PhD defence R. (Rik) Stoevelaar

In today's healthcare the individual choice and autonomy of the patient play an important role. At the same time, it is evident that healthcare is becoming more fragmented, specialized and complex. However, it is not known to what extent patients are willing and able to play an active role in their care, especially when faced with life-threatening diseases. Self-management of the patient is receiving increasing attention in research and in clinical practice, but has rarely been studied in patients with advanced disease. In addition, little is known about advance care planning (ACP) in patients with advanced diseases other than cancer. For these reasons, this thesis investigated self-management in patients with advanced cancer and ACP in a population of patients with an implantable cardioverter defibrillator (ICD).

The results of this thesis show that living with a progressive, life-threatening illness is hard work. While some patients seem to be dealing well with the consequences of their illness, some experience their illness as a great burden and are overwhelmed by the work involved, while trying to live their lives as normally as possible. In addition, patients show a variety in the need and willingness to engage in ACP. Self-management will remain an essential part of healthcare, and patients with progressive, life-threatening illness should be supported in this by their healthcare provider. ACP should also be promoted, so that wishes and preferences regarding future care can be recorded.

Due to corona, the PhD defences do not take place publicly in the usual way in the Senate Hall or in the Professor Andries Querido Room. The candidates will defend their dissertation either in a small group or online.