A qualitative meta-synthesis of patients' experiences of intra- and inter-hospital transitions.

AIM: To aggregate, interpret and synthesize findings from qualitative studies of patients' experiences on being transferred/in transition from one hospital to another or from one ward to another.
BACKGROUND: Studies about patients' experiences of transfer focused on concepts such as transfer stress, transfer anxiety, and translocation syndrome; however, a meta-synthesis on experiences of transition across different patient populations was lacking.
DESIGN: The meta-synthesis approach was based on the guidelines by Sandelowski and Barroso. DATA SOURCE: Six electronic databases were searched for articles published between the years 1999-2011, based on the target phenomenon: patients' experiences of transition after transfer between hospitals or units. Reference lists of included articles were screened for eligible papers. REVIEW
METHODS: Data were analysed into meta-summary and meta-synthesis. The qualitative content analysis process started with a search for common themes, concepts, and metaphors.
RESULTS: Fourteen qualitative studies were included. Three main categories were identified: transfer as unpredictable, scary and stressful; transfer as recovery and relief; and transfer as sliding into insignificance. The meta-synthesis showed patients' experiences of transitions as critical events where nurses need to focus on patient outcome of transfer as safe, predictable, and individual.
CONCLUSION: It was difficult for patients to leave their experiences behind when feeling unimportant. Evidence existed for clinical nurses to continue the development of care quality and safety for patients in transfer/transition. Intervention studies and policy development to improve transfers and transitions for patients are recommended.