Abstract: Objective: To understand the experience of hospitalized patients and their families towards patient safety participation, in order to provide references for enabling patient and family participation, promoting hospital patient harmonious and reducing preventable harm. Methods: A describing qualitative approach was used to conduct in-depth interviews with 11 hospitalized patients and 13 family members from four types departments from March to May, 2023. Thematic analysis was used to analyze the data. Results: Three main themes and six sub-themes were identified: high willingness to participate (endogenous motivation for health needs, exogenous motivation for doctor-patient cooperation), inadequate preparation for participation (individual differences in participation ability, deviation in understanding of participation roles), and poor support for participation (limited opportunities for participation, insufficient participation resources). Conclusion: Hospitalized patients and their families still face many difficulties in engaging in patient safety. The healthcare system could empower patients by stimulating endogenous motivation, expanding participation channels, and strengthening institutional support, to promote the development of a cultural atmosphere in which everyone engaging in patient safety. This would effectively promote patients' sense of fulfillment, security, and happiness during the medical treatment process.

Key words: patient safety; patient and family engagement; preventable harm; influencing factor; qualitative study