Exploring Emotional Safety and Harm Among Hospitalized Patients: A Qualitative Study of Patients’ and Providers’ Perspectives
Abstract
1. Introduction
2. Methodology
2.1. Study Design
2.2. Study Setting
2.3. Study Participants and Sampling
2.4. Data Collection
2.5. Data Analysis
2.6. Ethical Consideration
3. Results
3.1. Patients’ Perspectives
3.1.1. Pre-Hospital Anxiety
“I was scared about what would happen inside. Will they even listen to me?” (Male, 35 years old, medical unit.)
“I had no idea where to go or what to do when I arrived.” (Male, 50 years old, orthopedic unit.)
3.1.2. Impact of Communication
“The doctor just wrote something on paper and left without telling me what was happening.” (Male, 42 years old, surgical unit.)
“Whenever I asked questions, they either ignored me or told me to wait.” (Female, 29 years old, medical unit.)
“The doctor explained my condition and treatment options in detail. I felt comfortable and informed.” (Male, 40 years old, medical unit.)
3.1.3. Emotional Stress Due to Treatment Delays
“I was in severe pain, but they just kept telling me to wait for my turn.” (Male, 48 years old, orthopedic unit.)
“Three days just for a test result, while I kept suffering. It was unbearable.” (Female, 55 years old, medical unit.)
“I was admitted quickly, and the doctors started my treatment immediately.” (Male, 38 years old, orthopedic unit.)
3.1.4. Systemic Factors
“Why do I have to go to so many counters and fill so many forms just to get a simple approval?” (Male, 60 years old, medical unit.)
“They lost my file, and I had to redo my tests. It felt like nobody cared.” (Female, 38 years old, medical unit.)
3.1.5. Financial Factors
“The treatment cost kept increasing, and I didn’t know what I was actually paying for.” (Male, 44 years old, surgical unit.)
“I was told insurance would cover everything, but at the end, I had to pay extra.” (Male, 52 years old, medical unit.)
3.1.6. Lack of Emotional Support
“Nobody asked how I was feeling”… “Days in the hospital feel endless with no one to talk to.” (Male, 36 years old, orthopedic unit.)
“I was crying in pain, but nobody tried to comfort me.” (Female, 58 years old, medical unit.)
“The doctor not only treated my illness but also gave me emotional support. That meant a lot.” (Male, 52 years old, medical unit.)
3.1.7. Post-Hospitalization Concerns
“They just gave me a paper and said I could go home. I had no idea what to do next.” (Male, 49 years old, medical unit.)
“Who do I call if something goes wrong? Nobody told me.” (Female, 41 years old, medical unit.)
3.2. Care Provider Perspectives
3.2.1. Theme 1: Factors Contributing to Emotional Harm
Systemic Factors
“Patients are stress due to our admission process… and the admission counter, means that it is almost 800 m or 1 km away” (Dr., 28 years old, medical unit)
“… normally our tests take an hour or two, but some time the laboratory, it takes two to three hours” (RN, 32 years old, obstetric unit)
“Because these people have come to the hospital for the first time. And they do not know this place” (RN, 25 years old, psychiatric unit)
Staff-Related Factors
“what I feel, which causes the most emotional harm, is that when you treat the patient, then sometimes I have seen that when you become overburdened, then automatically you have a lack of empathy” (Dr., 34, surgical unit)
Patient-Related Factors
“the anxiety level of a patient who comes to the hospital is much higher than before… When he comes to know that he has this problem, people do not get mentally prepared” (Dr., 45, psychiatry)
“Some patients worry about extra tests or procedures, thinking they are being done for financial gain rather than medical necessity.” (RN, 25, surgical unit)
3.2.2. Theme 2: Coping Mechanisms and Solutions
Improving Communication and Education
…communication directly affect the patient. If there is a doctor and a patient comes to him, he does not listen to what the patient is saying or not… (RN, 35, obstetric unit)
“The patient should be explained in their local language” (Dr., 28, medical unit)
Staff Support and Training
