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Children's lived experiences of transitioning between hospital and home in paediatric oncology: A qualitative study
Josefine Tang Rørbech1, Claus Sixtus Jensen2, Karin Enskär3
1Department of Paediatrics and Adolescent Medicine, Unit for Research and Development in Nursing for Children and Young People, Aarhus University Hospital, Aarhus N, Denmark.
Insights
Children with cancer find hospital-to-home transitions both relieving and uncertain. Improved discharge planning must include child-centered preparation and acknowledge their liminal phase for better family support.
Area of Science:
- Paediatric Oncology
- Child Psychology
- Family Care
Background:
- Pediatric cancer treatments improve survival but disrupt family life.
- Hospital-to-home transitions are critical but underexplored in pediatric cancer care.
- Current discharge planning overlooks children's experiences, focusing mainly on parental readiness.
Purpose of the Study:
- To explore the lived experiences of children and adolescents transitioning from hospital to home after cancer treatment.
- To understand the child's perspective on hospital discharge and homecoming.
- To identify gaps in current discharge practices concerning pediatric cancer patients.
Main Methods:
- Qualitative study employing a phenomenological-hermeneutic approach.
- Fieldwork included go-along and photo-elicitation interviews with ten children (aged 6-17).
- Data analysis was guided by Paul Ricoeur's theory of interpretation.
Main Results:
- Children perceived homecoming as a mix of relief and uncertainty.
- The transition was often abrupt, with insufficient child-centered preparation.
- Participants described a liminal state: not fully hospitalized but not secure at home, managing ongoing risks.
- Prominent experiences included heightened alertness, bodily awareness, and altered sense of time and identity.
Conclusions:
- Hospital-to-home transitions are significant existential and emotional shifts for pediatric cancer patients.
- Discharge planning needs to prioritize children's emotional readiness and involvement.
- Recognizing the transition as a liminal phase can inform more supportive and inclusive care models for families.
Purpose:
Advances in paediatric oncology have improved survival rates, but intensive treatments and frequent hospitalisations disrupt family life. Hospital-to-home transitions are critical yet underexplored in the cancer trajectory. Existing models of discharge planning primarily address parental readiness, with limited attention to how children themselves experience these transitions.
Methods:
This qualitative study used a phenomenological-hermeneutic approach to explore the experiences of children and adolescents during transitions from hospital to home. Fieldwork, using go-along and photo-elicitation interviews, was conducted with ten children aged 6 to 17. Paul Ricoeur's theory of interpretation inspired the data analysis.
Results:
Findings revealed that children experienced homecoming as both a relief and a source of uncertainty. The transition to home was often abrupt and marked by limited child-centred preparation. Participants described being in a liminal position -no longer hospitalised but not fully secure at home-while continuing to manage illness-related risks. Feelings of alertness, bodily awareness, and disconnection from time and identity were prominent.
Conclusions:
Hospital-to-home transitions are more than clinical endpoints; they represent an existential and emotional shift for children and adolescents with cancer. Discharge practices should consider the child's emotional readiness, involve them in the preparation, and consider the broader family context. Recognising the transition as a liminal phase may lead to more supportive and inclusive care models for families navigating these complex transitions.
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