Project: Well understood

On the way to appropriate information and decision-making in palliative care in secondary healthcare for peole with limited health capacity.

In collaboration with Pharos and Nivel, financed by ZonMw.

Communication at the transition to palliative care

As healthcare professional you prefer tot take decisions in good consultation with your patient. Sometimes, however, it is hard to make sure that a patient has really understood you well. For example in situations that are charged with emotions when a patient hears that his prospects of recovery are bad.Or when the patient has little health capacity and an overall problem at understanding you.When both these situations occur at the same time, things are getting really complicated.

The project Well Understood investigates what can go wrong in the communication between professional and patient and how this can be improved. DialogueTrainer is developing a toolbox to enable professionals to practise their skills.

29% of all Dutchmen have limited health capacity (BGV); in this group people with literacy problems (11% of the Dutch population between 16 and 65 and even 13,5% if people over 65 are included) deserve special attention. Palliative care makes great demands on professionals in the way of appropriate and effective information, communication and shared decision-making. Limited health capacity hinders patient participation in palliative care.

Healthcare professionals generally have difficulty recognizing low literacy and limited health capacity and therefore do not sufficiently adjust their information and communication. In secondary healthcare the specialist first talks with the patient and his near relatives about the disease being untreatable, starting the palliative phase and the options at hand.

This requires that secondary healthcare professionals can quickly identify the skills of a patient and his near relatives and that they can adjust the information and shared decision-making to the desires and needs of the patient.


Improving information to and decision-sharing with patients with limited health capacity in secondary palliative healthcare. This will be brought about by increasing insight into the desires and needs of these patients (in medical, psychological, spiritual and social areas) and insight into the experience and strategies of professionals in clinical practice. Based on these insights a toolkit for medical staff (both medical specialists and nursing staff) will be developed and implemented.

We provide this toolkit in a digital learning environment. Besides we focus on advice to strengthen the collaboration between primary and secondary healthcare.