Factors Influencing Consumer Engagement in Hospital Care: An Interview Study of Perceptions and Experiences of Patients, Carers and Care Providers

AIM(S): To explore the challenges and facilitators to consumer engagement in care during hospital attendance, integrating the perspectives of patients, informal carers and care providers. DESIGN: A qualitative descriptive study using semi-structured interviews. METHODS: A total of 102 individual interviews were conducted with patients (n = 43), informal carers (n = 31) and hospital care providers (n = 28) recruited from across Australia using purposive, convenience and snowball sampling. Data were collected between March 2023 and January 2024. Interviews were audio-recorded, transcribed and analysed using thematic analysis. RESULTS: Eight themes illustrating factors that facilitated or hindered consumer engagement were nested within three overarching domains: relational conditions for engagement; consumer capacity and support; and organisational, system, and safety conditions. Patients, carers and care providers identified many overlapping barriers and facilitators, but differed in how they experienced and emphasised them. CONCLUSION: Consumer engagement in hospital care is shaped by individual, interpersonal, organisational, cultural, systemic and ethical factors. Improving engagement therefore requires care environments that actively legitimise patient and carer engagement while providing staff with the time, resources and policy clarity needed to support safe and meaningful participation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Healthcare organisations could strengthen consumer engagement by improving staff communication practices and cultural sensitivity, supporting patient and carer health literacy, creating structured opportunities for engagement, clarifying confidentiality and safety boundaries, and considering locally feasible support roles or technologies. Such strategies require adaptation to workforce and resource constraints and should be evaluated in future research. IMPACT: What problem did the study address? ○ Consumer engagement is central to high-quality, patient-centred care, yet the factors that shape it remain incompletely understood, with prior research typically focusing on single perspectives or discrete episodes of hospital care. What were the main findings? ○ Eight themes were nested within three overarching domains: relational conditions for engagement; consumer capacity and support; and organisational, system, and safety conditions. Although themes were broadly consistent across patients, carers, and care providers, the groups differed in how they experienced and emphasised these factors. Where and on whom will the research have an impact? ○ The findings will inform care providers, healthcare organisations, and policymakers in developing strategies to improve consumer engagement across hospital settings, with relevance to international contexts where patient-centred care is a priority. REPORTING METHOD: This study adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines. PATIENT OR PUBLIC CONTRIBUTION: Patients and members of the public were involved in the study design, participant recruitment, and interpretation and dissemination of findings. A Patient and Carer Advisory Board provided input from inception to dissemination, ensuring the research addressed patient-relevant priorities. REGISTRATION: Not registered.