| 153
Pensar Enfermagem / v.27 n.01 / December 2023
DOI: 10.56732/pensarenf.v27i1.268
Qualitative Original Article)
How to cite this article: de Souza JB, Beckert RAT, Pilger KCP, Mafra SK, Rosario E, Ost KM, Moura V.
Hospitalization experiences: the perspective of individuals admitted to the medical clinic. Pensar Enf
[Internet]. 2023 Dec; 27(1):153-160. Available from: https://doi.org/10.56732/pensarenf.v27i1.268
Hospitalization experiences: the perspective of
individuals admitted to the medical clinic
Abstract
Introduction
Contemporary society is witnessing a population that struggles to look after their health
due to the relentless pace of their lives, consequently rendering them susceptible to the
experience of hospitalization. Within this context, individuals relinquish their autonomy
and are confronted with a plethora of reactions and emotions, requiring an individualized
and humane approach for a prompt and effective recovery.
Objective
To comprehend the lived experience of hospitalization, from the perspective of individuals
admitted to the medical clinic.
Methods
This is an exploratory study, with a qualitative approach, and draws upon partial data from
a matrix research project, rooted in the theoretical framework of Health Promotion. The
manuscript has been organized in adherence with the consolidated criteria for reporting
qualitative research (COREQ). It was conducted with a cohort of 15 inpatients from the
medical clinic department of a public hospital in the Southern region of Brazil. Data was
collected by the authors, using a semi-structured questionnaire, between September and
October 2021. Thematic content analysis was used to organize and interpret the data.
Results
Two categories emerged: the first highlighted the experiences lived during hospitalization.
While some participants felt secure and supported by the multi-professional team, others
perceived the hospital environment as a place associated with pain and suffering. The second
category emphasized the sentiment of longing experienced during hospitalization, such as
for spending time with family, friends, leisure activities, and daily routines.
Conclusion
The experience of the hospitalization process triggers feelings of security, vulnerability, and
longing. The importance of qualified professionals to facilitate moments of effective and
compassionate care within the hospital setting is evident.
Keywords
Hospitalization; Humanization of Care; Health Promotion; Nursing.
Jeane Barros de Souza1 (In Memoriam)
https://orcid.org/0000-0002-0512-9765
Richard Augusto Thomann Beckert2
https://orcid.org/0000-0002-3788-0991
Kelly Cristina de Prado Pilger3
https://orcid.org/0000-0002-5670-7799
Samantha Karoline Mafra4
https://orcid.org/0000-0002-3305-6516
Evelyn do Rosario5
https://orcid.org/0009-0003-2644-7476
Kasey Martins Ost6
https://orcid.org/0009-0007-5060-5728
Vitória de Moura7
https://orcid.org/0009-0008-2862-5340
1 Post-doctorate in Nursing, Universidade Federal da
Fronteira Sul, Chapecó/SC, Brazil.
2 Undergraduate Student in Nursing, Universidade
Federal da Fronteira Sul, Chapecó/SC, Brazil.
3 Undergraduate Student in Nursing, Universidade
Federal da Fronteira Sul, Chapecó/SC, Brazil.
4 Undergraduate Student in Nursing, Universidade
Federal da Fronteira Sul, Chapecó/SC, Brazil.
5 Undergraduate Student in Nursing, Universidade
Federal da Fronteira Sul, Chapecó/SC, Brazil.
6 Undergraduate Student in Nursing, Universidade
Federal da Fronteira Sul, Chapecó/SC, Brazil.
7 Undergraduate Student in Nursing, Universidade
Federal da Fronteira Sul, Chapecó/SC, Brazil.
Corresponding author
Vitória de Moura
E-mail: vitoriamoura16.rb@gmail.com
Received on: 19.03.2023
Approved on: 05.10.2023
154 | Moura, V.
