Constructing Safety at Home: Parents' Experiences of the First Hospital-to-Home Transition in Childhood Cancer.
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Background/Objectives: The first hospital discharge during childhood cancer treatment marks a transition from continuous professional monitoring to greater parental responsibility at home. This study aimed to explore parents' experiences of this hospital-to-home transition and how they sought to establish safety while assuming responsibility for care. Methods: This qualitative study presents a focused analysis of data from a broader grounded theory study conducted according to Corbin and Strauss at a single specialised paediatric oncology centre in Portugal. The broader study included 16 parents recruited through theoretical sampling; the present analysis included 14 participants whose interviews provided substantive accounts of the discharge transition relevant to this analytical category. Data were generated through open interviews and analysed using constant comparison and progressive category development. Results: The first hospital discharge was characterised by relief and renewed family connection alongside uncertainty, perceived vulnerability, and fear of clinical deterioration. Parents sought to construct safety at home through vigilance, environmental adaptation, preventive practices, organisation of complex care, and mobilisation of professional and informal support. Four interrelated subcategories were identified: transitioning beyond professional monitoring, establishing safety at home, assuming responsibility for complex care, and protecting the child while sustaining family life. Conclusions: Safety following discharge was not simply restored by returning home but progressively constructed through parental action, learning, and adaptation. Nursing support should extend beyond technical discharge instruction to include progressive preparation, assessment of parental readiness, development of caregiving competence, accessible nursing guidance, multidisciplinary support, and attention to family conditions influencing sustainable care at home. This study was not registered.