A Study on the Patient Journey Map of Inpatients with Mood Disorders

A Study on the Patient Journey Map of Inpatients with Mood Disorders | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article A Study on the Patient Journey Map of Inpatients with Mood Disorders Shi Wen, Ye Yinyin, Wu Yanling, Chen Lingqing This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7946414/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 17 Mar, 2026 Read the published version in BMC Psychiatry → Version 1 posted 15 You are reading this latest preprint version Abstract Objective To explore the emotional responses, behavioral adaptations, and core needs of inpatients with mood disorders during the admission, hospitalization, and discharge phases, and to construct their inpatient journey map, thereby providing a basis for optimizing psychiatric healthcare services. Methods A qualitative research approach utilizing interpretive phenomenological analysis was adopted. Through purposive sampling, 15 inpatients with mood disorders from a tertiary A-grade psychiatric hospital in Fujian Province were selected for semi-structured interviews. Data were analyzed using Colaizzi's seven-step method, and patient experiences across the three phases were mapped based on the patient journey map framework. Results The study found that the mode of admission (voluntary/involuntary) proved to be decisive for patients' initial emotions and subsequent adaptation. Involuntarily admitted patients commonly experienced intense feelings of trauma, anger, and helplessness. During hospitalization, while patients gained a sense of security within the structured environment, they also faced challenges such as restricted freedom, monotonous activities, and insufficient personalized care. Treatment-related fears and environmental discomfort emerged as significant negative experiences. In the discharge phase, patients commonly expressed widespread concern about relapse, resistance to re-hospitalization, and strong expectations for continuity of support systems.Based on these findings, the study proposes phased intervention recommendations, including optimizing admission communication, enhancing autonomy and humanized experiences during hospitalization, and constructing a seamless "hospital-family-community" continuous care system. Conclusion The patient journey map reveals the dynamic changes in emotions, behaviors, and needs of inpatients with mood disorders throughout their healthcare journey. It suggests that psychiatric services should shift from a "disease-centered" to a "patient-centered" approach, improving patient treatment experience and rehabilitation quality through holistic, continuous, and emotionally-attuned integrated care. Mood Disorders Patient Journey Map Inpatient Experience Qualitative Research Figures Figure 1 Introduction Mood disorders (including bipolar disorder and depressive disorders), also known as affective disorders, are a common category of mental illnesses characterized by high prevalence, high recurrence rate, and high disability rates, exerting profound impacts on patients' personal functioning, family relationships, and social participation [1][2]. Inpatient treatment serves as a crucial means for acute-phase intervention and severe case management. However, traditional psychiatric services often focus predominantly on controlling affective symptoms, administering pharmacotherapy, and managing the heavy burden on healthcare resources, paying insufficient attention to patients' subjective experiences, emotional changes, and diverse needs throughout the entire hospitalization process [3]. In recent years, the patient-centered care concept has gradually gained prominence, emphasizing that healthcare processes should fully respect patients' feelings and rights [4]. The Patient Journey Map, as a visual research tool, helps identify service gaps and optimize service design by systematically mapping patients' key touchpoints, emotional fluctuations, and core needs during their healthcare journey, thereby enhancing the healthcare experience [5]. Currently, this tool has been widely applied in the field of somatic diseases, but systematic research within mental health, particularly targeting inpatients with mood disorders, remains relatively scarce. Therefore, this study aims to employ qualitative research methods to construct the patient journey map for inpatients with mood disorders, conducting an in-depth analysis of their emotional responses, behavioral adaptations, and evolving needs during the admission, hospitalization, and discharge phases. The findings are intended to provide empirical evidence for healthcare institutions to develop more humanized, refined, and continuous psychiatric services, ultimately enhancing patient treatment adherence, rehabilitation quality, and quality of life. 1. Research Objects and Methods 1.1 Research Objects This study employed a purposive sampling method. Between December 2024 and May 2025, participants were recruited from the inpatient wards of a tertiary A-grade psychiatric hospital in Fujian Province. Included patients with mood disorders met all the following criteria: (1) a confirmed diagnosis of bipolar disorder or depressive disorder according to ICD-10 criteria; (2) age between 18 and 60 years; (3) a length of hospitalization lasting two weeks or more; (4) basic language communication skills; (5) availability to complete the interview within the three days prior to discharge; (6) no family members accompanying them during the hospitalization period; and (7) voluntary provision of informed consent. To ensure research quality, patients were excluded if they: (1) had significant memory impairment or confabulation; (2) were scheduled to remain hospitalized for more than 72 hours post-interview; or (3) were unable to clearly recall their specific experiences during hospitalization. Sample size was determined based on the principle of theoretical saturation, whereby data collection and analysis continued until no new themes emerged, resulting in the inclusion of 15 patients. Among these participants, 3 were male and 12 were female. Regarding educational background, 6 had college or undergraduate degrees or above, 6 had junior high or high school education, and 3 had primary school education or below. In terms of occupation, 2 were students, 9 were unemployed, and 4 had other occupations. Concerning disease type, 6 had bipolar disorder and 9 had depressive disorder; 4 were experiencing their first hospitalization, while 11 had previous hospitalization experiences. (Detailed information is presented in Table 1 ). 1.2 Research Methods This study adopted a qualitative research approach using Interpretative Phenomenological Analysis (IPA) [ 6 ], conducting face-to-face, semi-structured interviews to gain an in-depth understanding of patients' subjective experiences during hospitalization. 1.2.1 Interview Guide Design : Based on the theoretical framework of the Patient Journey Map, a semi-structured interview guide was developed focusing on the three phases of admission, hospitalization, and discharge, with particular attention to patients' experiences in terms of emotional responses, behavioral adaptations, and evolving needs. Prior to the formal interviews, pre-tests were conducted with 3 patients to assess the logical flow of questions and the clarity of language. After internal research team discussion and revision, the final interview guide was established (see Appendix 1). Example interview questions included: "How did you feel when going through the admission procedure?", "What were your experiences during the hospitalization?", and "What are your expectations or needs regarding home-based treatment after discharge?". 1.2.2 Data Collection and Analysis : Interviews were conducted in a private room, with each session lasting between 15 and 40 minutes. The interviews were audio-recorded, and participants' non-verbal behaviors were documented simultaneously. To ensure data accuracy, before each interview, the researcher explained the study purpose, interview duration, confidentiality principles, and the necessity of recording in detail. Formal interviews commenced only after participants signed the informed consent form. During the interviews, the researcher clarified ambiguous statements through paraphrasing and probing questions, and flexibly adjusted the question sequence based on the flow of conversation until information saturation was approached. Within 24 hours post-interview, the transcribed text was returned to the respective participant for content verification. All audio materials were anonymized and sequentially coded as P1 to P15. This study strictly adhered to the principle of voluntariness. All participants were informed that they could withdraw unconditionally at any stage without affecting their medical care. Considering that the interview content might evoke emotional responses, the research team had a senior psychotherapist on standby to provide necessary psychological support if needed. During the data analysis phase, Colaizzi's seven-step phenomenological analysis method [ 7 ] was employed, and the Nvivo 11.0 software was used to assist with coding and data management. 2. Results 2.1 General Information of the Research Subjects No. Age Gender Education Level Occupation Marital Status Diagnosis First Admission P1 30 Female Junior High School Freelance Married Bipolar disorder, current episode manic with psychotic features No P2 20 Female Junior High School Freelance Unmarried Severe depressive episode with psychotic symptoms No P3 55 Male Primary School Unemployed Married Bipolar disorder, current episode manic without psychotic features No P4 60 Female Primary School Unemployed Married Recurrent depressive disorder, current episode moderate with somatic symptoms No P5 29 Female College Unemployed Married Bipolar disorder, current episode manic with psychotic features Yes P6 19 Female University Student Unmarried Severe depressive episode with psychotic symptoms No P7 25 Female Undergraduate Unemployed Unmarried Severe depressive episode with psychotic symptoms Yes P8 48 Male Primary School Unemployed Married Bipolar disorder, current episode depressed without psychotic features No P9 59 Female High School Unemployed Married Severe depressive episode without psychotic symptoms Yes P10 20 Female College Student Unmarried Severe depressive episode with psychotic symptoms No P11 44 Female College Unemployed Married Recurrent depressive disorder, current episode severe with psychotic symptoms No P12 38 Female High School Freelance Married Bipolar disorder, current episode manic without psychotic features No P13 38 Male Junior High School Unemployed Married Bipolar disorder, current episode manic with psychotic features No P14 18 Female High School Unemployed Unmarried Moderate depressive episode without somatic symptoms Yes P15 53 Female College Professional/Technical Divorced Recurrent depressive disorder, current episode severe without psychotic symptoms No Table 1: General Information of the Participants (n=15) 2.2 Construction of the Inpatient Journey Map The Patient Journey Map constructed in this study (Figure 1) visually displays the complete process for patients from admission to discharge. It encompasses the key touchpoints, dominant emotions, typical behaviors, and core needs at each stage, revealing the peaks and troughs of their experience. 2.3 Thematic Analysis of Emotions, Behaviors, and Needs Across Three Phases 2.3.1 Phase One: Admission Period 1. Emotional Responses (1) Touchpoint: Hope and Acceptance Relief from Active Help-Seeking: Patients who voluntarily sought admission, hoping to escape distress, obtain a clear diagnosis, or meet family expectations, experienced a sense of hope. P9: "I needed to be hospitalized because without it, I felt like life wasn't worth living." P10: "I needed a confirmed diagnosis." P11: "Hospitalization was a way to seek a solution to the difficulties in my life." Being Understood and Soothed: When medical staff showed concern for the patient's discomfort during admission, it helped alleviate their fear. P1: "The doctors and nurses said... 'We need to cut this tape off first'... they understood my difficulty." Rational Acceptance Based on Familial Affection/Previous Experience: Patients calmly accepted admission out of love/feelings of indebtedness towards family members or due to previous hospitalization experiences. P8: "(My daughter brought me)... I always feel I dote on my daughter... felt I owed her a little." P15: "(For my son's peace of mind)... I'll respect his wish... after considering everything." P3: "My wife did the right thing by insisting I come in for treatment." (2) Pain Point: Fear, Anger, and Helplessness Trauma from Deception and Coercion: Patients felt anger, fear, and helplessness when they were tricked into admission under pretenses (e.g., "physical examination") or forcibly brought in by police/family members. P4: "(I thought it was for a check-up)... Then I ran... they caught me and brought me in... they restrained me." P7: "(They took me away as soon as I woke up)... No warning at all... I was very tense then... scared." P12: "(My family said it was a check-up)... When I reached the door, I said 'Why are we here?'