Caring is the foundational construct of nursing and accordingly a desirable characteristic of all nurses. While most studies have focused on patient descriptions of nurse caring, few studies have examined how nurses convey caring to the recipients of their care.  This poses an important irony for a discipline that places its highest value on evidence-based practice but has yet to propose substantive theory validation of this cornerstone construct.  The specific aim of this study was to develop a substantive theory of nurse caring using nurse-patient dyads with a particular focus on perceived health care outcomes as a result of the caring interaction.  

Method

This Glaserian grounded theory study utilized a theoretical sample of 14 nurses who individually participated in audio-taped semi-structured interviews to discuss nurse caring of chronically ill, elderly patients. Constant comparative data analysis was conducted simultaneously with coding, summarizing of concepts and themes, and memoing. Data analysis resulted in an original substantive theory of caring in nursing.      

Findings

Knowing the Patient Caring Theory consists of three phases.  The nurse first enters the Phase of Conveying Caring Behaviors, where through authentic presence and genuine concern, specific affective, cognitive, and psychomotor responses are selected and conveyed to the patient.  Moving into the Phase of Individualized Caring, the nurse uses critical thinking and teamwork to deliver distinctly chosen patient care interventions. In the final phase, Health Outcomes of Caring, the nurse identifies perceived patient health outcomes of caring that include improved physical and emotional well-being. 

Implications

This study sets the stage for further investigation on caring in nursing.  Knowing the Patient Caring Theory has practice implications for enhancing positive patient care outcomes, pedagogical implications for teaching students about the caring construct, and research significance by continuing to develop theoretical knowledge that will culminate in a formal theory of nurse caring.