Qualitative Original Article
Introduction
In contemporary times, people demand swift and effective
solutions, aiming to save time and accomplish numerous
tasks. To achieve this goal, individuals often resort to
various practices, some of which may be inadequate, such
as the consumption of ultra-processed foods and self-
medication to alleviate certain conditions. Such practices
seem to offer effective solutions at first glance. This results
in numerous long-term detriments, such as the marked
increase in chronic diseases, an alarming trend in society.1
Thus, it is evident that due to the fast-paced routine, many
individuals lack the time to indulge in leisure or to prioritize
and promote their health. Consequently, they fail to
contemplate the pleasures of daily life, such as freedom,
autonomy, and well-being, rendering daily existence even
more exhausting and demotivating,2 subjecting themselves
to the risk of illness and occasionally requiring
hospitalization.3
The hospitalization process can pose a threat to the
autonomy and social roles enacted prior to admission, as
the individual shifts from an active role to that of a patient,
relinquishing their independence, privacy, and interaction
with their support group.4 These circumstances can
provoke diverse reactions and feelings, given the
uniqueness of each individual; however, certain sentiments
are recurrent, including longing for home or family,
alongside the potential perception of the hospital
environment as an unpleasant place. Conversely, being
present in an environment that is reminiscent of pain,
suffering, and fear tends to evoke an appreciation for what
was experienced previously. Therefore, the individual,
vulnerable in this situation, requires a holistic, humanized,
and multi-professional approach to achieve a prompt and
satisfactory recovery.5
In this context, humanization emerges as a means to
preserve the basic rights of the hospitalized individual,
reinforcing the need for dignified and respectful treatment
while safeguarding their agency and autonomy.
Humanization in the healthcare domain has received a great
deal of attention in recent years, given the imperative of this
practice across all procedures and protocols. As a result, in
2003, the Brazilian Ministry of Health published the
National Humanization Policy (NHP) with the aim of
implementing the principles of the Brazilian Unified Health
System (SUS) in the routine of health services.
Furthermore, it is crucial to emphasize that the NHP is
applicable across all sectors, regardless of the level of
complexity, as it is grounded in the qualification of care.6
Therefore, to ensure humanization, it is imperative to
attend to the patient with a multidisciplinary team, with
professionals such as nurses, physicians, physiotherapists,
nutritionists, speech therapists, among others. Teamwork
is essential to guarantee more effective and higher-quality
care across all areas of healthcare services, especially in the
medical clinic, where patients are admitted with various and
sometimes impactful diagnoses, requiring more complex
procedures and treatments.7
It should be highlighted that multidisciplinary teamwork
can contribute to enhancing empathy among professionals,
making them more efficient and compassionate in
providing healthcare to the hospitalized individual and their
family. However, it is essential that collaborative efforts are
undertaken by all and not merely a subset of professionals
within a specific unit or sector.8 Additionally, nurses are
indispensable during the hospitalization process, as they
accompany the patient from admission to discharge, and
are responsible for managing the nursing team, which will
carry out all the care and procedures necessary to assist the
individual's health, ensuring their comfort and significantly
contributing to their recovery. Moreover, it is crucial to
attend to each patient in an integral and holistic manner,
continuously evaluating both the environment and the
individual, considering not only physical aspects but also
psychological, emotional, social, cultural, and spiritual
dimensions, ensuring greater well-being and quality in the
provision of healthcare.9-10
Furthermore, in line with humanized care, the principle of
comprehensiveness, which, along with others, underpins
the SUS in Brazil, is valued in the NHP and was further
emphasized in the National Health Promotion Policy
(NHPP). In the NHPP, comprehensiveness is defined as
the articulation and harmony among health services, as well
as the broadening of the workers' and health services'
listening capacities towards patients, considered universal
citizens deserving of care without prejudices or privileges.
This comprehensive approach is applied in the spheres of
health promotion, prevention, protection, and recovery.11
In this context, the Social Determinants of Health are
essential in healthcare, as they consider aspects of an
individual's life that extend beyond illness and the
biological body, such as work, the environment in which
the person lives, social, cultural, economic, ethnic, and
behavioral issues, among others.12
Health promotion, an essential aspect of the SUS and the
backdrop of the aforementioned policies, can be seen as a
promising strategy to produce health and address related
challenges. This notion was further emphasized in the
Ottawa Charter, a document born out of the First
International Conference on Health Promotion. The
charter defined health promotion as a process of
empowering individuals, communities, and society to have
greater control and autonomy, utilizing personal and social
resources, in pursuit of improvements in quality of life and
health.13-14
The Charter outlined five action areas which concern
healthy public policies, environments favorable to health,
community action, autonomy and development of personal
skills, and reorientation of health services in the light of
health promotion. The document emphasizes the
importance of collectively building health, self-care, and
caring for others. Specifically, it indicates that these items,
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DOI: 10.56732/pensarenf.v27i1.268
Qualitative Original Article
in addition to holism, which is related to
comprehensiveness, and ecology, are indispensable for the
development and implementation of health promotion
strategies.13-14 The document also outlines commitments
for participating countries in pursuit of effective health
promotion. In Brazil, the NHPP highlights the five axes
derived from the Charter and aims to fulfill these
commitments related to the development of public policies,
equity, valuing the individual/community in their health-
disease process, the reorganization of health services to
achieve health promotion, among others.13,15
Based on the foregoing, the following research question
emerged: What is the experience of the hospitalization
process like from the perspective of individuals admitted to
the medical clinic? It is believed that by shedding light on
the demands of those experiencing hospitalization, it is
possible to reflect upon and implement strategies to qualify
healthcare assistance in the hospitalization process.
