Chapter 8 194 Integration of palliative care and end-of-life care education into undergraduate medical curricula contributes to the preparation of future medical doctors to provide generalist palliative care. Promoting their knowledge and skills is a prerequisite for employing a proactive palliative care approach in clinical practice. 2. Patient and family empowerment This paragraph demonstrates how this thesis articulates to the concept of patient empowerment as part of the person-centred care model. Proactive palliative care includes the improvement of patients and family’s self-initiation: empowerment. Part of empowerment is the exploration of the values and needs of individual patients, which is also essential in person-centred care. Many definitions of person-centred or patientcentred care exist and are often used interchangeably. Little et al. identified core activities of patient-centred care:30, 33 • Exploring how patients experience their disease and illness, including their ideas and feelings about it, their expectations of the consultation and how their functioning is affected; • Understanding the patient as a whole, including personal and developmental aspects and their context; • Establishing a partnership with the patients, sharing problems, priorities, and goals of treatment, agreeing on the patient and clinician’s roles, enhancing this patientclinician relationship by sharing power and sustaining a relationship that is caring and healing; • Promoting health, including enhancement of health, reduction of risks and the early detection of disease. Person-centred care originates from care for people with a chronic illness, where planned care (i.e., proactive care) is preferred to reactive care because it creates more opportunities to provide appropriate care. A person-centred approach is then appropriate since the person himself is the expert of his own experience of being ill. It is patient-friendly to support them so that they can manage their needs in a way that fits their way of life and being best.34 Person-centred care has favourable patient outcomes: patients have a better understanding of their illness, are more aware of their health and treatment options, feel more capable and confident to make decisions, and know more about symptoms.34-36 Person-centred care is a model of care that makes it possible to share knowledge, status, and decision-making in an equitable patient-clinician relationship. McWilliam et al. argue that these are elements that support the empowerment of patients and family.37 The ‘power’ in a patient-clinician relationship changes when the ‘expert ’ role of being ill is balanced between the clinician and the patient by sharing knowledge and experiences,
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