BMC Nurs. 2026 Apr 24. doi: 10.1186/s12912-026-04636-6. Online ahead of print.
ABSTRACT
BACKGROUND: The transition from hospital to home presents significant psychological and practical challenges for older heart failure patients living alone (OHELP), who must navigate complex self-care needs within a socially isolated context. Although discharge preparation is a critical period for adapting to solitary living, the psychological and behavioral coping mechanisms of this vulnerable population remain underexplored.
OBJECTIVE: This study aimed to explore the psychological experiences during the pre-discharge period regarding self-care readiness, and to describe the behavioral strategies preferred by the OHELP.
METHODS: This descriptive qualitative study employed purposive sampling to recruit 26 participants from a geriatric hospital in Zhengzhou, China, between January and June 2025. Interview data were systematically organized and coded using NVivo 12, and reflexive thematic analysis was conducted through the research.
RESULTS: Four themes and twelve sub-themes emerged from the analysis: (a) anticipated psychological burden of living alone, (b) perceived deficits: needs vs. resources, (c) coping strategies for self-care and the defense of autonomy, (d) reconstructing one's self-worth and meaning.
CONCLUSIONS: The OHELP addressed anticipatory psychological burden during discharge preparation through adaptive strategies such as reestablishing daily routines and enhancing technological literacy, thereby reconstructing self-worth and maintaining autonomy.
CLINICAL TRIAL NUMBER: Not applicable.
PMID:42032540 | DOI:10.1186/s12912-026-04636-6

