Understanding Transition from Home to Inpatient Setting in Palliative Care: A Qualitative Synthesis.

CONTEXT: Patients receiving palliative care often experience multiple transitions among care settings at the end of life, with transitions from home to inpatient settings being the most common. However, how these transitions occur and how care needs and preferences change over time have not been systematically synthesized. OBJECTIVE: To synthesize the experiences of patients receiving palliative care and their caregivers regarding transitions from home to inpatient settings. METHODS: A qualitative evidence synthesis was conducted following JBI guidance and reported in accordance with ENTREQ. The PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, WanFang and VIP databases were searched from inception to January 2024 and updated in March 2026. The eligible studies were assessed using the Joanna Briggs Institute critical appraisal instrument for qualitative research. Thematic synthesis was conducted by using Thomas and Harden's approach. FINDINGS: A total of 9 studies were included. Three themes emerged: 1) triggers for making decisions, including symptom crises, caregiving burden, treatment preferences, and reluctance to die at home; 2) concerns about inpatient care, involving continuity of care, communication, and comfort; 3) reflections on the care transfer, with caregivers viewing the transition as the right decision and describing a calmer period with their loved ones. CONCLUSIONS: Preferences regarding the place of care at the end of life are not a clear and stable choice but are shaped by uncertainty relating to the illness, the caregiver and the services needed.