... I was done for... I just had to go in." P14: "It wasn't voluntary... I was dragged in later... I kept crying." Confusion from Lack of Information: Unfamiliarity with the reasons for admission, the procedures, and the hospital environment exacerbated feelings of uncertainty and anxiety. P2: "(I have) no memory of (the admission process)." P7: "(They) didn't explain anything to me... I didn't know where they were taking me... I was scared then." 2. Behavioral Adaptation (1) Touchpoint: Voluntary Cooperation and Effective Communication Voluntary Admission through Negotiation/Support: Patients voluntarily admitted themselves after discussing with family or while accompanied by relatives/friends. P2: "(My mom and I) agreed that I should come in." P8: "(My daughter brought me)... I was willing to come." P9: "(My best friend's husband, brother, and sister all came to see me off)... I came voluntarily... my mood was still quite good." Cooperation Based on Clear Understanding: Patients actively cooperated because they had insight into their own problems or trusted the hospital. P3: "(After breaking things, I felt)... that this was very wrong." P11: "(The hospital is proper and conveniently located)... I was confident that it could meet my needs." (2) Pain Point: Resistance and Passive Compliance Intense Behavioral Resistance: Manifested as direct opposition like crying, making a scene, running away, or throwing objects. P1: "(During admission) I cried hysterically... I threw the cup on the ground." P4: "(During the admission procedures) I ran... they caught me and brought me in... they restrained me." P7: "(At that time) I made a scene... I didn't want to go." Passive Acceptance and Emotional Detachment: While not showing intense resistance, patients behaved passively, were emotionally withdrawn, or avoided reality through activities like playing on their phones. P5: "(My younger brother brought me)... Had no choice but to accept it... didn't have any particular emotions." P10: "(During the admission procedures)... I'll play on my phone for a bit first." P13: "(Brought in by 110 police)... Since they caught me and brought me in, fine, I'll come in... I'll cooperate." P14: "(After being dragged in)... I didn't have any (thoughts)... I just kept crying." 3. Evolving Needs (1) Touchpoint: Safety, Information, and Respect Need for Safety and Symptom Control: Hoping that hospitalization would quickly control symptoms and ensure safety. P1: "(I hope to) recover." P3: "(Hospitalization is for) treatment... If I just took medication at home, it would relapse." P4: "(I hope to) get better and not have a relapse again." Need for Transparent Information and Informed Consent: Required to be informed in advance and given adequate explanation regarding the reasons for admission and procedures. P5: "(The reason I was unwilling was that) nobody told me in advance... I wasn't prepared." P6: "(I was angry because) they told me I'd be in a semi-closed ward, but it turned out to be a fully closed one... I felt a bit deceived." P7: "(I wished) they had explained things to me." Need for Respect and Family Support: Desired that the decision for admission be respected and to receive family understanding and companionship. P8: "(I listened to my daughter)... I always feel I owe her something." P9: "(After hospitalization) my husband also knew I had this illness... he understood too." P15: "(For my son to feel reassured about working abroad)... I respect his decision... to set his mind at ease." (2) Pain Point: Loss of Autonomy and Communication Breakdown Loss of Autonomy in Decision-Making: Felt their personal wishes were completely ignored due to involuntary or deceptive admission. P1: "I didn't want to be hospitalized." P4: "(I was tricked)... and then I was hospitalized." P7: "(I was taken away as soon as I woke up)... No warning at all." P12: "(Tricked into coming for a 'check-up')... I was done for... I just had to be hospitalized." Impaired Need for Immediate Family Communication: The need to communicate with family initially to understand the situation was unmet. P7: "(I asked my mom in the car)... She didn't respond to me... didn't answer me." 2.3.2 Phase Two: Hospitalization Period 1. Emotional Responses (1) Touchpoint: Comfort, Growth, and Connection Environmental Comfort and Mental Peace: Acknowledged the hospital environment as comfortable and the schedule as reasonable, leading to feelings of calmness. P1: "The environment here is very comfortable... very reasonable." P3: "(The environment) is much better than over there." P6: "(The environment) is quite clean... acceptable." P8: "My mood settled down a bit... quieter, more peaceful." Emotional Stability and Positive Shift: Through treatment, emotions shifted from anxiety and low mood towards stability and happiness, gaining a sense of achievement. P6: "From initial anger to compromise... to now being relatively calm... my condition is also getting better and better." P9: "Mood changed from initial anxiety to current happiness... basically cured." P11: "Mood is okay... quite happy." Feeling Cared For and Sense of Belonging: Felt warmth, care, and support from interactions with medical staff and fellow patients. P6: "(The nurses) are all very patient... quite gentle... very responsible." P9: "(The nurses) did a very good job with details like feeding... moved us." P12: "(I'm grateful to my husband for) bringing me in early... I'm also very grateful to him." P15: "(The nurses') smiles... gave me great comfort... like family." (2) Pain Point: Distress, Fluctuation, and Suppression Distress and Fear Related to Treatment: Experienced fear, painful memories, or psychological shadows regarding treatments like electroacupuncture and MECT. P1: "The electroacupuncture was so intense I was a bit stunned... couldn't help but cry hysterically during the last session." P2: "(Electroacupuncture) generated some negative emotions... left a psychological shadow." P10: "(Seeing others receive electroacupuncture) the way they screamed in agony... left a deep impression." P12: "(MECT) was so painful." Boredom and Irritability from Restricted Freedom: Experienced intense boredom, irritability, and feelings of suppression due to closed management, limited activities, and inability to access nature. P5: "(The downside is) lack of freedom... unable to adjust things according to my own needs." P7: "(The downside is) boredom... not knowing what to do every day." P10: "(Feel) very uncomfortable being locked up all the time... bored... confined." P14: "(Feel) a bit bored." Environmental Distress and Emotional Fluctuations: Emotional states were affected by witnessing disordered behaviors of other patients or due to their own illness fluctuations. P2: "(When I first came in) seeing... all the wailing and howling... my illness was instantly 'cured'... I wanted to get out even more." P7: "My mood is sometimes good, sometimes bad... sometimes my mind wanders to unwanted thoughts." P9: "(When I first came in) seeing them scream and shout... my heart was pounding." 2. Behavioral Adaptation (1) Touchpoint: Active Participation and Integration Engagement in Rehabilitation Activities: Actively participated in occupational and recreational therapy (e.g., singing, crafts, card games) and benefited from them. P1: "(I like) singing, listening to music... doing flower arranging." P2: "(Playing cards) is fun... teasing the other patients." P6: "(Playing cards, making friends) can add a little fun to life." P13: "(Playing cards) Everyone feels very united." Establishing Ward Social Networks: Communicated with, helped, and built friendships with fellow patients, gaining emotional support. P2: "(What I gained) I made a group of friends." P6: "(Getting along with other patients) Made quite a few friends... patiently responding to them." P12: "(Among patients) we increased mutual understanding... felt very warm." Treatment Compliance and Self-Management: Adhered to ward rules, cooperated with treatment, and proactively took on some ward chores. P3: "(I think the) rules are good... it needs to be this strict, without it patients wouldn't do well." P4: "(After restraints were removed) If there's work, I do a bit... sweeping the beds, making the beds." P9: "(Could describe clearly) On the fifth day... the medication was increased... later it was slowly reduced." (2) Pain Point: Maladaptation and Negative Interactions Resistance to Institutionalized Management: Described the uniform management as "herding pigs" or "shepherding sheep," expressing discomfort with the loss of personalized daily rhythms. P2: "(Feel) like raising pigs every day... herded here and there." P5: "(Hospitalization) is exactly the same for everyone... all have to follow the hospital rules." P10: "(You staff) are like a bunch of sheepdogs, herding us around." Selective Participation or Withdrawal: Lack of interest in organized activities led to non-participation, exacerbating feelings of boredom. P7: "(Exercise, crafts) I didn't participate in any... not interested." P14: "(Experience) None... none at all... (activities) none." Impact of Negative Peer Interactions: Were disturbed by the verbal or behavioral actions of specific patients. P2: "(A few patients) their mouths are really nasty... they say some bad things." P7: "(Some patients) have very loud voices." 3. Evolving Needs (1) Touchpoint: Personalized Care and Rehabilitation Support Need for Personalized Living and Diet: Desired more variety in food, better taste, and some flexibility in daily schedules. P1: "(Suggestion) Don't always have rice every day... could cook some noodles sometimes." P5: "(The food) is not great... the cooking methods aren't good." P7: "(Hope) I could adjust my sleep schedule myself." P12: "(Lunch and dinner) Really not tasty... could be improved a bit." Need for Diverse Recreation and Activities: Craved more varied and abundant recreational activities, especially outdoor ones. P6: "(In the evening) Hope they could add some other activities... the time is just too long." P7: "(Recreational activities) Too few... (want to) run, hike, take photos." P10: "(Hope) Could go for a walk outside in an open space... breathe fresh air." P15: "(I see) There are also many activities... mahjong, cards, dancing, exercise." Need for In-Depth Communication and Emotional Support: Required more communication time, emotional support, and personalized attention from medical staff. P7: "(Suggestion) Nurses usually spend relatively little time communicating with patients... should chat more often." P13: "(Reported) I've been here so long and no one has talked to me." P15: "(Grateful) Your smile... like family... very caring and protective." Need for Environmental Comfort and Privacy: Needed a clean, tidy living environment and a sleep space free from disturbance. P11: "(Dissatisfied) Hygiene... the bathroom... the toilet often gets clogged." P12: "(Suggestion) Put those who snore together... otherwise they disturb others' rest." P15: "(Applied for a bed change due to poor sleep)... they arranged it for us... very thankful." (2) Pain Point: Unmet Basic Needs Core Lack of Freedom and Autonomy: Strict restrictions on movement, schedule, and communication freedom were the most significant source of distress. Strongly reflected in the accounts of P1, P2, P5, P7, P10, P14, etc. Insufficient Basic Living Amenities: Issues like poor bathroom hygiene, clogged toilets, and shortages of daily necessities significantly impacted the experience. P11: "(The bathroom) toilet often clogs... it's still clogged now." P13: "(The bathroom) is very smelly... a bit clogged... toilet paper... not enough... toilets aren't open enough." Anxiety from Unclear Information: Lack of clarity regarding treatment plans or discharge dates caused suffering and uncertainty. P6: "(Asked doctors about discharge date) They all said it's not certain... it's really agonizing." P10: "(The doctors) are vague... (discharge date) it's all 'not certain'." 2.3.3 Phase Three: Discharge Period 1. Emotional Responses (1) Touchpoint: Joy, Gratitude, and Anticipation Happiness and Relief upon Regaining Freedom: Felt very happy about discharge and looked forward to returning to family and society. P2: "(Upon receiving the news) Very happy... grinned from ear to ear." P3: "(The doctor said this morning) My mood suddenly, suddenly became happy." P5: "(Upon receiving the news) Very happy." P10: "(Upon receiving the news) Happy ah... finally leaving this awful place." Gratitude and Positive Reflection: Felt grateful for the care from medical staff and held a more positive attitude towards the future. P9: "(Felt) they saved my life... very thankful." P12: "(Felt) Grateful for heaven's arrangement in all things... holding a grateful heart." P15: "(Felt) Very grateful to the doctors and nurses... very grateful to have met everyone." Calmness and Rational Restraint: Emotional response was muted; maintained an even-keeled attitude to avoid disappointment from unmet high expectations. P1: "(Upon receiving the news) Very calm... no particular anticipation... because I know this feeling (disappointment from unmet expectations is disheartening)." (2) Pain Point: Worry and Complex Emotions Fear of Relapse and Resistance to Re-hospitalization: Alongside happiness, worried about disease relapse and expressed resistance to being hospitalized again. P7: "(If I relapse) I actually don't want, don't want to go again... I hope my mood remains stable." P10: "(If I relapse) I wouldn't be willing... mainly because... I hate the closed ward." P14: "(If I relapse) Not really keen (on hospitalization)." P15: "(If I relapse) Still willing... but I'll try my best not to... it would affect him (son)." Indirect Stressors from Hospitalization: Worried about the impact of hospitalization on work, income, and family. P11: "(Hospitalization) Affects my work, I have to ask for leave again... lost my performance bonus." P15: "(Hospitalization) Affected my children quite a bit... he doesn't want me hospitalized." 