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

Background: The ageing population in Norway is steadily increasing, and both the number and complexity of patient-related tasks assigned to the primary health service, including GPs, are growing. This study aimed to investigate how experienced GPs conducted and reflected on conversations with their patients about death.

Material and method: Semi-structured in-depth interviews with ten experienced GPs, all specialists in general practice, were analysed using cross-case thematic analysis.

Results: Almost all the GPs viewed talking about death with their patients as a natural part of a GP's duties. The conversations were perceived as both challenging and meaningful. Having sufficient time for the conversation and getting to know the patients over time were considered valuable factors for good conversations. The GPs looked for golden moments in which to address the topic. The content of the conversation could vary, from specific measures to alleviate symptoms to the more existential and philosophical. The GPs expressed that they lacked formal competence and largely relied on their experience and belief in their communication skills when interacting with patients. Several described the lack of clarity on treatment intensity from the specialist health service as a barrier to initiating and conducting good conversations about death.

Interpretation: Most of the GPs in this study talked to their patients about death and considered it a natural and necessary part of the GP's role.