## 3 Results
### Uncertainties in Clinical Decision-Making  
Throughout the analysis, different features of uncertainty were evident in most aspects of clinical decision-making. Already during the first phase of analysis, when reading transcripts alongside with the field notes, we reflected over uncertainties as an aspect that seemed to impact clinical decision-making. At the final stages of the analysis, the overarching theme became clear, with uncertainties described in all main themes. This overarching theme is linked with all main and sub-themes. This was confirmed during the analytic process by the two authors not present during the FGI's. \begin{table}
\begin{tabular}{c c} \hline \hline
**Characteristics of the Participants** & **N = 22** \\ \hline Gender & \\ Men & 4 \\ Women & 18 \\ Age groups & 20–40 years & 7 \\
41–60 years & 15 \\ Profession & \\ Nurse & 14 \\ Physician & 8 \\ Years in profession & \\
0–5 years & 4 \\
6–15 years & 11 \\ \textgreater{}15 years & 7 \\ Workplace & \\ SPC at home & 16 \\ Acute cancer care & 6 \\ Specialization & \\ Oncology & 8 \\ Geriatrics and/or palliative care & 1 \\ Not specified & 2 \\ Not specialized & 11 \\ Years at current workplace & \\
0–5 years & 6 \\
6–15 years & 13 \\ \textgreater{}15 years & 3 \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Characteristics of participants in the focus groups. Across the FGIs, uncertainties were reported regarding organizational factors; an inconsistency between organizations (access to care, resources, and competencies), were described to largely impact clinical decisions, i.e., how to act, plan for care activities and interact with patients and their families. In addition, uncertainty of who should make and/or initiate important decisions, are portrayed in a theme, _Organizational factors impacting clinical decision-making_. Other examples of uncertainty related to the patient's prognostic understanding or the patients living situation also seemed to influence clinical decisions and were reported in, _Patients and informal caregivers' prerequisites_. In addition, aspects of uncertainty were apparent in a theme related to goals-of-care as well as an uncertainty of the patients' prognosis, _Balancing patient's medical condition and needs based on the uncertainty of the future_. These aspects of uncertainty appeared to hinder and impact the clinical decisions, leading to ethical conflicts, presented in the theme, _Balancing ethical dilemmas_. Figure 2: The overarching theme, main themes, and sub-themes. Organizational Factors Impacting Clinical Decision-Making  
Organizational factors seemed to impact clinical decisions, several related to different aspects of resources, covered in the sub-theme, _Resources, geography and timing_. Participants from both SPC and acute cancer care described how their resources affected their decisions, e.g., the ratio of nurses/physicians per patient, or whether a physician was on call during weekends or not. As an example, geography seemed to impact clinical decision-making; if a patient lived remotely on an island difficult to access, they were more likely to send the patient to the ER, or at least to the hospital, since frequent visits were hindered by location and travel time. It was also discussed by several SPC teams how the workload (number of patients in need of multiple home visits) impacted decisions on whether to send a patient to ER or not (rather than the medical and/or psychosocial condition). _\"It's Friday evening and then you cannot expect an assessment by a physician until Monday really, the threshold for sending the patient in is lower, since this is the only way of getting an appropriate assessment.\"_ (FG2, MD2)  
The health care professionals (HCPs) discussed healthcare inequalities and the heterogeneity of resources in the sub-theme, _Uncertainty of the organization_.