2. Behavioral Adaptation (1) Touchpoint: Planning for Return and Active Management Plans for Medication Adherence: Clearly stated intentions to adhere to medication schedules after discharge. P3: "(After discharge) Definitely need to take medication at home." P8: "(After discharge) Properly... take medication." P9: "(After discharge) Take medication on time... take the medicine as prescribed by the doctor." P11: "(After discharge) Persist with medication."; P13: "(After discharge) Take medication on time at home." Building/Utilizing Support Systems: Planned to seek support from family, friends, or school, and to utilize outpatient resources. P6: "(If feeling unwell) Will talk to my friend."; P8: "(If having problems) Listen to my family." P10: "(The school) counselor will specially assign me a room." P15: "(If having problems) Promptly go to the outpatient clinic to see the doctor." Positive Lifestyle Adjustments: Planned to adjust routines, cultivate hobbies, return to work, applying gains from hospitalization. P3: "(After discharge) Continue selling pork to earn money." P8: "(After discharge) Continue delivering takeout." P11: "(After discharge) Do what I am capable of... gradually add swimming and running." P12: "(After discharge) Money that should be spent, still needs to be spent." (2) Pain Point: Passivity and Avoidance Lack of Concrete Future Plans: Appeared passive, with no clear thoughts or needs regarding post-discharge treatment and life. P5: "(Needs after discharge) None."; P14: "(Needs after discharge) None at all." Potential Risk Behaviors: Mentioned potentially using methods like alcohol to relieve stress, indicating risk. P2: "(After returning home) When I'm very tired, I will... drink some alcohol... relax a bit." 3. Evolving Needs (1) Touchpoint: Continuity of Support and System Linkage Ongoing Professional Medical Support: Needed clear medication guidance, accessible outpatient follow-up, and consultation channels. P1: "(For pregnancy planning) Tell the doctor during the outpatient visit... listen to the doctor's professional opinion." P3: "(After discharge) Need to take medication... listen to the doctor."; P9: "(After discharge) Will definitely follow up at the outpatient clinic." P11: "(If unwell) Can seek medical attention promptly."; P15: "(After discharge) Must persist with medication." Family and Social Understanding: Urgently needed more understanding, tolerance, and support from family after discharge. P11: "(Hope) family members can... understand and 包容 me more." P15: "(Worried about) affecting my child... (hope) try my best not to (relapse)." Social Reintegration and Value Fulfillment: Eager to regain work capacity, resume family roles, and achieve self-worth. P3: "(After discharge) Feel I can still continue working and earning money." P4: "(After discharge) Go back to live with my grandchildren." P9: "(After discharge) Do what I am capable of, look after my little grandchildren." P15: "(After discharge) Return to work." Relapse Prevention and Early Intervention: Acknowledged the concept of "solving small problems in outpatient care," needing to establish relapse prevention awareness and action plans. P7: "(Hope) small problems can be solved in outpatient care, so I don't have to be hospitalized again." P11: "(If minor problems arise) Promptly go to the outpatient clinic to see the doctor... don't delay." P15: "(After discharge) Persist with medication... (avoid) affecting my children." (2) Pain Point: Fragile Support Systems and Uncertainty Concerns about Adequacy of Family Support: Uncertain about receiving sustained family understanding and support after discharge. P11: "(Hope) family members can... understand me more." Fear of the "Outpatient-Hospitalization" Transition: Due to negative hospitalization experiences, strongly desired to avoid re-hospitalization, shifting pressure onto outpatient care. P7: "(Don't want to be hospitalized again) Because... it's even more boring... cut off from the outside world." P10: "(Don't want to be hospitalized again) Because... I hate the closed ward... too many people." P14: "(Don't want to be hospitalized again)... I'll try my best not to get sick." 2.4 Intervention Recommendations 2.4.1 Phase One: Admission Period Intervention Recommendations Core Objective: Transform "Passivity and Fear" into "Informed Collaboration". Trauma from Deception and Coercion: Establish a standardized, humane admission communication protocol: For involuntarily admitted patients, the initial contact should be made by specially trained medical staff or social workers who provide an honest, empathetic explanation of the legal basis, necessity, and preliminary treatment goals for admission, replacing simple coercion or deception [8]. Avoid using stimulating words like "caught" or "restrained" in front of patients. Implement an "admission buffer period" or "observation area": Where conditions allow, let patients stay briefly in a supervised open area, accompanied by family or a trusted person, for preliminary communication and reassurance, mitigating the direct shock of being sent to a closed ward. Confusion from Lack of Information: Provide an "Admission Guide" information package: Create illustrated, easy-to-understand booklets or leaflets covering: ward environment introduction, daily schedule, main treatment programs, patient rights and responsibilities, and communication/channels for seeking help (e.g., attending physician, primary nurse, psychological therapist) [9]. Distribute and briefly explain this during the admission process. Implement a "Dedicated Nurse Responsibility System on the First Day": Upon admission, the primary nurse must conduct an in-depth introduction on the first day, guide the patient through the environment, and clearly state "you can come to me with any questions," establishing initial trust. Sense of Lost Autonomy: Grant limited choices where safe: In the early admission phase, offer patients inconsequential choices, such as "Would you prefer a bed by the window or the door?" or "Here is our menu, are there any foods you particularly dislike or are allergic to?" This conveys respect and restores a sense of control. Introduce synchronous family education: Briefly communicate with the family members who brought the patient, explaining the long-term negative impacts of deception and coercion, and encourage them to align with medical staff in subsequent communications, adopting a more cooperative and honest attitude. 2.4.2 Phase Two: Hospitalization Period Intervention Recommendations Core Objective: Maximize patient "Autonomy and Humanized Experience" while ensuring treatment and safety. Boredom and Irritability from Restricted Freedom: Design and implement "Personalized Activity Prescriptions": Based on assessment of the patient's condition and interests, tailor recommendations for occupational and recreational therapy activities, rather than enforcing mandatory "one-size-fits-all" participation. For patients reluctant to join group activities, provide rich individual resources like books, art supplies, music players, etc. [10]. Create spaces and times that "simulate the external environment": With strict security measures, regularly organize activities for patients in outdoor areas like hospital gardens or rooftops ("to breathe fresh air") [11]. Optimize the indoor environment using nature murals, adding plants, or creating sunrooms with outdoor views. Introduce structured "Free Choice Time": Incorporate fixed 1-2 hour periods into the daily schedule, allowing patients to freely choose among rest, reading, socializing, or permitted individual activities within common areas, reducing the passive feeling of "being herded." Distress and Fear Related to Treatment: Enhance pre-treatment informed consent and psychological preparation: Before treatments like MECT that may cause discomfort, the treatment team should use models, videos, or plain language to explain the procedure, potential sensations, purpose, and safety in detail, fully addressing patient concerns and managing expectations. Optimize comfort measures during treatment: Employ necessary analgesic and soothing measures during procedures. Allow patients to bring comfort objects (e.g., a small stuffed animal) or be accompanied by trusted medical staff to reduce fear. Provide timely follow-up after treatment to address any adverse reactions. Insufficient Basic Living Amenities and Environmental Discomfort: Establish an "Environmental Quality Rapid Response Team": Create clear channels for reporting repairs and feedback. Commit to, and actually deliver, quick responses and solutions for issues like toilet blockages, bad odors, and noise. Conduct regular patient satisfaction surveys on environmental hygiene. Implement a "Sleep-Friendly Initiative": Concentrate patients who snore severely in specific areas and provide sleep aids like earplugs. Establish a quiet pre-sleep routine, such as dimming lights and playing soft music, to create a conducive sleep environment. Lack of In-Depth Communication and Emotional Support: Implement "Structured Doctor-Patient Communication Time": Beyond daily ward rounds, schedule fixed, no less than 15-minute sessions weekly for each patient with their attending physician or psychological therapist for in-depth communication, ensuring ample opportunity to express confusion and needs. Launch a "Peer Support" program: Train and organize well-recovered former patients as volunteers to communicate with new patients as "peers," sharing experiences and providing emotional support to reduce loneliness [12]. 2.4.3 Phase Three: Discharge Period Intervention Recommendations Core Objective: Build a "seamlessly connected" continuous care system to reduce relapse and rehospitalization rates. Fear of Relapse and Resistance to Re-hospitalization: Develop and explain an "Individualized Relapse Prevention Plan": Before discharge, collaborate with the patient and family to create this plan, clearly identifying early warning signs, specific steps to take when they occur (e.g., who to contact, when to follow up), and crisis resources. This fosters a sense of preparedness and enhances self-efficacy. Conduct "pre-discharge scenario simulation": Use role-playing to simulate stressful situations the patient might encounter after discharge (e.g., family conflict, work pressure), jointly practicing how to apply learned skills to cope without requiring hospitalization. Fragile Support Systems and Uncertainty: Establish a "Discharge Planning Team": 1-2 weeks before discharge, convene a discharge planning meeting involving doctors, nurses, social workers, family (and community workers if necessary) to ensure arrangements for medication, follow-up, community resources, and family support are in place. Provide "Proactive Transitional Follow-up": During the critical first week and first month post-discharge, the hospital should proactively conduct phone or video follow-ups to understand the patient's adaptation, answer questions, and reinforce medication adherence, rather than passively waiting for the patient to seek help. Conduct "Family Empowerment Education": Offer lectures or workshops for families, educating them on how to be effective supporters, including recognizing relapse signs, communication skills, and stress management, alleviating family helplessness and patient guilt [13]. Indirect Stressors from Hospitalization (Work/Income): Provide medical documentation support: Timely and standardize the issuance of diagnostic and hospitalization certificates for patients needing sick leave, and, where possible, include medically descriptive language that supports the patient's rights and interests. Link to social resources: The hospital's medical social workers should be knowledgeable and able to provide information on relevant social welfare, charitable assistance, or legal aid to help patients alleviate economic and employment pressures arising from the illness. 3. Conclusion This study, utilizing interpretive phenomenological analysis, systematically delineated the complete inpatient journey of individuals with mood disorders from admission to discharge, revealing their emotional fluctuations, behavioral strategies, and core needs across three distinct phases. The research found that the mode of admission (voluntary/involuntary) decisively influences patients' initial emotions and subsequent adaptation. Involuntarily admitted patients commonly experienced intense feelings of trauma, anger, and helplessness, closely linked to the loss of autonomy and lack of information. This underscores the need for fundamental improvements in admission communication, procedural transparency, and respect for patient rights within healthcare institutions. During hospitalization, while the structured environment provided patients with a sense of security and symptom control, they also commonly encountered challenges including restricted freedom, monotonous routines, and inadequate personalized care. Furthermore, treatment-related fears–such as those associated with MECT and electroacupuncture—along with environmental discomforts like poor sanitation and sleep disturbances, constituted significant sources of negative experiences. These findings highlight the need for psychiatric inpatient services to place greater emphasis on patients’ psychological well-being and humanized care demands, without compromising medical safety. Implementing strategies such as personalized activity plans, environmental enhancements, and structured in-depth communication mechanisms is essential to strengthen patients’ sense of autonomy and active engagement in their treatment. The discharge period, serving as a transition from hospital to home, was generally characterized by patient concerns about relapse and resistance to re-hospitalization, coupled with strong expectations for continuous support systems (e.g., family understanding, outpatient linkage, community resources). The findings of this study support the construction of an integrated "hospital-family-community" service model. By developing individualized relapse prevention plans, conducting proactive follow-up, and providing family empowerment education, patients can be assisted in achieving a smooth transition from hospital to home, thereby reducing the risk of rehospitalization. This study not only presents findings but also demonstrates the strong potential of the "Patient Journey Map" as a methodological tool. It translates the abstract concept of "patient-centeredness" into specific, identifiable, and improvable service touchpoints and emotional fluctuations through a visual and systematic approach. The journey map constructed in this study, along with the phased intervention recommendations derived from it, provides healthcare institutions with a clear, evidence-based "roadmap" for service optimization grounded in patient experience. It signifies a shift in service design thinking: from isolated, professionally-assumed process management towards holistic journey management based on authentic patient experiences. In conclusion, the patient journey map represents more than a methodological tool; it is a conceptual framework for service optimization and practical implementation. The future of psychiatric services lies in moving beyond the singular aim of "disease treatment" to embrace a form of integrated care that is holistic, continuous, and responsive to emotional needs. Through a dedicated focus on optimizing the patient journey, healthcare institutions can effect a fundamental transformation from a "disease-centered" to a "patient-centered" approach, ultimately improving treatment adherence, rehabilitation quality, and patient well-being.The findings and intervention recommendations of this study should be considered within the specific context of China's healthcare culture and system. Future research could explore the transferability of this patient journey map to other cultural and healthcare settings. Abbreviations Not applicable. Declarations Ethics approval and consent to participate Clinical trial number: not applicable. This study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of the Neurological and Psychiatric Prevention and Treatment Hospital, Fuzhou Second General Hospital (Approval No.: 2024-53; Date of Approval: October 28, 2024). Written informed consent was obtained from all individual participants included in the study. Consent for publication Not applicable. Availability of data and materials The datasets generated and/or analysed during the current study are not publicly available due to the sensitive nature of the qualitative interview transcripts and to protect participant confidentiality but are available from the corresponding author on reasonable request. Competing Interests The authors declare that they have no competing interests. