# Exploring Emotional Safety and Harm Among Hospitalized Patients: A Qualitative Study of Patients’ and Providers’ Perspectives

## TL;DR

This study explores how emotional safety and harm are perceived by hospitalized patients and healthcare providers in Pakistan, highlighting the need for better communication and support.

## Contribution

The study provides new insights into emotional safety in healthcare by comparing perspectives of patients and providers in a public-sector hospital setting.

## Key findings

- Emotional harm is influenced by communication issues, staff behavior, and systemic challenges.
- Patients experience anxiety and stress due to treatment delays and financial burdens.
- Both patients and providers agree on the importance of improving communication and emotional support.

## Abstract

Background: Emotional safety is increasingly recognized as crucial for high-quality patient care, encompassing a patient’s sense of security, courteous treatment, being heard, and a peaceful environment. Purpose: The purpose of this study was to explore the perceptions of patients and providers (doctors and nurses) regarding emotional harm and safety in relation to hospitalized patients. Methods: We conducted a qualitative study in public-sector teaching hospitals in Peshawar, Pakistan. Data were collected after we obtained informed consent using individual interviews with 15 providers, namely, doctors (n = 7) and nurses (n = 8), and five focus group discussions (FGDs) with 25 hospitalized patients. Data from both the interviews and FGDs were analyzed using Braun and Clarke’s six-phase approach to thematic analysis. Results: The key themes revealed by the providers’ perspectives were factors contributing to emotional harm, staff-related factors, coping mechanisms and solutions, and the impact of prior experiences and involvement. The main themes that emerged from the patients’ perspectives were anxiety upon admission, the impact of communication, emotional stress due to treatment delays, systemic/bureaucratic challenges, financial burden, a lack of emotional support, and post-hospitalization concerns. The consistent perspectives shared by both patients and providers included the impact of systemic factors, communication issues, the role of staff attitude/behavior, financial concerns, and the influence of prior experiences. Conclusions: This study highlights the complex interplay of systemic, staff-related, and patient-specific factors. It suggests a need to improve communication, staff support, administrative processes, financial counseling, emotional support integration, and discharge planning to minimize harm and create a patient-centered environment.