Navigating healthcare systems: A qualitative study on socially marginalised patients' experiences of hospital transition and support by social nurses

Background: Socially marginalised patients face many challenges related to their health condition and often have several contacts with healthcare and social service workers. The Danish social nursing initiative, whose nurses have experience and knowledge about marginalisation, aims to support socially marginalised patients during hospital admission and through hospital transitions. However, there is limited knowledge about the hospital transitions of patients being supported by a social nurse.

Objectives: The objectives of this study were to explore (1) the perspectives of socially marginalised patients on the transition from hospital to home and (2) how these patients experience the importance of social nursing on patient trajectories after hospital discharge.

Methods: A qualitative study with a phenomenological and hermeneutic approach was performed at a large hospital in southern Denmark. Adult patients who had contact with a social nurse during hospital admission were purposely sampled. Data were collected between January 2023 and March 2023. Initial patient interviews were conducted during hospital admission with a second interview 7-22 days after discharge. Systematic text condensation was used for the analysis, and Nvivo 12 supported data storage and coding.

Ethical approval: The study is registered with the Danish Data Protection Agency (22/47509). Informed consent was given by the participants.

Results: Sixteen patients participated in the study. The participants experienced major challenges in their transitions from the hospital, which were generally related to their interactions with many different social and healthcare services. While the social nurses supported the patients and helped facilitate care during hospital admission and after discharge, the participants identified transitional care gaps related to multidisciplinary cooperation and standardised care options.

Conclusions: This study identifies challenges related to the hospital transition of socially marginalised patients, which indicates a gap in healthcare services. Future research should focus on improving interprofessional collaboration with socially marginalised patients across healthcare services.