Chapter 8 190 The first paragraph explains more about what proactivity and proactive palliative care entail. The following three paragraphs elaborate on the characteristics of proactive palliative care that are derived from paragraph 1 and studied in this thesis. 8.3.1 Definition and meaning of proactive palliative care Proactivity is an integral part of palliative care. When searching for the definition of proactivity in English dictionaries, the following definitions of ‘proactivity’ can be found: • Taking action by causing change and not only reacting to change when it happens (Cambridge dictionary) • Intending or intended to produce a good result or avoid a problem, rather than waiting until there is a problem (American dictionary) • Taking action to make changes yourself rather than reacting to things that happen (Business English dictionary) From these definitions of proactivity, the following characteristics of a proactive person (‘the actor’) can be derived: • the actor must have knowledge and self-initiation to act himself and take control. • the actor must have an intention to make a change to have good results or to avoid problems; • the actor must think ahead to be able to act before things happen; The concept of proactivity is studied in-depth in management and business studies and can be regarded as a process in which goals are proactively set and strived for.3 In health care, the concept of proactivity is not widely studied yet. Proactivity is mainly described as patient behaviour, a characteristic or behaviour of (successful) healthcare professionals and as health promotion.4-8 In these studies, proactivity was defined as: anticipating in correcting problems before they “become insurmountable mountains”; information-seeking, advice-seeking, participating in decision-making, assertiveness towards healthcare professionals, actively taking care of one’s health status, promoting health and wellbeing. ‘The actor’ in health care can refer to patients, their family, and clinicians. Palliative care is deemed appropriate already early in the illness trajectory concurrent with life-prolonging treatments. Palliative care models such as illustrated by Murray et al. show that patients and family have care needs in physical, psychological, social, and spiritual domains during the whole illness trajectory (Fig.1 in Chapter 1).9, 10 Palliative care integrated early into standard life-prolonging or even curative therapy creates the opportunity to support patients and family to express what they value in life and how they want to live their lives. In this way, appropriate care can be organised
RkJQdWJsaXNoZXIy MTk4NDMw