Keywords
Hospitalization
Geriatric nursing
Nursing theory
Stress, psychological
How to Cite
Abstract
Objective: To describe the stressors experienced by older adults during hospitalization. Method: A qualitative study conducted in a large university hospital involving 30 hospitalized older adults admitted to medical and surgical units. Data were collected through interview-conversations and participant observation, conducted individually at the bedside, based on a script grounded in the Neuman Systems Model. Data were analyzed according to the methodological framework proposed by Trentini, Paim, and Silva. Results: Among participants, there was a predominance of males, individuals aged 60 to 69 years, and the presence of previous comorbidities. Intrapersonal stressors included limited knowledge regarding the health-disease process and organic changes, such as functional decline and the presence of signs and symptoms. Interpersonal stressors arose from relationships established with family members, healthcare professionals, and other patients. Extrapersonal stressors were related to infrastructure and institutional rules and routines. Conclusion: Hospitalization exposes older adults to various stressors that may compromise the care provided and their well-being. In the presence of these stressors, nurses should act to strengthen lines of defense and develop coping strategies in order to promote the maintenance of well-being and minimize the negative impacts resulting from hospitalization.
References
Barbosa MEM, Silveira AE da, Vieira MCU, Pereira EM, Hamm JR, Andrade GF de, et al. Síndrome da fragilidade e fatores associados em idosos adscritos de uma unidade básica de saúde. Rev Eletrôn Acervo Saúde. 2025;25:e19278. https://doi.org/10.25248/reas.e19278.2025
Morais TSA de, Siquara GM, Magalhães SB de. Intervenções psicológicas na UTI: fluxograma de cuidado para idosos sob estressores. Rev SBPH. 2024;27:e008. https://doi.org/10.57167/Rev-SBPH.v27.590
Baixinho CRSL, Ferreira M de A, Huarcaya SSL. Special issue: aging, aging process and health; active citizenship and sustainable development. Esc Anna. Nery. 2025;29:e2025E002. https://doi.org/10.1590/2177-9465-EAN-2025-E002en
Barros RS, Teixeira GTM, Pinto JM, Sampaio RX, Mendes FAS, Garcia PA. Factors predicting hospital admission and death in older adults with cognitive impairment: a longitudinal study. Texto Contexto Enferm. 2024;3:e202301493. https://doi.org/10.1590/1980-265X-TCE-2023-0149en
Rodrigues JAM, Lenardt MH, Cechinel C, Cruz EDA, Tsunoda AT, Kuznier TP. Hospital admission and the occurrence of delirium in older adults with physical frailty: cross-sectional study. Rev Esc Enferm USP. 2023;57:e20230156. https://doi.org/10.1590/1980-220X-REEUSP-2023-0156en. PMID: 38100603.
Santos NRP, Rabelo DF. Racism and stressful events: narratives of black elders. Ciencias Psi. 2022;16(2):e-2494. https://doi.org/10.22235/cp.v16i2.2494
Neuman B. The Neuman systems model. In: Neuman B, Fawcett J. The Neuman systems model. Upper Saddle River (NJ): Pearson; 2011.
Pestana-Santos M, Santos M da SR, Cabral IE, Sousa PC, Lomba M de LLF. Neuman Systems Model in perioperative nursing care for adolescents with juvenile idiopathic scoliosis. Rev Esc Enferm USP. 2021;55:e03711. https://doi.org/10.1590/S1980-220X2020001703711. PMID: 34190880.
Santos J de C, Arreguy-Senna C, Pinto PF, Paiva EP de, Pereira PM dos SD, Brandão MAG. Home fall of elderly people: implications of stressors and representations in the COVID-19 context. Rev Gaúcha Enferm. 2021;42(esp):e20200221. https://doi.org/10.1590/1983-1447.2021.20200221. PMID: 34037182.
Brito NN de S, Soares SSS, Carvalho EC, Souza DG de, Franco AS, Almeida LF de, et al. Environmental stressors in a cardio-intensive unit and Nursing care planning: a descriptive study. Online Braz J Nurs. 2021;20:e20216539. https://doi.org/10.17665/1676-4285.20216539
Lemos RCPB, Arreguy-Sena C, Melo LD, Brandão MAG, Braga LM, Krempser P. Peripheral venous puncture and contrast in radiological exams: social representations anchored in Neuman’s stressors. Texto Contexto Enferm. 2022;31:e20220030. https://doi.org/10.1590/1980-265X-TCE-2022-0030en
Souza VR dos S, Marziale MHP, Silva GTR, Nascimento PL. Translation and validation into Brazilian Portuguese and assessment of the COREQ checklist. Acta Paul Enferm. 2021;34:eAPE02631. http://dx.doi.org/10.37689/acta-ape/2021AO02631
Folstein MF, Folstein SE, McHugh PR. “Mini-Exame State”. A practical method for grading the cognitive state of patients for the clinicians. J Psychiatr Res. 1975;12(3):189-198. https://doi.org/10.1016/0022-3956(75)90026-6. PMID: 1202204.
Bertolucci PHF, Brucki SMD, Campacci SR, Juliano Y. O mini-exame do estado mental em uma população geral. Impacto da escolaridade. Arq Neuro-Psiquiatr. 1994;52(1):1-7. https://doi.org/10.1590/S0004-282X1994000100001. PMID: 8002795.
Caramelli P, Nitrini R. Como avaliar de forma breve e objetiva o estado mental de um paciente? Rev Assoc Med Bras. 2000;46(4):301. https://doi.org/10.1590/S0104-42302000000400018
Minayo MC de S. Amostragem e saturação em pesquisa qualitativa: consensos e controvérsias. Rev Pesq Qual [Internet]. 2017 [citado 2025 Abr 01];5(7):1-12. Disponível em: https://editora.sepq.org.br/rpq/article/view/82
Trentini M, Paim L, Silva DMGV. Pesquisa Convergente Assistencial: delineamento provocador de mudanças nas práticas de saúde. 3 ed. Porto Alegre: Moriá; 2014.
