Mutual Learning and Boundary Work in Palliative Oncology Care: A Qualitative Evaluation Study of a Transdisciplinary Intervention Using Arts-Based Methods

Cross-disciplinary, arts-based interventions are gaining recognition for improving palliative care by addressing the complex experiences of patients with life-limiting illnesses. These interventions integrate healthcare, arts, and spiritual care. Despite their acknowledged value, challenges remain regarding the positioning, legitimacy, and autonomy of artistic and spiritual perspectives within academic and clinical settings. This study investigates how executors – researchers, spiritual caregivers (SCers), and professional artists – of the In Search of Stories (ISOS) intervention experienced transdisciplinary collaboration. Focus of the study is on exploring if and how ISOS fostered mutual learning between executors on working with art-based methods, including Rich Pictures (RPs), text-elicitation interviews, and artistic co-creation; or whether practices of boundary work dominate. Data from 21 evaluation interviews were analyzed using inductive thematic analysis. Mutual learning occurred between artists and SCers on time and agenda management skills, and on the relevance of using arts-based methods in palliative care. SCers framed the artistic co-creation as extending and deepening the outcomes of the RPs and text-elicitation interviews used to visualize and explore patients’ illness experiences. This broadened the scope of supportive care beyond the conventional role of the SCer. Artists and SCers also employed boundary work, as they were protecting the autonomy of their professions against perceived instrumentalization tendencies by researchers. As the arts and spiritual care become more common in healthcare contexts, tensions may emerge between practitioners’ wish for autonomy and the perceived goal-driven nature of medical care and research. To navigate these tensions, developers and implementers of cross-disciplinary collaborations in the medical fields should engage in proactive discussions with practitioners regarding their positioning and legitimacy within existing or emergent research and care frameworks. This ensures that their professional identities are acknowledged and reflected in their work, which may contribute to more equal collaborations in healthcare.