Understanding Inpatient Falls From the Patient Perspective Across the Hospitalisation Trajectory: A Systematic Review and Qualitative Meta-Synthesis

Inpatient falls remain a major patient safety concern; yet, existing research has rarely examined fall-related factors from the hospitalised patients’ perspective. Understanding how patients perceive and experience falls is essential for developing effective prevention strategies. This study systematically synthesised qualitative evidence on fall-related factors based on patients’ lived experiences during hospitalisation. A comprehensive search was conducted on PubMed, Cochrane Library, and Web of Science. The analysis identified six themes: risk-recognition factors, learning factors, physical factors, psychological factors, environmental factors, and unknown reasons for falls. A temporal pattern emerged across the hospitalisation trajectory: (1) ‘readaptation to the body and environment’, (2) ‘expansion of autonomy accompanying recovery’, and (3) ‘fatigue associated with rehabilitation training’. Furthermore, the findings suggested that falls in the hospital are not merely accidental physical incidents, but they may occur as patients attempt to re-evaluate their altered physical functions and adapt to them within the unfamiliar hospital environment. These findings highlight the requirement for a patient-centred approach to fall prevention that considers these changes during patients’ recovery and adaptation to the hospital environment.