Conselho Nacional de Saúde (BR). Resolução n. 466, de 12 de dezembro de 2012. Aprovar as seguintes diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos [Internet]. Brasília: Conselho Nacional de Saúde; 2012 [citado 2025 Abr 10]. Disponível em: https://www.gov.br/conselho-nacional-de-saude/pt-br/atos-normativos/resolucoes/2012/resolucao-no-466.pdf/view
Antequera IG, Lopes MCBT, Batista REA, Campanharo CRV, Costa PCP, Okuno MFP. Rastreamento de violência contra pessoas idosas: associação com estresse percebido e sintomas depressivos em idosos hospitalizados. Esc Anna Nery. 2021;25(2):e20200167. https://doi.org/10.1590/2177-9465-EAN-2020-0167
Oliveira SG de, Caldas CP, Nicoli EM, Silva FVC e, Cardoso RB, Lopes FM do VM. Applicability of the Neuman Systems Model to the Gerontology Nursing practice: a scoping review. Rev Latino-Am Enfermagem. 2024;32:e4224. https://doi.org/10.1590/1518-8345.6977.4224. PMID: 39082502.
Simões EPC, Michelin A de F, Bonifácio NA, Sakamoto SR, Ferreira LB, Nascimento G do. Percepção dos pacientes hospitalizados sobre privacidade, exposição e manipulação corporal. Braz J Health Rev. 2023;6(3):10030-10046. https://doi.org/10.34119/bjhrv6n3-132
Hussein Y, Edwards S, Patel HP. Psychological Impact of Hospital Discharge on the Older Person: A Systematic Review. Geriatrics. 2024;9(6):167. https://doi.org/10.3390/geriatrics9060167. PMID: 39727826.
Kalani Z. Patients’ Perception of Stressors in Medical-Surgical Units. J Client Care. 2017;2(1):6-9. https://doi.org/10.15412/J.JCC.02020102
Gerges S, Hallit R, Hallit S. Stressors in hospitalized patients and their associations with mental health outcomes: testing perceived social support and spiritual well-being as moderators. BMC Psychiatry. 2023;23(1):323. https://doi.org/10.1186/s12888-023-04833-6. PMID: 37161403.
Palmer PK, Wehrmeyer K, Florian MP, Raison C, Idler E, Mascaro JS. The prevalence, grouping, and distribution of stressors and their association with anxiety among hospitalized patients. PLoS One. 2021;16(12):e0260921. https://doi.org/10.1371/journal.pone.0260921. PMID: 34871325.
Tajdari S, Irajpour A, Shahriari M, Saghaei M. Identifying the dimensions of patient privacy in intensive care units: a qualitative content analysis study. J Med Ethics Hist Med. 2022;25;15:6. https://doi.org/10.18502/jmehm.v15i6.11048. PMID: 37143512.
Fhon JRS, Sousa EF de, Li W, Silva ARF, Silva LM. Nursing care for hospitalized elderly at the end of life: integrative review. Rev Eletr Enferm. 2022;24:1-14. https://doi.org/10.5216/ree.v24.70169
Pinto VAH, Paiva FS de. “Ah, com certeza iam me dá alta, né…’: autonomia no processo de cuidado em saúde de sujeitos hospitalizados. Physis. 2021;31(3):e310315. https://doi.org/10.1590/S0103-73312021310315
Pereira MM, Rezende KTA, Santos IF, Tonhon SF da R. O processo de hospitalização sob a ótica do paciente. Rev Bras Promoc Saúde. 2020;33:11657. https://doi.org/10.5020/18061230.2020.11657
Frank C, Holmberg M, Jernby EE, Hansen AS, Bremer A. Older patients’ autonomy when cared for at emergency departments. Nurs Ethics. 2022;29(5):1266-1279. https://doi.org/10.1177/09697330221105637. PMID: 35727146.
Just SA, Seethaler M, Sarpeah R, Waßmuth N, Bermpohl F, Brandl EJ. Loneliness in Elderly Inpatients. Psychiatr Q. 2022;93(4):1017-1030. https://doi.org/10.1007/s11126-022-10006-7. PMID: 36350482.
Savage RD, Wu W, Li J, Lawson A, Bronskill SE, Chamberlain SA, et al. Loneliness among older adults in the community during COVID-19: a cross-sectional survey in Canada. BMJ Open. 2021;11(4):e044517. https://doi.org/10.1136/bmjopen-2020-044517. PMID: 33811054.
Tomazela M, Valente SH, Lima MAD da S, Bulgarelli AF, Fabriz LA, Zacharias FCM, et al. Care transition of older adults from hospital to home. Acta Paul Enferm. 2023;36:eAPE00291. https://doi.org/10.37689/acta-ape/2023AO00291
Scheerman K, Klaverweide JS, Meskers CGM, Maier AB. Toward Senior-Friendly Hospitals: An Overview of Programs, Their Elements and Effectiveness in Improving Care. Gerontologia. 2025;71(1):1–12. https://doi.org/10.1159/000540655. PMID: 39317167.
Sá-Serafim RC da N, Silva RPR da, Bú EA do. Representações sociais da hospitalização elaboradas por pacientes crônicos e acompanhantes. Arq Bras Psicol [Internet]. 2021 [citado 2025 Nov 30];73(1):52-69. Disponível em: https://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1809-52672021000100005
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Online Brazilian Journal of Nursing