Older patients' experiences of hospitalization and intrahospital transitions in cardiac care: a qualitative interview study

Intrahospital transitions of older patients between bed units, departments, or hospitals are frequent in cardiac care and often necessary to provide specialized treatment. These transitions are critical events that can compromise patient safety due to potential loss of essential patient information. However, patients’ experiences of intrahospital transitions during hospitalization remain sparsely explored. Understanding these experiences is essential to strengthening nursing practice and to identify areas for improvement from a patient perspective.

To explore older (≥65 years of age) patients' experiences of being hospitalized with a special focus on intrahospital transitions in cardiac care.

A qualitative study, guided by a hermeneutic approach, and using individual semi-structured interviews with patients was conducted between April and September 2025. Patients were recruited during hospitalization at a highly specialized department of cardiology. Interviews were conducted either during hospitalization, by telephone, or in the patients’ homes, according to patient preference. An interview guide inspired by Meleis’ transition theory was applied, and data were analysed using qualitative content analysis as described by Graneheim and Lundman.

In total, 20 patients with various cardiovascular disease were interviewed: 11 men and 9 women, with a mean age of 77.4 years and a mean hospital stay of 14.1 days. One overarching theme, "Navigating an unfamiliar situation – anxiety, gratitude, and dependency in encounters with hospital routines," was identified, along with four categories: "Fear related to disease severity and deterioration during hospitalization," "Substantial variation in quality between departments and hospitals," "Hospitalization and transfers governed by institutional routines," and "The importance of being acknowledged as a whole person during hospitalization."

Hospitalization and intrahospital transitions place patients in an unfamiliar and vulnerable situation. Clinical practices and procedures, which are routine activities for healthcare professionals, such as intrahospital transitions between departments or referrals to life-saving procedures, represent not only patient safety risks but are also perceived as a significant psychological burden when patients were not adequately prepared or involved. This was particularly evident among an already vulnerable patient group, for whom concerns about disease severity and mortality were prominent.