# Challenges and Adaptive Strategies in Transitional Care During COVID-19: A Qualitative Study of Nurses’ Experiences in Japan

## TL;DR

This study explores how nurses in Japan adapted transitional care practices during the pandemic by using digital tools and community partnerships.

## Contribution

The first detailed examination of adaptive strategies used by Transitional Care Nurses in Japan during the COVID-19 pandemic.

## Key findings

- Transitional Care Nurses faced disrupted connections with patients, families, and community services during the pandemic.
- Nurses used hybrid approaches combining face-to-face and digital tools to manage care effectively.
- Strengthened community partnerships helped maintain essential care principles during the crisis.

## Abstract

Background/Objectives: To examine shifts and challenges in transitional care practices during COVID-19 and the adaptive strategies developed by Transitional Care Nurses (TCNs) in response. Methods: A qualitative descriptive study was conducted using semi-structured interviews with 15 TCNs from acute care hospitals in Japan. Data were collected from October 2021 to October 2022 and analyzed using qualitative thematic analysis. The study is reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: Three main themes emerged: (1) disrupted connections in transitional care with patients and families, among hospital staff, and with community services; (2) professional pressures in pandemic care, including the mental and physical burden on TCNs and navigating unexpected changes to transitional care plans; and (3) adaptive strategies through digital solutions and community partnerships. TCNs implemented hybrid approaches combining selective face-to-face interactions for complex procedures and strategic use of digital tools for routine communication. Conclusions: This study provides the first detailed examination of how TCNs in Japan adapted to transitional care during COVID-19. TCNs maintained essential care principles while implementing digital tools and strengthening community partnerships using hybrid approaches. These findings offer practical guidance for healthcare organizations to enhance transitional care practices during future healthcare crises.