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Authors' contributions Shi Wen contributed to the study conception, design, data collection, analysis, and manuscript writing. Ye Yinyin, Wu Yanling, and Chen Lingqing contributed to data collection, analysis, and critical revision of the manuscript. All authors read and approved the final manuscript. Acknowledgements Not applicable. References Eggleston K, Flemming K, Clark LV. (2025). Experiences of functioning in mood disorders: A systematic review and qualitative meta-synthesis. J Psychiatr Ment Health Nurs. Online ahead of print. Huang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J, Wu Y. Prevalence of mental disorders in China: A cross-sectional epidemiological study. Lancet Psychiatry. 2019;6(3):211–24. Xu F, Cheng P, Xu J, Yu Y, Zhang M, Li M, Chen Y. Influencing factors of length of stay among repeatedly hospitalized patients with mood disorders: A longitudinal study in China. Ann Gen Psychiatry. 2024;23(1):15. Abid MH, Bhavsar V, Kulkarni K, Kulkarni A, Satone P, Kadhe G, Mane A. Patient-centered healthcare: From patient experience to human experience. Global J Qual Saf Healthc. 2024;7(4):144–8. Simonse L, Albayrak A, Starre S. Patient journey method for integrated service design. Des Health. 2019;3(1):82–97. Smith JA, Osborn M. Interpretative phenomenological analysis as a useful methodology for research on the lived experience of pain. Br J Pain. 2015;9(1):41–2. Colaizzi PF. Psychological research as the phenomenologist views it. In: Valle RS, King M, editors. Existential-phenomenological alternatives for psychology. Oxford University Press; 1978. pp. 48–71. Sanz-Osorio MT, Soler-Martín C, García-Sánchez A, Pujol-Tuset M, Moya-Faz FJ, Castro-Sauras A. Humanization of care in acute psychiatric hospitalization units: A scoping review. J Psychiatr Ment Health Nurs. 2023;30(2):162–81. Schladitz K, Bär J, Bär I, Dams J, Gierschner S, Petermann A, Pfennig A. Demands on health information and clinical practice guidelines for patients from the perspective of adults with mental illness and family members: A qualitative study with in-depth interviews. Int J Environ Res Public Health. 2022;19(21):14262. Foye U, Simpson A, Jesper D, Stanyon M, Kwiecinska M, Stroud J, Pollock K. Activities on acute mental health inpatient wards: A narrative synthesis of the service users’ perspective. J Psychiatr Ment Health Nurs. 2020;27(4):482–93. Hjort M, Kjaer SB, Eplov LF, Petersen LS. The importance of the outdoor environment for the recovery of psychiatric patients: A scoping review. Int J Environ Res Public Health. 2023;20(3):2240. Lyons N, Cooper C, Lloyd-Evans B. A systematic review and meta-analysis of group peer support interventions for people experiencing mental health conditions. BMC Psychiatry. 2021;21(1):315. Arifin M, Budiarto E. (2022). Family empowerment as an effort to increase family independence in caring for clients with mental disorders at home: A literature review. In 3rd Borobudur International Symposium on Humanities and Social Science 2021 (BIS-HSS 2021) (pp. 500–504). Atlantis Press. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 17 Mar, 2026 Read the published version in BMC Psychiatry → Version 1 posted Editorial decision: Revision requested 21 Jan, 2026 Reviews received at journal 29 Dec, 2025 Reviews received at journal 26 Dec, 2025 Reviews received at journal 25 Dec, 2025 Reviews received at journal 22 Dec, 2025 Reviewers agreed at journal 21 Dec, 2025 Reviewers agreed at journal 18 Dec, 2025 Reviewers agreed at journal 17 Dec, 2025 Reviewers agreed at journal 17 Dec, 2025 Reviewers agreed at journal 16 Dec, 2025 Reviewers invited by journal 09 Dec, 2025 Editor assigned by journal 01 Dec, 2025 Editor invited by journal 05 Nov, 2025 Submission checks completed at journal 04 Nov, 2025 First submitted to journal 04 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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16:43:31","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":104452,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7946414/v1/fe6311d5f9d713e80fcad7e9.html"},{"id":98429133,"identity":"925deda8-9c1f-4532-8d2f-6c7c4d136232","added_by":"auto","created_at":"2025-12-17 16:42:50","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1108767,"visible":true,"origin":"","legend":"\u003cp\u003ePatient Journey Map for Inpatients with Mood Disorders\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7946414/v1/1fab0d772319ee42066bc0fb.png"},{"id":105224732,"identity":"66b81e26-0594-4043-80aa-237be944502a","added_by":"auto","created_at":"2026-03-23 16:15:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2070206,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7946414/v1/af1f36bb-f7ec-43f1-af46-4db2063cc1d0.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A Study on the Patient Journey Map of Inpatients with Mood Disorders","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMood disorders (including bipolar disorder and depressive disorders), also known as affective disorders, are a common category of mental illnesses characterized by high prevalence, high recurrence rate, and high disability rates, exerting profound impacts on patients\u0026apos; personal functioning, family relationships, and social participation [1][2]. Inpatient treatment serves as a crucial means for acute-phase intervention and severe case management. However, traditional psychiatric services often focus predominantly on controlling affective symptoms, administering pharmacotherapy, and managing the heavy burden on healthcare resources, paying insufficient attention to patients\u0026apos; subjective experiences, emotional changes, and diverse needs throughout the entire hospitalization process [3]. In recent years, the patient-centered care concept has gradually gained prominence, emphasizing that healthcare processes should fully respect patients\u0026apos; feelings and rights [4]. The Patient Journey Map, as a visual research tool, helps identify service gaps and optimize service design by systematically mapping patients\u0026apos; key touchpoints, emotional fluctuations, and core needs during their healthcare journey, thereby enhancing the healthcare experience [5]. Currently, this tool has been widely applied in the field of somatic diseases, but systematic research within mental health, particularly targeting inpatients with mood disorders, remains relatively scarce.\u003c/p\u003e\n\u003cp\u003eTherefore, this study aims to employ qualitative research methods to construct the patient journey map for inpatients with mood disorders, conducting an in-depth analysis of their emotional responses, behavioral adaptations, and evolving needs during the admission, hospitalization, and discharge phases. The findings are intended to provide empirical evidence for healthcare institutions to develop more humanized, refined, and continuous psychiatric services, ultimately enhancing patient treatment adherence, rehabilitation quality, and quality of life.\u003c/p\u003e"},{"header":"1. Research Objects and Methods","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e\u003ch2\u003e1.1 Research Objects\u003c/h2\u003e\u003cp\u003eThis study employed a purposive sampling method. Between December 2024 and May 2025, participants were recruited from the inpatient wards of a tertiary A-grade psychiatric hospital in Fujian Province. Included patients with mood disorders met all the following criteria: (1) a confirmed diagnosis of bipolar disorder or depressive disorder according to ICD-10 criteria; (2) age between 18 and 60 years; (3) a length of hospitalization lasting two weeks or more; (4) basic language communication skills; (5) availability to complete the interview within the three days prior to discharge; (6) no family members accompanying them during the hospitalization period; and (7) voluntary provision of informed consent. To ensure research quality, patients were excluded if they: (1) had significant memory impairment or confabulation; (2) were scheduled to remain hospitalized for more than 72 hours post-interview; or (3) were unable to clearly recall their specific experiences during hospitalization. Sample size was determined based on the principle of theoretical saturation, whereby data collection and analysis continued until no new themes emerged, resulting in the inclusion of 15 patients. Among these participants, 3 were male and 12 were female. Regarding educational background, 6 had college or undergraduate degrees or above, 6 had junior high or high school education, and 3 had primary school education or below. In terms of occupation, 2 were students, 9 were unemployed, and 4 had other occupations. Concerning disease type, 6 had bipolar disorder and 9 had depressive disorder; 4 were experiencing their first hospitalization, while 11 had previous hospitalization experiences. (Detailed information is presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e1.2 Research Methods\u003c/h2\u003e\u003cp\u003eThis study adopted a qualitative research approach using Interpretative Phenomenological Analysis (IPA) [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], conducting face-to-face, semi-structured interviews to gain an in-depth understanding of patients' subjective experiences during hospitalization.\u003c/p\u003e\u003cp\u003e\u003cb\u003e1.2.1 Interview Guide Design\u003c/b\u003e: Based on the theoretical framework of the Patient Journey Map, a semi-structured interview guide was developed focusing on the three phases of admission, hospitalization, and discharge, with particular attention to patients' experiences in terms of emotional responses, behavioral adaptations, and evolving needs. Prior to the formal interviews, pre-tests were conducted with 3 patients to assess the logical flow of questions and the clarity of language. After internal research team discussion and revision, the final interview guide was established (see Appendix 1). Example interview questions included: \"How did you feel when going through the admission procedure?\", \"What were your experiences during the hospitalization?\", and \"What are your expectations or needs regarding home-based treatment after discharge?\".\u003c/p\u003e\u003cp\u003e\u003cb\u003e1.2.2 Data Collection and Analysis\u003c/b\u003e: Interviews were conducted in a private room, with each session lasting between 15 and 40 minutes. The interviews were audio-recorded, and participants' non-verbal behaviors were documented simultaneously. To ensure data accuracy, before each interview, the researcher explained the study purpose, interview duration, confidentiality principles, and the necessity of recording in detail. Formal interviews commenced only after participants signed the informed consent form. During the interviews, the researcher clarified ambiguous statements through paraphrasing and probing questions, and flexibly adjusted the question sequence based on the flow of conversation until information saturation was approached. Within 24 hours post-interview, the transcribed text was returned to the respective participant for content verification. All audio materials were anonymized and sequentially coded as P1 to P15.\u003c/p\u003e\u003cp\u003eThis study strictly adhered to the principle of voluntariness. All participants were informed that they could withdraw unconditionally at any stage without affecting their medical care. Considering that the interview content might evoke emotional responses, the research team had a senior psychotherapist on standby to provide necessary psychological support if needed. During the data analysis phase, Colaizzi's seven-step phenomenological analysis method [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] was employed, and the Nvivo 11.0 software was used to assist with coding and data management.\u003c/p\u003e\u003c/div\u003e"},{"header":"2. Results","content":"\u003cp\u003e2.1 General Information of the Research Subjects\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"718\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eNo.