Moreover, considering the diversity of the population
served in the hospital network, both in terms of age and
culture, it is essential to perceive the factors involved in
recovery during this process, so as to make the hospital
environment more welcoming and pleasant. Therefore, the
objective of the study was to comprehend the experience
of the hospitalization process from the perspective of
individuals admitted to the medical clinic.
Methods
This is an exploratory study with a qualitative approach,
grounded in the theoretical assumptions of Health
Promotion. The manuscript was organized following the
consolidated criteria for reporting qualitative research
(COREQ).
The research took place in a referral public hospital in the
West of Santa Catarina, Brazil. Participants were 15
individuals, selected for convenience from those who met
the inclusion criteria: aged over 18 and hospitalized in the
medical clinic at the time of data collection. Lack of
physical and communicative aptitude to respond to
interview questions was the exclusion criterion. The
participants were intentionally selected, and all those
approached accepted to be part of the study.
Data collection was conducted through semi-structured
interviews carried out by the authors in the participants'
rooms, between September and October 2021. Each
interview had an average duration of 40 minutes and
followed a guide encompassing questions about the
experience of the hospitalization process and the feelings
evoked during the admission. All interviews were recorded
and subsequently transcribed into digital files.
Thematic content analysis was employed to organize and
interpret the data, which aims to uncover the central
significance that constitutes communication, prioritizing
interpretative approaches over statistical interference. In
the preliminary analysis stage, the transcribed data was
briefly skimmed to organize the content and define the
units of analysis. In the second stage of material
exploration, the data were coded to attain a comprehensive
understanding of the text. In the third stage, the data were
categorized and sub-categorized through classification and
interpretation.16 Two categories emerged from the analysis:
1) Experiencing hospitalization; 2) Longings evoked during
hospitalization, which will be discussed subsequently.
The study was approved by the Research Ethics Committee
of a public university in Santa Catarina, under opinion No.
4,960,473/2021, on September 9, 2021. It is emphasized
that, prior to data collection, all participants read and signed
the Informed Consent Form (ICF). To ensure anonymity,
the interviewees were labeled according to basic human
needs, based on the content of their testimonies. Hence,
the following pseudonyms were used: Food, Shelter, Rest,
Family, Friendship, Work, Self-esteem, Clothing, Health,
Hydration, Exercise, Safety, Spirituality, Sleep, Resilience.
Results
Participants' age ranged from 39 to 82 years, which
included four females and 11 males. The period of
hospitalization at the time of the interview varied from 2 to
30 days. In the first category, the interviewees reported that
they received adequate care and were well looked after
during their hospitalization. Additionally, they mentioned
that while at home, they experienced a feeling of impending
death, but upon receiving hospital care, they noticed an
improvement in their condition, which put them at ease.
"For me, it's good to be in the hospital. They are treating
me well, and I've already improved [...]” (Food)
"Now I'm fine, I feel better here. In fact, the doctor told
me I’d only be heading home tomorrow, and I felt at ease."
(Shelter)
"As I was at home [...] I thought I was going to die [...]
Being here in the hospital, I received all the care and I'm
fine [...]" (Rest)
The participants also discussed the administration of pain-
relief medications and the multi-professional work for
physical well-being in hospital care.
"...The medications are being administered correctly, so I
feel good." (Friendship)
"It's good because you don't feel pain, you're being taken
care of in the best possible way..." (Family).
"[...] The staff's visits can be entertaining, there are
physiotherapists, speech therapists, the whole team here,
the team of pharmacists, very good nurses, their care is very
good [...] It's clear, in these 6 days here, what good patient
treatment looks like [...]" (Work)
On the other hand, they revealed their dislike for the
hospital space, as it represents an environment visited
during illness, in a more serious state of health, leading
156 | Moura, V.
Qualitative Original Article
them to associate hospitalization with something
unpleasant and a tiring period.
"It's bad because we're here all the time, lying down."
(Family)
"I don't like being in the hospital because whoever comes
here is because they're not well, they're sick, so it's bad."
(Self-esteem)
"Oh, it's tiring [...]" (Clothing)
In the second category - longings evoked during
hospitalization -, the interviewees mentioned missing the
comfort and routine of their lives at home, along with the
freedom experienced in their households, as the hospital
environment imposes various restrictions.
"I miss everything: my bed, the food. Everything is
different here. At home, we feel more at ease."
