Conversations with patients about death - experienced GPs' reflections and experiences

Area of Science:

• Gerontology
• Primary Health Care
• Medical Communication

Background:

• Norway faces a growing elderly population, increasing the complexity of patient care in primary health services.
• General Practitioners (GPs) are central to managing this demographic shift and associated patient needs.

Purpose of the Study:

• To explore how experienced GPs conduct and reflect on conversations with patients regarding death.
• To understand the challenges and facilitators of end-of-life discussions in general practice.

Main Methods:

• Semi-structured, in-depth interviews were conducted with ten experienced GPs.
• Cross-case thematic analysis was employed to analyze the interview data.

Main Results:

• GPs perceive discussing death as a natural, albeit challenging and meaningful, part of their role.
• Sufficient time, established patient relationships, and opportune moments ('golden moments') facilitate these conversations.
• GPs reported relying on experience and communication skills, lacking formal training, and facing barriers due to unclear specialist treatment plans.

Conclusions:

• Most GPs view end-of-life conversations as integral to their practice.
• GPs' experiences highlight the importance of communication skills, adequate time, and inter-specialist clarity for effective patient care regarding death.