Family Caregivers' Understanding, Expectations, and Emotional Responses During Transition to a Palliative Care Unit: A Qualitative Study.

AIM: To explore how family caregivers interpret palliative care and respond to admission to a palliative care unit as a critical transition in care. DESIGN: A qualitative descriptive study using thematic content analysis. METHODS: Semi-structured interviews were conducted with 12 caregivers of patients with advanced cancer admitted to an inpatient palliative care unit between July and December 2024. Interviews were performed within 24-72 h of admission to capture early interpretations of referral. Data were analysed using thematic content analysis through coding, categorization, and theme development. Reflexive practice, supervisory review, and an audit trail supported rigour. RESULTS: Admission was experienced as a critical transition. Three interrelated themes were identified: understanding of palliative care, expectations regarding care, and emotional responses. Participants described partial familiarity with palliative care but frequently associated referral with terminal illness. Expectations focused on comfort and clear communication. Emotional responses included fear, uncertainty, and ambivalence, particularly when referral occurred abruptly. CONCLUSION: Admission to a palliative care unit represents a significant transition during which caregivers reconstruct meanings, adjust expectations, and respond emotionally to changes in care. Structured communication at admission may facilitate caregiver adaptation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Recognizing admission as a transitional process highlights the need for early communication, expectation-setting, and emotional support for caregivers. IMPACT: Limited understanding exists regarding how caregivers interpret admission to inpatient palliative care during transitions. Admission was experienced as a transition involving meaning-making, expectation formation, and emotional adjustment. Findings may inform nursing practice in inpatient palliative care by supporting caregiver-centered transition support. REPORTING METHOD: Standards for Reporting Qualitative Research guidelines. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, or reporting.