title: A qualitative meta-synthesis of patients' experiences of intra- and inter-hospital transitions.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  The meta-synthesis approach was based on the guidelines by Sandelowski and Barroso.
  
  
  METHODS
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Public Health, Aarhus University, Horsens Hospital Research Unit, Horsens, Denmark. lis.uhr@rm.dk
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Uhrenfeldt
authors.forename: Hanne
authors.initials: H
authors.lastname: Aagaard
authors.forename: Elisabeth O C
authors.initials: EO
authors.lastname: Hall
authors.forename: Liv
authors.initials: L
authors.lastname: Fegran
authors.forename: Mette Spliid
authors.initials: MS
authors.lastname: Ludvigsen
authors.forename: Gabriele
authors.initials: G
authors.lastname: Meyer
mesh_terms: D000223:Adaptation, Psychological; D001294:Attitude to Health; D006801:Humans; D009723:Nurse-Patient Relations; D010360:Patient Transfer; D036301:Qualitative Research; D011787:Quality of Health Care; D013315:Stress, Psychological / Q000517:prevention & control
keywords: Meleis transition theory; evidence-based practice; metasynthesis; nurse-patient interaction; patient perspectives; quality of care