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eEducation Level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eDiagnosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eFirst Admission\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eJunior High School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFreelance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eBipolar disorder, current episode manic with psychotic features\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eJunior High School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFreelance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSevere depressive episode with psychotic symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003ePrimary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eBipolar disorder, current episode manic without psychotic features\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003ePrimary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eRecurrent depressive disorder, current episode moderate with somatic symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eCollege\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eBipolar disorder, current episode manic with psychotic features\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUniversity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSevere depressive episode with psychotic symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUndergraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSevere depressive episode with psychotic symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003ePrimary School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eBipolar disorder, current episode depressed without psychotic features\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSevere depressive episode without psychotic symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eCollege\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSevere depressive episode with psychotic symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eCollege\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eRecurrent depressive disorder, current episode severe with psychotic symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFreelance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eBipolar disorder, current episode manic without psychotic features\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eJunior High School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eBipolar disorder, current episode manic with psychotic features\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eHigh School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eModerate depressive episode without somatic symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eP15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eCollege\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eProfessional/Technical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eRecurrent depressive disorder, current episode severe without psychotic symptoms\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 1: General Information of the Participants (n=15)\u003c/p\u003e\n\u003cp\u003e2.2 Construction of the Inpatient Journey Map\u003c/p\u003e\n\u003cp\u003eThe Patient Journey Map constructed in this study (Figure 1) visually displays the complete process for patients from admission to discharge. It encompasses the key touchpoints, dominant emotions, typical behaviors, and core needs at each stage, revealing the peaks and troughs of their experience.\u003c/p\u003e\n\u003cp\u003e2.3 Thematic Analysis of Emotions, Behaviors, and Needs Across Three Phases\u003c/p\u003e\n\u003cp\u003e2.3.1 Phase One: Admission Period\u003c/p\u003e\n\u003cp\u003e1. Emotional Responses\u003c/p\u003e\n\u003cp\u003e(1) Touchpoint: Hope and Acceptance\u003c/p\u003e\n\u003cp\u003eRelief from Active Help-Seeking: Patients who voluntarily sought admission, hoping to escape distress, obtain a clear diagnosis, or meet family expectations, experienced a sense of hope.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \"I needed to be hospitalized because without it, I felt like life wasn't worth living.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \"I needed a confirmed diagnosis.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \"Hospitalization was a way to seek a solution to the difficulties in my life.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eBeing Understood and Soothed: When medical staff showed concern for the patient's discomfort during admission, it helped alleviate their fear.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP1: \"The doctors and nurses said... 'We need to cut this tape off first'... they understood my difficulty.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eRational Acceptance Based on Familial Affection/Previous Experience: Patients calmly accepted admission out of love/feelings of indebtedness towards family members or due to previous hospitalization experiences.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP8: \"(My daughter brought me)... I always feel I dote on my daughter... felt I owed her a little.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \"(For my son's peace of mind)... I'll respect his wish... after considering everything.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP3: \"My wife did the right thing by insisting I come in for treatment.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e(2) Pain Point: Fear, Anger, and Helplessness\u003c/p\u003e\n\u003cp\u003eTrauma from Deception and Coercion: Patients felt anger, fear, and helplessness when they were tricked into admission under pretenses (e.g., \"physical examination\") or forcibly brought in by police/family members.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP4: \"(I thought it was for a check-up)... Then I ran... they caught me and brought me in... they restrained me.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(They took me away as soon as I woke up)... No warning at all... I was very tense then... scared.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP12: \"(My family said it was a check-up)... When I reached the door, I said 'Why are we here?'... I was done for... I just had to go in.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP14: \"It wasn't voluntary... I was dragged in later... I kept crying.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eConfusion from Lack of Information: Unfamiliarity with the reasons for admission, the procedures, and the hospital environment exacerbated feelings of uncertainty and anxiety.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP2: \"(I have) no memory of (the admission process).\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(They) didn't explain anything to me... I didn't know where they were taking me... I was scared then.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e2. Behavioral Adaptation\u003c/p\u003e\n\u003cp\u003e(1) Touchpoint: Voluntary Cooperation and Effective Communication\u003c/p\u003e\n\u003cp\u003eVoluntary Admission through Negotiation/Support: Patients voluntarily admitted themselves after discussing with family or while accompanied by relatives/friends.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP2: \"(My mom and I) agreed that I should come in.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP8: \"(My daughter brought me)... I was willing to come.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \"(My best friend's husband, brother, and sister all came to see me off)... I came voluntarily... my mood was still quite good.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eCooperation Based on Clear Understanding: Patients actively cooperated because they had insight into their own problems or trusted the hospital.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP3: \"(After breaking things, I felt)... that this was very wrong.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \"(The hospital is proper and conveniently located)... I was confident that it could meet my needs.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e(2) Pain Point: Resistance and Passive Compliance\u003c/p\u003e\n\u003cp\u003eIntense Behavioral Resistance: Manifested as direct opposition like crying, making a scene, running away, or throwing objects.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP1: \"(During admission) I cried hysterically... I threw the cup on the ground.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP4: \"(During the admission procedures) I ran... they caught me and brought me in... they restrained me.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(At that time) I made a scene... I didn't want to go.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ePassive Acceptance and Emotional Detachment: While not showing intense resistance, patients behaved passively, were emotionally withdrawn, or avoided reality through activities like playing on their phones.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP5: \"(My younger brother brought me)... Had no choice but to accept it... didn't have any particular emotions.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \"(During the admission procedures)... I'll play on my phone for a bit first.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP13: \"(Brought in by 110 police)... Since they caught me and brought me in, fine, I'll come in... I'll cooperate.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP14: \"(After being dragged in)... I didn't have any (thoughts)... I just kept crying.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e3. Evolving Needs\u003c/p\u003e\n\u003cp\u003e(1) Touchpoint: Safety, Information, and Respect\u003c/p\u003e\n\u003cp\u003eNeed for Safety and Symptom Control: Hoping that hospitalization would quickly control symptoms and ensure safety.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP1: \"(I hope to) recover.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP3: \"(Hospitalization is for) treatment... If I just took medication at home, it would relapse.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP4: \"(I hope to) get better and not have a relapse again.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNeed for Transparent Information and Informed Consent: Required to be informed in advance and given adequate explanation regarding the reasons for admission and procedures.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP5: \"(The reason I was unwilling was that) nobody told me in advance... I wasn't prepared.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP6: \"(I was angry because) they told me I'd be in a semi-closed ward, but it turned out to be a fully closed one... I felt a bit deceived.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(I wished) they had explained things to me.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNeed for Respect and Family Support: Desired that the decision for admission be respected and to receive family understanding and companionship.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP8: \"(I listened to my daughter)... I always feel I owe her something.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \"(After hospitalization) my husband also knew I had this illness... he understood too.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \"(For my son to feel reassured about working abroad)... I respect his decision... to set his mind at ease.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e(2) Pain Point: Loss of Autonomy and Communication Breakdown\u003c/p\u003e\n\u003cp\u003eLoss of Autonomy in Decision-Making: Felt their personal wishes were completely ignored due to involuntary or deceptive admission.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP1: \"I didn't want to be hospitalized.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP4: \"(I was tricked)... and then I was hospitalized.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(I was taken away as soon as I woke up)... No warning at all.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP12: \"(Tricked into coming for a 'check-up')... I was done for... I just had to be hospitalized.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eImpaired Need for Immediate Family Communication: The need to communicate with family initially to understand the situation was unmet.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(I asked my mom in the car)... She didn't respond to me... didn't answer me.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e2.3.2 Phase Two: Hospitalization Period\u003c/p\u003e\n\u003cp\u003e1. Emotional Responses\u003c/p\u003e\n\u003cp\u003e(1) Touchpoint: Comfort, Growth, and Connection\u003c/p\u003e\n\u003cp\u003eEnvironmental Comfort and Mental Peace: Acknowledged the hospital environment as comfortable and the schedule as reasonable, leading to feelings of calmness.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP1: \"The environment here is very comfortable... very reasonable.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP3: \"(The environment) is much better than over there.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP6: \"(The environment) is quite clean... acceptable.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP8: \"My mood settled down a bit... quieter, more peaceful.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eEmotional Stability and Positive Shift: Through treatment, emotions shifted from anxiety and low mood towards stability and happiness, gaining a sense of achievement.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP6: \"From initial anger to compromise... to now being relatively calm... my condition is also getting better and better.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \"Mood changed from initial anxiety to current happiness... basically cured.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \"Mood is okay... quite happy.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFeeling Cared For and Sense of Belonging: Felt warmth, care, and support from interactions with medical staff and fellow patients.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP6: \"(The nurses) are all very patient... quite gentle... very responsible.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \"(The nurses) did a very good job with details like feeding... moved us.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP12: \"(I'm grateful to my husband for) bringing me in early... I'm also very grateful to him.