“As long as our staff members are not educated, they don’t know how to deal with it”
“Psychologists should be there in each and every ward… So that they can deal with the patient on time” (Dr., 45, psychiatry)
Hospital Policy and System Improvements
“So I say that there should be a proper porter with them from ER to here. He should take them and explain to them that this is the process”
“And the procedure should be timely, there should be no delay in it. Because when the patient’s procedures are delayed, then their anxiety and tension level increases” (RN, 40, Medical)
3.2.3. Theme 3: Impact of Prior Experiences and Involvement
Influence of Previous Hospitalization
“if he is admitted again, then he recalls all the things in his mind, what happened to him in the past experience, he thinks that I will go to such people who do not cooperate with him, they will harm him” (RN, 35, Oncology)
Patient Involvement in Care and Decision-Making
“Patients should also be aware of all these things, that what is the complication of this thing, and what is not… So, if he is a well-educated patient, then he will know more, that this thing is good for me, this is not. So, it will be easy for him to make a decision” (Dr., 45, Psychiatry)
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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(A) | ||
S/NO | Category | No. |
Age in years | ||
18–40 | 10 | |
41–60 | 10 | |
60 and above | 5 | |
Gender | ||
Male | 20 | |
Female | 5 | |
Education | ||
Primary | 4 | |
Secondary | 7 | |
Graduate and above | 14 | |
Unit of admission | ||
Medical | 10 | |
Surgical | 5 | |
Orthopedic | 10 | |
Hospital stay | ||
1 week | 7 | |
2 weeks | 12 | |
More than 2 weeks | 5 | |
(B) | ||
S/NO | Characteristics | Number |
Age in years | ||
25–30 | 8 | |
31–40 | 4 | |
41–50 | 3 | |
Gender | ||
Male | 9 | |
Female | 6 | |
Profession | ||
Doctor | 7 | |
Nurse | 8 | |
Working Unit | ||
Medical | 3 | |
Surgical | 3 | |
Obstetrics | 3 | |
Oncology | 3 | |
Psychiatry | 3 | |
Experience in years | ||
1–5 | 6 | |
6–10 | 6 | |
More than 10 | 3 |
(A) | ||||
S/NO | Themes | Category | Codes | Quotes |
1 | Anxiety upon Admission | Pre-Hospital Anxiety | Fear and uncertainty upon hospital entry | “When we come to the hospital, our initial feeling is more about how we will be treated and dealt with, rather than the illness itself.” (Male, 35, Medical.) |
Stress due to an unfamiliar hospital environment | “I had to go to the hospital again and again to get treatment… It is sad that I cannot go back home (Female, 55, Medical) | |||
2 | Impact of Communication | Lack of Clear Information | Unclear explanations from hospital staff | “Doctors prescribe medicine without explaining it properly. Patients have to repeatedly ask for explanations” “We expect emergency treatment after being admitted, but that often gets delayed. No one explains why.” (Male, 48, Orthopedic) |
Staff Attitude and Responsiveness | Emotional distress caused by dismissive behavior | “I kept on calling for help, but the doctors did not listen to me” (Male, 35, Medical.) | ||
Perceived rude behavior of medical personnel | “Some people behave arrogantly when given a little authority.” (Male, 42, surgical.) | |||
3 | Emotional Stress due to Delayed Treatment | Waiting for treatment | Anxiety due to treatment delays | “There were vacant beds, but in their online system the beds were shown as occupied… This made me so disturbed.” (Male, 38, orthopedic.) |
Emotional distress due to delayed pain management | I was in pain on a stretcher, and I expected immediate relief… but no treatment was given after a long time.” (Male, 50, orthopedic) | |||
4 | Systemic Factors | Administrative Inefficiencies | Stress due to unclear hospital policies | “There should be regular surveys or interviews with patients to ensure policies are being implemented.” (Male, 52, medical) “Policies are well-formed but need proper implementation. Decisions made in meetings should be followed up.” (Male, 42, surgical) |
5 | Financial Burdens | Cost of Treatment | Anxiety due to high treatment expenses | “We are poor people but we are worried about our health. (Female, 55, Medical) |
