Children's lived experiences of transitioning between hospital and home in paediatric oncology: A qualitative study

Abstract

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.