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \"(The nurses') smiles... gave me great comfort... like family.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e(2) Pain Point: Distress, Fluctuation, and Suppression\u003c/p\u003e\n\u003cp\u003eDistress and Fear Related to Treatment: Experienced fear, painful memories, or psychological shadows regarding treatments like electroacupuncture and MECT.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP1: \"The electroacupuncture was so intense I was a bit stunned... couldn't help but cry hysterically during the last session.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP2: \"(Electroacupuncture) generated some negative emotions... left a psychological shadow.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \"(Seeing others receive electroacupuncture) the way they screamed in agony... left a deep impression.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP12: \"(MECT) was so painful.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eBoredom and Irritability from Restricted Freedom: Experienced intense boredom, irritability, and feelings of suppression due to closed management, limited activities, and inability to access nature.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP5: \"(The downside is) lack of freedom... unable to adjust things according to my own needs.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(The downside is) boredom... not knowing what to do every day.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \"(Feel) very uncomfortable being locked up all the time... bored... confined.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP14: \"(Feel) a bit bored.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eEnvironmental Distress and Emotional Fluctuations: Emotional states were affected by witnessing disordered behaviors of other patients or due to their own illness fluctuations.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP2: \"(When I first came in) seeing... all the wailing and howling... my illness was instantly 'cured'... I wanted to get out even more.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"My mood is sometimes good, sometimes bad... sometimes my mind wanders to unwanted thoughts.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \"(When I first came in) seeing them scream and shout... my heart was pounding.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e2. Behavioral Adaptation\u003c/p\u003e\n\u003cp\u003e(1) Touchpoint: Active Participation and Integration\u003c/p\u003e\n\u003cp\u003eEngagement in Rehabilitation Activities: Actively participated in occupational and recreational therapy (e.g., singing, crafts, card games) and benefited from them.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP1: \"(I like) singing, listening to music... doing flower arranging.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP2: \"(Playing cards) is fun... teasing the other patients.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP6: \"(Playing cards, making friends) can add a little fun to life.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP13: \"(Playing cards) Everyone feels very united.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eEstablishing Ward Social Networks: Communicated with, helped, and built friendships with fellow patients, gaining emotional support.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP2: \"(What I gained) I made a group of friends.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP6: \"(Getting along with other patients) Made quite a few friends... patiently responding to them.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP12: \"(Among patients) we increased mutual understanding... felt very warm.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTreatment Compliance and Self-Management: Adhered to ward rules, cooperated with treatment, and proactively took on some ward chores.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP3: \"(I think the) rules are good... it needs to be this strict, without it patients wouldn't do well.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP4: \"(After restraints were removed) If there's work, I do a bit... sweeping the beds, making the beds.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \"(Could describe clearly) On the fifth day... the medication was increased... later it was slowly reduced.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e(2) Pain Point: Maladaptation and Negative Interactions\u003c/p\u003e\n\u003cp\u003eResistance to Institutionalized Management: Described the uniform management as \"herding pigs\" or \"shepherding sheep,\" expressing discomfort with the loss of personalized daily rhythms.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP2: \"(Feel) like raising pigs every day... herded here and there.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP5: \"(Hospitalization) is exactly the same for everyone... all have to follow the hospital rules.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \"(You staff) are like a bunch of sheepdogs, herding us around.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSelective Participation or Withdrawal: Lack of interest in organized activities led to non-participation, exacerbating feelings of boredom.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(Exercise, crafts) I didn't participate in any... not interested.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP14: \"(Experience) None... none at all... (activities) none.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eImpact of Negative Peer Interactions: Were disturbed by the verbal or behavioral actions of specific patients.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP2: \"(A few patients) their mouths are really nasty... they say some bad things.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(Some patients) have very loud voices.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e3. Evolving Needs\u003c/p\u003e\n\u003cp\u003e(1) Touchpoint: Personalized Care and Rehabilitation Support\u003c/p\u003e\n\u003cp\u003eNeed for Personalized Living and Diet: Desired more variety in food, better taste, and some flexibility in daily schedules.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP1: \"(Suggestion) Don't always have rice every day... could cook some noodles sometimes.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP5: \"(The food) is not great... the cooking methods aren't good.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(Hope) I could adjust my sleep schedule myself.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP12: \"(Lunch and dinner) Really not tasty... could be improved a bit.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNeed for Diverse Recreation and Activities: Craved more varied and abundant recreational activities, especially outdoor ones.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP6: \"(In the evening) Hope they could add some other activities... the time is just too long.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(Recreational activities) Too few... (want to) run, hike, take photos.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \"(Hope) Could go for a walk outside in an open space... breathe fresh air.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \"(I see) There are also many activities... mahjong, cards, dancing, exercise.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNeed for In-Depth Communication and Emotional Support: Required more communication time, emotional support, and personalized attention from medical staff.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(Suggestion) Nurses usually spend relatively little time communicating with patients... should chat more often.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP13: \"(Reported) I've been here so long and no one has talked to me.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \"(Grateful) Your smile... like family... very caring and protective.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNeed for Environmental Comfort and Privacy: Needed a clean, tidy living environment and a sleep space free from disturbance.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \"(Dissatisfied) Hygiene... the bathroom... the toilet often gets clogged.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP12: \"(Suggestion) Put those who snore together... otherwise they disturb others' rest.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \"(Applied for a bed change due to poor sleep)... they arranged it for us... very thankful.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e(2) Pain Point: Unmet Basic Needs\u003c/p\u003e\n\u003cp\u003eCore Lack of Freedom and Autonomy: Strict restrictions on movement, schedule, and communication freedom were the most significant source of distress.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStrongly reflected in the accounts of P1, P2, P5, P7, P10, P14, etc.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eInsufficient Basic Living Amenities: Issues like poor bathroom hygiene, clogged toilets, and shortages of daily necessities significantly impacted the experience.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \"(The bathroom) toilet often clogs... it's still clogged now.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP13: \"(The bathroom) is very smelly... a bit clogged... toilet paper... not enough... toilets aren't open enough.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAnxiety from Unclear Information: Lack of clarity regarding treatment plans or discharge dates caused suffering and uncertainty.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP6: \"(Asked doctors about discharge date) They all said it's not certain... it's really agonizing.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \"(The doctors) are vague... (discharge date) it's all 'not certain'.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e2.3.3 Phase Three: Discharge Period\u003c/p\u003e\n\u003cp\u003e1. Emotional Responses\u003c/p\u003e\n\u003cp\u003e(1) Touchpoint: Joy, Gratitude, and Anticipation\u003c/p\u003e\n\u003cp\u003eHappiness and Relief upon Regaining Freedom: Felt very happy about discharge and looked forward to returning to family and society.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP2: \"(Upon receiving the news) Very happy... grinned from ear to ear.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP3: \"(The doctor said this morning) My mood suddenly, suddenly became happy.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP5: \"(Upon receiving the news) Very happy.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \"(Upon receiving the news) Happy ah... finally leaving this awful place.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eGratitude and Positive Reflection: Felt grateful for the care from medical staff and held a more positive attitude towards the future.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \"(Felt) they saved my life... very thankful.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP12: \"(Felt) Grateful for heaven's arrangement in all things... holding a grateful heart.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \"(Felt) Very grateful to the doctors and nurses... very grateful to have met everyone.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eCalmness and Rational Restraint: Emotional response was muted; maintained an even-keeled attitude to avoid disappointment from unmet high expectations.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP1: \"(Upon receiving the news) Very calm... no particular anticipation... because I know this feeling (disappointment from unmet expectations is disheartening).\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e(2) Pain Point: Worry and Complex Emotions\u003c/p\u003e\n\u003cp\u003eFear of Relapse and Resistance to Re-hospitalization: Alongside happiness, worried about disease relapse and expressed resistance to being hospitalized again.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(If I relapse) I actually don't want, don't want to go again... I hope my mood remains stable.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \"(If I relapse) I wouldn't be willing... mainly because... I hate the closed ward.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP14: \"(If I relapse) Not really keen (on hospitalization).\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \"(If I relapse) Still willing... but I'll try my best not to... it would affect him (son).\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIndirect Stressors from Hospitalization: Worried about the impact of hospitalization on work, income, and family.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \"(Hospitalization) Affects my work, I have to ask for leave again... lost my performance bonus.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eP15: \"(Hospitalization) Affected my children quite a bit... he doesn't want me hospitalized.\"\u003c/p\u003e\n\u003cp\u003e2. Behavioral Adaptation\u003c/p\u003e\n\u003cp\u003e(1) Touchpoint: Planning for Return and Active Management\u003c/p\u003e\n\u003cp\u003ePlans for Medication Adherence: Clearly stated intentions to adhere to medication schedules after discharge.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP3: \"(After discharge) Definitely need to take medication at home.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP8: \"(After discharge) Properly... take medication.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \"(After discharge) Take medication on time... take the medicine as prescribed by the doctor.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \"(After discharge) Persist with medication.\"; P13: \"(After discharge) Take medication on time at home.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eBuilding/Utilizing Support Systems: Planned to seek support from family, friends, or school, and to utilize outpatient resources.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP6: \"(If feeling unwell) Will talk to my friend.\"; P8: \"(If having problems) Listen to my family.