Navigating together toward shared decision-making in home-based palliative care – perspectives from general practitioners and cancer care coordinators

Abstract Background As the global population ages and chronic diseases increase, the demand for high-quality palliative care services—particularly in primary healthcare settings—is increasing. General practitioners and cancer care coordinators play crucial roles in this context. This study explores their experiences with shared decision-making in palliative care for home-dwelling patients within primary healthcare. Specifically, this study examines how these professionals perceive their roles in decision-making and how their collaboration influences patients’ quality of care. Methods A qualitative hermeneutic design was employed. Four focus group interviews were conducted with 12 cancer care coordinators (autumn 2023) and 14 general practitioners (spring 2024). Participants were recruited through national professional networks from urban and rural municipalities across Norway. The interviews were interpreted via Fleming’s four-phase hermeneutical approach. Results Three main themes emerged: (1) confidence in communication, involving balancing hope with reality; (2) diversity in responsibilities, particularly in addressing treatment decision-making and facilitating shared decision-making; and (3) understanding one’s role and function in decision-making, as influenced by the complexity of the decisions. Conclusions The implementation of an interprofessional shared decision-making model, combined with an emphasis on confidence in communication and a clear understanding of roles, responsibilities, and functions, can enhance collaboration, foster shared understanding, and improve patient-centered care. Policies should promote frameworks for shared decision-making that empower all team members to contribute to the key decisions to alleviate patient suffering. This supportive shared decision-making framework, as outlined in policies, facilitates shared responsibility and enables healthcare providers to achieve patient-centered decisions.