(Friendship)
"Oh, I like being at home, walking, having visitors over, and
now I have nothing here in the hospital." (Health)
"Oh, we miss home, of course, because it's freer there, there
are no restrictions. Here, everything is regulated, and if you
don't follow orders, you won't get better." (Food)
Hospitalization led the participants to miss being with their
families. Missed conversing with them, taking care of them,
and having them close, revealing their concern for them:
"My husband [is alone], I'm very worried about him."
(Hydration)
"I miss looking after my granddaughters [...], miss my
daughter. [...]" (Shelter)
"I miss my daughters and my mother." (Clothing)
Moreover, the interviewees mentioned feelings of longing
related to their contact with neighbors, friends, and
colleagues, as well as the work activities they engaged in
before hospitalization:
"[I miss] my neighbors because we used to visit [each
other]. I always took some time out for everyone, to help
people too, and now I've been here for almost 30 days."
(Family)
"Chatting with my colleagues, I miss that." (Exercise)
"Working, for sure, I miss it a lot [...]" (Family)
Additionally, the participants reported missing the leisure
moments that were part of their daily lives, in which they
set aside time to promote self-care, have fun, attend church
services, and experience the freedom of life.
"Going to the [beauty] salon, dressing up." (Safety)
"Oh, being free, drinking mate. I miss it very much..."
(Exercise)
"I wanted to be having a beer [...] and singing [...] That's
what we used to do, right?" (Rest)
"[...] I can't attend the worship service." (Health)
It was clear, in the interviewees' testimonies, the
deprivation of various significant aspects of their lives due
to the hospitalization period, as they expressed longing for
their routines, frequented environments, their families,
friends, and leisure activities. It became evident that the
hospital environment is perceived as a place that evokes
pain and suffering, as well as a space that provides security
and support due to the care routines performed by
the professionals.
Discussion
The hospital environment is complex and demands
knowledge and efficiency from professionals to provide
quality care. In this context, safety within the hospital
setting is essential. It contributes to minimizing harm
associated with health care to an acceptable level for the
institution. This consideration includes the infrastructure,
professionals' expertise, and material resources of the
respective health service.17
Medication management is crucial in this setting and
requires professional responsibility, which is tasked with
addressing doubts and treating each need individually to
provide comfort and well-being. It is known that the use of
medications is not limited to a therapeutic practice based
on the biomedical model. When used correctly and
rationally, they become important mechanisms for the
prevention, maintenance, and recovery of health, reducing
symptoms, and providing physical and mental well-being.18
Another critical element in the hospitalization process is
the promotion of a suitable and humanistic environment.
This encompasses the building's physical structure, which
is developed through architectural design. The design aims
to meet criteria for enhancing patient satisfaction and
comfort. This involves the implementation of
organizational methods that facilitate their stay and
integration within the hospital. The architectural design
aims to harmonize and seeks to meet the different realities
of the hospital setting, promoting well-being and creating
spaces that provide physical and psychological support to
patients, as the environment is essential to the quality of
care.19
Furthermore, hospital environments can induce stress and
tension. And sometimes, physical structures do not provide
the comfort of human sensitivity, attention, and care,
despite being an important aspect in the recovery of
patients. Humanizing the environment is significant, as it
contributes to improved patient experiences and outcomes.
This approach should be practiced in the training of
professionals, ensuring they develop effective strategies to
meet the individual needs of each person in a
comprehensive and humanized manner. This effort makes
each sector as welcoming and pleasant as possible for
patients, their families, and co-workers.20
Moreover, professional training and interdisciplinary work
are essential for promoting effective health care.21 Both
ensure greater resolution, shorter durations, and reduced
health spending, enabling comprehensive and humanized
care.9 As a tool for ensuring professional qualification,
continuing education is mentioned, encompassing
specialization and ongoing professional development,
along with permanent education, addressing work process
demands, aiming for more qualified health care.22 To
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DOI: 10.56732/pensarenf.v27i1.268
Qualitative Original Article
encourage multi-professional practice, there are residency
programs in this field, which combine theoretical-practical
knowledge with teamwork and intense insertion in health
services.23
Another critical consideration for professionals working in
the hospital environment is that, during the experience of
hospitalization, patients commonly feel longing, whether
for work, habitual activities as a means to occupy time and
ensure financial support, friends and family, or gatherings
for leisurely conversation and distraction. Furthermore,
there is the longing to attend religious centers, participating
in worship, and strengthening spirituality. Thus, longing
signifies the absence felt from what was experienced before
hospitalization.
