Physicians' Perceptions of the Quality of Palliative Care and of the Importance of Collaboration in Interdisciplinary Teams in Norwegian Nursing Homes.

Purpose: The palliative phase of a patient's life is often characterized by disease complexity, increasing the need for holistic care, support for the patient's relatives, and the up-to-date knowledge of a multidisciplinary healthcare team. Physicians in nursing homes have the main responsibility for providing palliative care to vulnerable and fragile patients. There is limited research uncovering physicians' experience and perceptions of what is important in this phase of patients' lives. The aim of the study was thus to investigate physicians' perceptions of factors that influence the quality of palliative care in Norwegian nursing homes and their descriptions of the importance of the team's collaboration. Materials and Methods: The study has a qualitative research design based on interviews with twelve nursing home physicians in Eastern Norway. Interviews were conducted between February 2023 to May 2023, analyzed using qualitative content analysis. Results: Three themes describe the content of the findings: i) Comprehensive care plans enhance the quality of palliative care, ii) A collaborative team provides higher-quality care than the sum of its parts, iii) Systemic and environmental factors affect the ability to ensure continuity of care. Conclusion: The physicians in this study expressed that the quality of palliative care in nursing homes depended on comprehensive care plans, including up-to-date knowledge of medical treatment options, partnership with the patient and relatives, and a consistent holistic approach to the patient. The quality also depended on the interdisciplinary team's collaboration in assessing the patient, observing symptoms, and planning further care and treatment in accordance with patients' and their relatives' preferences and wishes. Finally, systemic and environmental factors affected the ability to ensure continuity of care. Further work is needed to ensure that systemic factors enable physicians to deliver high-quality palliative care and that a comfortable physical environment is created in nursing homes.