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \"(The school) counselor will specially assign me a room.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \"(If having problems) Promptly go to the outpatient clinic to see the doctor.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ePositive Lifestyle Adjustments: Planned to adjust routines, cultivate hobbies, return to work, applying gains from hospitalization.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP3: \"(After discharge) Continue selling pork to earn money.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP8: \"(After discharge) Continue delivering takeout.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \"(After discharge) Do what I am capable of... gradually add swimming and running.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP12: \"(After discharge) Money that should be spent, still needs to be spent.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e(2) Pain Point: Passivity and Avoidance\u003c/p\u003e\n\u003cp\u003eLack of Concrete Future Plans: Appeared passive, with no clear thoughts or needs regarding post-discharge treatment and life.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP5: \"(Needs after discharge) None.\";\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP14: \"(Needs after discharge) None at all.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ePotential Risk Behaviors: Mentioned potentially using methods like alcohol to relieve stress, indicating risk.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP2: \"(After returning home) When I'm very tired, I will... drink some alcohol... relax a bit.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e3. Evolving Needs\u003c/p\u003e\n\u003cp\u003e(1) Touchpoint: Continuity of Support and System Linkage\u003c/p\u003e\n\u003cp\u003eOngoing Professional Medical Support: Needed clear medication guidance, accessible outpatient follow-up, and consultation channels.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP1: \"(For pregnancy planning) Tell the doctor during the outpatient visit... listen to the doctor's professional opinion.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP3: \"(After discharge) Need to take medication... listen to the doctor.\"; P9: \"(After discharge) Will definitely follow up at the outpatient clinic.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \"(If unwell) Can seek medical attention promptly.\"; P15: \"(After discharge) Must persist with medication.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFamily and Social Understanding: Urgently needed more understanding, tolerance, and support from family after discharge.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \"(Hope) family members can... understand and\u003c/em\u003e\u003cem\u003e包容\u003c/em\u003e\u003cem\u003e\u0026nbsp;me more.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \"(Worried about) affecting my child... (hope) try my best not to (relapse).\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSocial Reintegration and Value Fulfillment: Eager to regain work capacity, resume family roles, and achieve self-worth.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP3: \"(After discharge) Feel I can still continue working and earning money.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP4: \"(After discharge) Go back to live with my grandchildren.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP9: \"(After discharge) Do what I am capable of, look after my little grandchildren.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \"(After discharge) Return to work.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eRelapse Prevention and Early Intervention: Acknowledged the concept of \"solving small problems in outpatient care,\" needing to establish relapse prevention awareness and action plans.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(Hope) small problems can be solved in outpatient care, so I don't have to be hospitalized again.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \"(If minor problems arise) Promptly go to the outpatient clinic to see the doctor... don't delay.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP15: \"(After discharge) Persist with medication... (avoid) affecting my children.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e(2) Pain Point: Fragile Support Systems and Uncertainty\u003c/p\u003e\n\u003cp\u003eConcerns about Adequacy of Family Support: Uncertain about receiving sustained family understanding and support after discharge.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP11: \"(Hope) family members can... understand me more.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFear of the \"Outpatient-Hospitalization\" Transition: Due to negative hospitalization experiences, strongly desired to avoid re-hospitalization, shifting pressure onto outpatient care.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP7: \"(Don't want to be hospitalized again) Because... it's even more boring... cut off from the outside world.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP10: \"(Don't want to be hospitalized again) Because... I hate the closed ward... too many people.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eP14: \"(Don't want to be hospitalized again)... I'll try my best not to get sick.\"\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e2.4 Intervention Recommendations\u003c/p\u003e\n\u003cp\u003e2.4.1 Phase One: Admission Period Intervention Recommendations\u003c/p\u003e\n\u003cp\u003eCore Objective: Transform \"Passivity and Fear\" into \"Informed Collaboration\".\u003c/p\u003e\n\u003cp\u003eTrauma from Deception and Coercion:\u003c/p\u003e\n\u003cp\u003eEstablish a standardized, humane admission communication protocol: For involuntarily admitted patients, the initial contact should be made by specially trained medical staff or social workers who provide an honest, empathetic explanation of the legal basis, necessity, and preliminary treatment goals for admission, replacing simple coercion or deception [8]. Avoid using stimulating words like \"caught\" or \"restrained\" in front of patients.\u003c/p\u003e\n\u003cp\u003eImplement an \"admission buffer period\" or \"observation area\": Where conditions allow, let patients stay briefly in a supervised open area, accompanied by family or a trusted person, for preliminary communication and reassurance, mitigating the direct shock of being sent to a closed ward.\u003c/p\u003e\n\u003cp\u003eConfusion from Lack of Information:\u003c/p\u003e\n\u003cp\u003eProvide an \"Admission Guide\" information package: Create illustrated, easy-to-understand booklets or leaflets covering: ward environment introduction, daily schedule, main treatment programs, patient rights and responsibilities, and communication/channels for seeking help (e.g., attending physician, primary nurse, psychological therapist) [9]. Distribute and briefly explain this during the admission process.\u003c/p\u003e\n\u003cp\u003eImplement a \"Dedicated Nurse Responsibility System on the First Day\": Upon admission, the primary nurse must conduct an in-depth introduction on the first day, guide the patient through the environment, and clearly state \"you can come to me with any questions,\" establishing initial trust.\u003c/p\u003e\n\u003cp\u003eSense of Lost Autonomy:\u003c/p\u003e\n\u003cp\u003eGrant limited choices where safe: In the early admission phase, offer patients inconsequential choices, such as \"Would you prefer a bed by the window or the door?\" or \"Here is our menu, are there any foods you particularly dislike or are allergic to?\" This conveys respect and restores a sense of control.\u003c/p\u003e\n\u003cp\u003eIntroduce synchronous family education: Briefly communicate with the family members who brought the patient, explaining the long-term negative impacts of deception and coercion, and encourage them to align with medical staff in subsequent communications, adopting a more cooperative and honest attitude.\u003c/p\u003e\n\u003cp\u003e2.4.2 Phase Two: Hospitalization Period Intervention Recommendations\u003c/p\u003e\n\u003cp\u003eCore Objective: Maximize patient \"Autonomy and Humanized Experience\" while ensuring treatment and safety.\u003c/p\u003e\n\u003cp\u003eBoredom and Irritability from Restricted Freedom:\u003c/p\u003e\n\u003cp\u003eDesign and implement \"Personalized Activity Prescriptions\": Based on assessment of the patient's condition and interests, tailor recommendations for occupational and recreational therapy activities, rather than enforcing mandatory \"one-size-fits-all\" participation. For patients reluctant to join group activities, provide rich individual resources like books, art supplies, music players, etc. [10].\u003c/p\u003e\n\u003cp\u003eCreate spaces and times that \"simulate the external environment\": With strict security measures, regularly organize activities for patients in outdoor areas like hospital gardens or rooftops (\"to breathe fresh air\") [11]. Optimize the indoor environment using nature murals, adding plants, or creating sunrooms with outdoor views.\u003c/p\u003e\n\u003cp\u003eIntroduce structured \"Free Choice Time\": Incorporate fixed 1-2 hour periods into the daily schedule, allowing patients to freely choose among rest, reading, socializing, or permitted individual activities within common areas, reducing the passive feeling of \"being herded.\"\u003c/p\u003e\n\u003cp\u003eDistress and Fear Related to Treatment:\u003c/p\u003e\n\u003cp\u003eEnhance pre-treatment informed consent and psychological preparation: Before treatments like MECT that may cause discomfort, the treatment team should use models, videos, or plain language to explain the procedure, potential sensations, purpose, and safety in detail, fully addressing patient concerns and managing expectations.\u003c/p\u003e\n\u003cp\u003eOptimize comfort measures during treatment: Employ necessary analgesic and soothing measures during procedures. Allow patients to bring comfort objects (e.g., a small stuffed animal) or be accompanied by trusted medical staff to reduce fear. Provide timely follow-up after treatment to address any adverse reactions.\u003c/p\u003e\n\u003cp\u003eInsufficient Basic Living Amenities and Environmental Discomfort:\u003c/p\u003e\n\u003cp\u003eEstablish an \"Environmental Quality Rapid Response Team\": Create clear channels for reporting repairs and feedback. Commit to, and actually deliver, quick responses and solutions for issues like toilet blockages, bad odors, and noise. Conduct regular patient satisfaction surveys on environmental hygiene.\u003c/p\u003e\n\u003cp\u003eImplement a \"Sleep-Friendly Initiative\": Concentrate patients who snore severely in specific areas and provide sleep aids like earplugs. Establish a quiet pre-sleep routine, such as dimming lights and playing soft music, to create a conducive sleep environment.\u003c/p\u003e\n\u003cp\u003eLack of In-Depth Communication and Emotional Support:\u003c/p\u003e\n\u003cp\u003eImplement \"Structured Doctor-Patient Communication Time\": Beyond daily ward rounds, schedule fixed, no less than 15-minute sessions weekly for each patient with their attending physician or psychological therapist for in-depth communication, ensuring ample opportunity to express confusion and needs.\u003c/p\u003e\n\u003cp\u003eLaunch a \"Peer Support\" program: Train and organize well-recovered former patients as volunteers to communicate with new patients as \"peers,\" sharing experiences and providing emotional support to reduce loneliness [12].\u003c/p\u003e\n\u003cp\u003e2.4.3 Phase Three: Discharge Period Intervention Recommendations\u003c/p\u003e\n\u003cp\u003eCore Objective: Build a \"seamlessly connected\" continuous care system to reduce relapse and rehospitalization rates.\u003c/p\u003e\n\u003cp\u003eFear of Relapse and Resistance to Re-hospitalization:\u003c/p\u003e\n\u003cp\u003eDevelop and explain an \"Individualized Relapse Prevention Plan\": Before discharge, collaborate with the patient and family to create this plan, clearly identifying early warning signs, specific steps to take when they occur (e.g., who to contact, when to follow up), and crisis resources. This fosters a sense of preparedness and enhances self-efficacy.\u003c/p\u003e\n\u003cp\u003eConduct \"pre-discharge scenario simulation\": Use role-playing to simulate stressful situations the patient might encounter after discharge (e.g., family conflict, work pressure), jointly practicing how to apply learned skills to cope without requiring hospitalization.\u003c/p\u003e\n\u003cp\u003eFragile Support Systems and Uncertainty:\u003c/p\u003e\n\u003cp\u003eEstablish a \"Discharge Planning Team\": 1-2 weeks before discharge, convene a discharge planning meeting involving doctors, nurses, social workers, family (and community workers if necessary) to ensure arrangements for medication, follow-up, community resources, and family support are in place.\u003c/p\u003e\n\u003cp\u003eProvide \"Proactive Transitional Follow-up\": During the critical first week and first month post-discharge, the hospital should proactively conduct phone or video follow-ups to understand the patient's adaptation, answer questions, and reinforce medication adherence, rather than passively waiting for the patient to seek help.\u003c/p\u003e\n\u003cp\u003eConduct \"Family Empowerment Education\": Offer lectures or workshops for families, educating them on how to be effective supporters, including recognizing relapse signs, communication skills, and stress management, alleviating family helplessness and patient guilt [13].\u003c/p\u003e\n\u003cp\u003eIndirect Stressors from Hospitalization (Work/Income):\u003c/p\u003e\n\u003cp\u003eProvide medical documentation support: Timely and standardize the issuance of diagnostic and hospitalization certificates for patients needing sick leave, and, where possible, include medically descriptive language that supports the patient's rights and interests.\u003c/p\u003e\n\u003cp\u003eLink to social resources: The hospital's medical social workers should be knowledgeable and able to provide information on relevant social welfare, charitable assistance, or legal aid to help patients alleviate economic and employment pressures arising from the illness.