Interdisciplinary collaboration in Serious Illness Conversations in patients with multiple myeloma and caregivers – A qualitative study

Abstract

Abstract Background There is growing evidence that conversations between healthcare professionals and patients with serious illness can improve the quality of end-of-life cancer care. Yet, there is lack of insight into how different professions collaborate to deliver serious illness communication as well as patients’ and caregivers’ perception of this collaboration between the nurse and physician. This study explores the interdisciplinary collaboration between nurses and physicians in serious illness conversations with patients diagnosed with multiple myeloma and their caregivers. Methods Eleven dyadic interviews were conducted with 22 patients and caregivers and two focus group interviews, one with four nurses and one with four physicians. Data analysis and reporting were conducted using reflexive thematic analysis within phenomenological epistemology. Results The interdisciplinary collaboration was characterized by three main themes: 1) Importance of relationships, 2) Complementary perspectives, and 3) The common goal. Conclusion This study highlights the importance of interdisciplinarity in serious illness conversations as it strengthens the use of existential and descriptive language in conversations involving medical, holistic, and existential issues. The use of broader language also reflects that interdisciplinary interaction strengthens each professional's expertise in patient care. Through interdisciplinary collaboration, the patient’s and caregiver’s medical preferences and hopes, and values can be integrated into the treatment plan, which is the key to providing the best care for the patient and caregiver. It is recommended to make organizational changes to support continuity in patient–healthcare professional relationships, support interdisciplinary training, and a few minutes of preparation before the conversation and debriefing afterward to avoid fragmented and uncoordinated collaboration.