Longing is understood as a human feeling that is difficult
to define and can symbolize the experience of pain or joy
related to the deprivation or distance from a beloved object
or person.24 Within the hospital environment, this
sentiment is common and can be evaluated to ascertain its
influence on the patient's treatment and recovery.4,25
These everyday activities that generate longing, when
restricted, can significantly impact the well-being of
hospitalized individuals, as they evoke feelings of
helplessness due to the loss of control over their own
bodies, as well as the inability to engage in daily activities,
along with feelings of anguish and anxiety resulting from
the disruption of routines, leisure moments, and contact
with family, all crucial for quality of life.26
Longing also arises from the hospital environment itself,
which typically evokes pain, suffering, and sadness, in
addition to subjecting patients to invasive procedures, the
loss of privacy, and autonomy. Therefore, it is essential that
each patient is seen as a unique individual, with a
comprehensive approach, considering each of their
statements, complaints, or feelings, in pursuit of an
effective and healthy recovery. Furthermore, through
dialogues with patients and attending to their complaints, it
is possible to improve the service, considering that they
benefit from daily care and are the most qualified to suggest
changes.4,25
To this end, the healthcare professional, especially in
nursing, plays an important role in ensuring a humanized
care that brings a sense of security and comfort in the
hospital setting.27 In addition to the safe administration of
medications, care in the hospital environment, and multi-
professional work, communication with patients promotes
a more welcoming space, as mentioned by the interviewees.
Communication enables moments of sharing knowledge
and feelings, strengthening the relationship and bond
between the professional and the patient. It is also
important for this bond to be established with the family
during the hospitalization period, as they provide important
support in increasing the patient's confidence and
security.28
Dialogue with the hospitalized patient helps them to
choose the most appropriate course of action for their
health condition, contributing to the reduction of hospital
stay, as well as pain and risks to their well-being.28 These
behaviors can make the hospital environment more
humanized, allowing for less uncomfortable experiences
for both patients and their families who also experience this
period. Therefore, it is essential that professionals can
provide care while striving to enhance communication
continually throughout the work process, thus reflecting
the provision of safe and quality care.27
Conclusion
Considering the above, it is possible to understand the
hospitalization process from the perspective of patients
admitted to the medical clinic, who experience moments of
satisfaction and security when they feel cared for.
Therefore, good care and a welcoming environment
directly impact their well-being, providing comfort, hope,
and significantly facilitating their recovery.
On the other hand, they feel vulnerable, mainly due to
sudden changes in their routine and being deprived from
carrying out their daily activities, relying on the help and
care of the multi-professional team and others. This
situation is related to the perception of the hospital as a
place of suffering, anguish, restrictions, which evokes
longing for family, home, work, friends, and leisure
activities.
Thus, the significant importance of the multi-professional
work by professionals aligned with the principles of
comprehensive care becomes evident, willing to implement
new care strategies in the hospital environment. This
approach is essential to promote a humanized, qualified,
and efficient service, considering the needs and
individualities of each individual, recognizing all aspects of
the patient's life rather than just the illness. These aspects
will broaden the possibilities for effective recovery and
make hospitalization more bearable for the patient and
their family.
Among the limitations of the study is the focus on people
hospitalized in the hospital's medical clinic, most of whom
were living with chronic health conditions. The focus on
this cohort excluded other units of hospitalization, such as
the surgical clinic, which receives many people with acute
health conditions requiring other interventions. As a
contribution, the study demonstrates some of the feelings
experienced by hospitalized individuals regarding their own
condition, their stay in the hospital, and the multi-
professional team, providing insight into possibilities for
health promotion in situations such as the one presented
here. It also contributes to the development of a holistic
perspective in health care, seeking to address more unique
and individual patient concerns and needs. It emphasizes
the importance of hospital ambiance, as well as
158 | Moura, V.
Qualitative Original Article
contributing to the discussion of multi-professional work
in health and comprehensive care, all important aspects of
the NHP and the NHPP.
Authors’ contributions
JBS: Conception and design of the study; drafting the
manuscript; critical review of the manuscript.
RATB: Conception and design of the study; data analysis
and interpretation; drafting the manuscript; critical review of
the manuscript.
KCPP: Conception and design of the study; data analysis
and interpretation; drafting the manuscript; critical review of
the manuscript.
SKM: Conception and design of the study; data analysis and
interpretation; drafting the manuscript; critical review of the
manuscript.
ER: Conception and design of the study; drafting the
manuscript; critical review of the manuscript.
KMO: Conception and design of the study; drafting the
manuscript; critical review of the manuscript.
VM: Conception and design of the study; drafting the
manuscript; critical review of the manuscript.
Conflicts of interest and funding
The authors declare that there is no conflict of interest.
The authors declare that there was no funding.
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