based behavioral research and interventions could help to better understand and more successfully change behaviors of patients and family carers, and could as such also improve their care outcomes.
In this dissertation, a health promotion approach and behavioral theories were used to better understand and explain why people with incurable cancer start a conversation about palliative care with their physician or why not. Following, a theory-based behavioral intervention was developed to help people with incurable cancer in starting the palliative care conversation and to support the physicians in reacting
Additionally, behavioral theories were used to explore relevant family carers’ behaviors and its factors.
This dissertation can be used as a guideline to use a health promotion approach and behavioral theories in end-of-life care and palliative care research; to improve patient empowerment; to improve timely communication about palliative care; and to improve timely initiation of palliative care.