RESUMO
Introduction: The purpose of this study was to identify the thinking and practice of skilled home health care nurses to determine the necessity of multidisciplinary collaboration for users with complex issues.Methods: Semi-structured interviews were conducted with 7 home health care nurses who met the following criteria: years of home health care nursing experience, affiliation, etc. Data on the thoughts and practices of the home-visit nurses were extracted from the interview records and analyzed qualitatively.Results: Seven categories were extracted as thoughts of skilled home health care nurses when judging the need for multidisciplinary collaboration to support users with complex issues, such as: "intending to foster a common understanding among related organizations and professions". Eight categories were extracted for practices of related organizations and professions, such as: "Establish a system appropriate for the conditions of the user and his/her family", and 4 categories were extracted regarding practices for users and their families, such as: "Involvement to reduce the burden of caregiving on the family".Conclusion: The study revealed that skilled home health care nurses promote multidisciplinary collaboration by utilizing various means while emphasizing a common understanding with related organizations and professionals. In collaboration with other professions, it was necessary to utilize the expertise of nursing professionals for assessment and management.