\u003c/p\u003e"},{"header":"3. Conclusion","content":"\u003cp\u003eThis study, utilizing interpretive phenomenological analysis, systematically delineated the complete inpatient journey of individuals with mood disorders from admission to discharge, revealing their emotional fluctuations, behavioral strategies, and core needs across three distinct phases. The research found that the mode of admission (voluntary/involuntary) decisively influences patients' initial emotions and subsequent adaptation. Involuntarily admitted patients commonly experienced intense feelings of trauma, anger, and helplessness, closely linked to the loss of autonomy and lack of information. This underscores the need for fundamental improvements in admission communication, procedural transparency, and respect for patient rights within healthcare institutions.\u003c/p\u003e\u003cp\u003eDuring hospitalization, while the structured environment provided patients with a sense of security and symptom control, they also commonly encountered challenges including restricted freedom, monotonous routines, and inadequate personalized care. Furthermore, treatment-related fears\u0026ndash;such as those associated with MECT and electroacupuncture\u0026mdash;along with environmental discomforts like poor sanitation and sleep disturbances, constituted significant sources of negative experiences. These findings highlight the need for psychiatric inpatient services to place greater emphasis on patients\u0026rsquo; psychological well-being and humanized care demands, without compromising medical safety. Implementing strategies such as personalized activity plans, environmental enhancements, and structured in-depth communication mechanisms is essential to strengthen patients\u0026rsquo; sense of autonomy and active engagement in their treatment.\u003c/p\u003e\u003cp\u003eThe discharge period, serving as a transition from hospital to home, was generally characterized by patient concerns about relapse and resistance to re-hospitalization, coupled with strong expectations for continuous support systems (e.g., family understanding, outpatient linkage, community resources). The findings of this study support the construction of an integrated \"hospital-family-community\" service model. By developing individualized relapse prevention plans, conducting proactive follow-up, and providing family empowerment education, patients can be assisted in achieving a smooth transition from hospital to home, thereby reducing the risk of rehospitalization.\u003c/p\u003e\u003cp\u003eThis study not only presents findings but also demonstrates the strong potential of the \"Patient Journey Map\" as a methodological tool. It translates the abstract concept of \"patient-centeredness\" into specific, identifiable, and improvable service touchpoints and emotional fluctuations through a visual and systematic approach. The journey map constructed in this study, along with the phased intervention recommendations derived from it, provides healthcare institutions with a clear, evidence-based \"roadmap\" for service optimization grounded in patient experience. It signifies a shift in service design thinking: from isolated, professionally-assumed process management towards holistic journey management based on authentic patient experiences.\u003c/p\u003e\u003cp\u003eIn conclusion, the patient journey map represents more than a methodological tool; it is a conceptual framework for service optimization and practical implementation. The future of psychiatric services lies in moving beyond the singular aim of \"disease treatment\" to embrace a form of integrated care that is holistic, continuous, and responsive to emotional needs. Through a dedicated focus on optimizing the patient journey, healthcare institutions can effect a fundamental transformation from a \"disease-centered\" to a \"patient-centered\" approach, ultimately improving treatment adherence, rehabilitation quality, and patient well-being.The findings and intervention recommendations of this study should be considered within the specific context of China's healthcare culture and system. Future research could explore the transferability of this patient journey map to other cultural and healthcare settings.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eNot applicable.\u003c/strong\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClinical trial number: not applicable.\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of the Neurological and Psychiatric Prevention and Treatment Hospital, Fuzhou Second General Hospital (Approval No.: 2024-53; Date of Approval: October 28, 2024). Written informed consent was obtained from all individual participants included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe datasets generated and/or analysed during the current study are not publicly available due to the sensitive nature of the qualitative interview transcripts and to protect participant confidentiality but are available from the corresponding author on reasonable request.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe authors declare that they have no competing interests.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eShi Wen contributed to the study conception, design, data collection, analysis, and manuscript writing. Ye Yinyin, Wu Yanling, and Chen Lingqing contributed to data collection, analysis, and critical revision of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eEggleston K, Flemming K, Clark LV. (2025). Experiences of functioning in mood disorders: A systematic review and qualitative meta-synthesis. J Psychiatr Ment Health Nurs. Online ahead of print.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHuang Y, Wang Y, Wang H, Liu Z, Yu X, Yan J, Wu Y. Prevalence of mental disorders in China: A cross-sectional epidemiological study. Lancet Psychiatry. 2019;6(3):211\u0026ndash;24.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eXu F, Cheng P, Xu J, Yu Y, Zhang M, Li M, Chen Y. Influencing factors of length of stay among repeatedly hospitalized patients with mood disorders: A longitudinal study in China. Ann Gen Psychiatry. 2024;23(1):15.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAbid MH, Bhavsar V, Kulkarni K, Kulkarni A, Satone P, Kadhe G, Mane A. Patient-centered healthcare: From patient experience to human experience. Global J Qual Saf Healthc. 2024;7(4):144\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSimonse L, Albayrak A, Starre S. Patient journey method for integrated service design. Des Health. 2019;3(1):82\u0026ndash;97.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSmith JA, Osborn M. Interpretative phenomenological analysis as a useful methodology for research on the lived experience of pain. Br J Pain. 2015;9(1):41\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eColaizzi PF. Psychological research as the phenomenologist views it. In: Valle RS, King M, editors. Existential-phenomenological alternatives for psychology. Oxford University Press; 1978. pp. 48\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSanz-Osorio MT, Soler-Mart\u0026iacute;n C, Garc\u0026iacute;a-S\u0026aacute;nchez A, Pujol-Tuset M, Moya-Faz FJ, Castro-Sauras A. Humanization of care in acute psychiatric hospitalization units: A scoping review. J Psychiatr Ment Health Nurs. 2023;30(2):162\u0026ndash;81.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSchladitz K, B\u0026auml;r J, B\u0026auml;r I, Dams J, Gierschner S, Petermann A, Pfennig A. Demands on health information and clinical practice guidelines for patients from the perspective of adults with mental illness and family members: A qualitative study with in-depth interviews. Int J Environ Res Public Health. 2022;19(21):14262.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFoye U, Simpson A, Jesper D, Stanyon M, Kwiecinska M, Stroud J, Pollock K. Activities on acute mental health inpatient wards: A narrative synthesis of the service users\u0026rsquo; perspective. J Psychiatr Ment Health Nurs. 2020;27(4):482\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHjort M, Kjaer SB, Eplov LF, Petersen LS. The importance of the outdoor environment for the recovery of psychiatric patients: A scoping review. Int J Environ Res Public Health. 2023;20(3):2240.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLyons N, Cooper C, Lloyd-Evans B. A systematic review and meta-analysis of group peer support interventions for people experiencing mental health conditions. BMC Psychiatry. 2021;21(1):315.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eArifin M, Budiarto E. (2022). Family empowerment as an effort to increase family independence in caring for clients with mental disorders at home: A literature review. In \u003cem\u003e3rd Borobudur International Symposium on Humanities and Social Science 2021 (BIS-HSS 2021)\u003c/em\u003e (pp. 500\u0026ndash;504). Atlantis Press.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Mood Disorders, Patient Journey Map, Inpatient Experience, Qualitative Research","lastPublishedDoi":"10.21203/rs.3.rs-7946414/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7946414/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e To explore the emotional responses, behavioral adaptations, and core needs of inpatients with mood disorders during the admission, hospitalization, and discharge phases, and to construct their inpatient journey map, thereby providing a basis for optimizing psychiatric healthcare services.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e A qualitative research approach utilizing interpretive phenomenological analysis was adopted. Through purposive sampling, 15 inpatients with mood disorders from a tertiary A-grade psychiatric hospital in Fujian Province were selected for semi-structured interviews. Data were analyzed using Colaizzi's seven-step method, and patient experiences across the three phases were mapped based on the patient journey map framework.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e The study found that the mode of admission (voluntary/involuntary) proved to be decisive for patients' initial emotions and subsequent adaptation. Involuntarily admitted patients commonly experienced intense feelings of trauma, anger, and helplessness. During hospitalization, while patients gained a sense of security within the structured environment, they also faced challenges such as restricted freedom, monotonous activities, and insufficient personalized care. Treatment-related fears and environmental discomfort emerged as significant negative experiences. In the discharge phase, patients commonly expressed widespread concern about relapse, resistance to re-hospitalization, and strong expectations for continuity of support systems.Based on these findings, the study proposes phased intervention recommendations, including optimizing admission communication, enhancing autonomy and humanized experiences during hospitalization, and constructing a seamless \"hospital-family-community\" continuous care system.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e The patient journey map reveals the dynamic changes in emotions, behaviors, and needs of inpatients with mood disorders throughout their healthcare journey. It suggests that psychiatric services should shift from a \"disease-centered\" to a \"patient-centered\" approach, improving patient treatment experience and rehabilitation quality through holistic, continuous, and emotionally-attuned integrated care.\u003c/p\u003e","manuscriptTitle":"A Study on the Patient Journey Map of Inpatients with Mood Disorders","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-12 13:29:23","doi":"10.21203/rs.3.rs-7946414/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-21T07:23:13+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-29T20:35:19+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-26T14:36:39+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-25T18:03:59+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-22T13:49:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"16472582417214653243704993792913721615","date":"2025-12-21T10:03:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"249917500707644554480791671107997661078","date":"2025-12-18T06:59:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"170301070692338308970382894558355288348","date":"2025-12-17T13:52:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"58176826312036232272264386566657154504","date":"2025-12-17T13:02:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"126808058906285402066039170354940739372","date":"2025-12-16T14:34:23+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-09T10:04:20+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-01T21:00:57+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-05T13:29:29+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-04T12:02:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychiatry","date":"2025-11-04T11:55:48+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychiatry","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bpsy","sideBox":"Learn more about [BMC Psychiatry](http://bmcpsychiatry.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bpsy/default.aspx","title":"BMC Psychiatry","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ad4a4174-c225-49a9-8f81-c7c2cf9d75eb","owner":[],"postedDate":"December 12th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-23T16:12:30+00:00","versionOfRecord":{"articleIdentity":"rs-7946414","link":"https://doi.org/10.1186/s12888-026-07971-9","journal":{"identity":"bmc-psychiatry","isVorOnly":false,"title":"BMC Psychiatry"},"publishedOn":"2026-03-17 15:58:41","publishedOnDateReadable":"March 17th, 2026"},"versionCreatedAt":"2025-12-12 13:29:23","video":"","vorDoi":"10.1186/s12888-026-07971-9","vorDoiUrl":"https://doi.org/10.1186/s12888-026-07971-9","workflowStages":[]},"version":"v1","identity":"rs-7946414","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7946414","identity":"rs-7946414","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}