Stress due to unclear billing | “They just keep writing something on paper, and…don’t know if it’s a bill… “They keep adding charges… How can I afford this?” (Female, 38, medical.) | |||
(B) | ||||
S/No | Themes | Categories | Codes | Quotes |
1 | Factors Contributing to Emotional Harm | Systemic Factors | Public hospital setup | “On the government setup, the emotional stress of the patient or his relatives is mostly high… because the patient’s rights are not considered properly.” (Dr., 45, psychiatry) |
Bed allocation problems | “When the patient comes for admission, he has the biggest problem of bed allocation…” (RN, 40, Medical) | |||
Staff-Related Factors | Ill-mannered behavior | “patients will say that the staff’s behavior is not right… they are afraid to ask me.” (RN, 35, Oncology) | ||
Lack of empathy | “There should be a receptionist and PRO (Public Relations Officer) who should support the patient’s family… but no one listens to his complaints. (Dr., 30, Surgical) | |||
Patient-Related Factors | Financial stress | “They do not have money, nor do they have a health care… this is also a factor for their emotional harm (Dr., 28, medical). | ||
Past experiences | “He is already scared… someone told him from the past that the staff is ill-mannered.” (Dr 30, Surgical) | |||
2 | Coping Mechanisms and Solutions | Improving Communication and Education | Proper counseling | “At the arrival and on hospital admission… we explain everything to patient and their attendant (RN, 40, Medical) |
Timely procedures | “Sometimes we order CT or MRI, but they give us time 10 days later… this exhausts the patient and attendant emotionally.” (Dr., 45, Psychiatry) | |||
Staff Support and Training | Empathetic behavior | “I try to help those who don’t have availability of a health card…I understand their concerns (RN, 35, Oncology) | ||
Training of staff | “Proper communication skills should be in our staff and doctors… so the emotional distress of the patient can be controlled (Dr., 45, psychiatry) | |||
Hospital Policy and System Improvements | Policies designed to reduce emotional harm | “If there is a proper triage department… then many problems causing emotional distress can be reduced and the patient can be facilitated.” (Dr., 28, medical) | ||
Relaxing environment | “The environment of the hospital should be proper. There should be a reception… to guide patients on which ward, which floor.” (Dr., 34, surgical unit) | |||
3 | Impact of Prior Experiences and Involvement | Influence of Previous Hospitalization | Good interaction benefits | “If they had a good experience… they would request the same doctor or nurse who previously took care of them.” (RN, 35, obstetric unit) |
Patient Involvement in Care and Decision Making | Patient involvement | “We involve patients and their attendants in the care process, which helps in reducing their stress.” (Dr., 28, medical) |
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Khan, A.; Muhammad, D.; Naz, N.; Khanum, S.; Khan, A. Exploring Emotional Safety and Harm Among Hospitalized Patients: A Qualitative Study of Patients’ and Providers’ Perspectives. Healthcare 2025, 13, 1842. https://doi.org/10.3390/healthcare13151842
Khan A, Muhammad D, Naz N, Khanum S, Khan A. Exploring Emotional Safety and Harm Among Hospitalized Patients: A Qualitative Study of Patients’ and Providers’ Perspectives. Healthcare. 2025; 13(15):1842. https://doi.org/10.3390/healthcare13151842
Chicago/Turabian StyleKhan, Afsha, Dildar Muhammad, Najma Naz, Sabiha Khanum, and Awal Khan. 2025. "Exploring Emotional Safety and Harm Among Hospitalized Patients: A Qualitative Study of Patients’ and Providers’ Perspectives" Healthcare 13, no. 15: 1842. https://doi.org/10.3390/healthcare13151842
APA StyleKhan, A., Muhammad, D., Naz, N., Khanum, S., & Khan, A. (2025). Exploring Emotional Safety and Harm Among Hospitalized Patients: A Qualitative Study of Patients’ and Providers’ Perspectives. Healthcare, 13(15), 1842. https://doi.org/10.3390/healthcare13151842