Åbo Akademi University, Department of Caring Science
kASÉN ANNE: The caring relationship
Doctoral thesis, 223 pages, 12 appendixes
Supervisor: Professor Katie Eriksson
March 2002
Keywords: caring relationship, caring science, hermeneutical concept exploration
The aim of the study is to enrich the knowledge of caring from the angle of caring science and to add new aspects by discovering and describing the meaning of a caring relationship.
A survey of previous research shows great terminological variety and conceptual diffuseness. The concept is linked to the profession and the outward form of the relation has been focused on. Less attention is paid to the form and design of the caring substance of the caring relationship.
The theoretical perspective of the study is based on the idea that the fundamental category of caring is suffering. The suffering of the patient can be alleviated within the scope of a caring relationship and this constitutes the fundament of caring.
Eriksson's model of concept exploration, seen as a hermeneutical spiral, determines the methodological approach of the study. It involves a dialogue between the horizon of understanding which emanates from the theoretical perspective and the new understanding which is based on ontological and contextual description. The material for the ontological description is found in Swedish dictionaries published between 1850 and 1999 as well as in selected texts by Buber and Lévinas. The contextual description is based on tape-recorded conversations with 10 patients and 14 nurses in a context of internal medicine and surgery. A pattern of thought for outlining a caring relationship emerges.
The main substance in forming a caring relationship is the protection of the patient's dignity. The creation of such a caring relationship is ultimately based on the protection of the patient's dignity by the alleviation of his/her suffering.
The asymmetrical relation between the patient as a suffering human being and the carer who bears responsibility for him/her describes the external frame of a caring relationship. Alleviating the suffering of the patient is a prerequisite that characterizes the forming of a caring relationship.
An internal design of the caring relationship is based on the patient's account of his/her suffering, the relating of the story touching the entity of body, soul and spirit. Relating in terms of focusing can enhance vitality and arouse enthusiasm and thus promote the movement of health and alleviate suffering.
The substance of a caring relationship is the story of suffering and the obligation. The story of suffering is the story of the patient's fight against suffering and the carer's participation in it. The obligation appears in a caring relationship in which the carer assumes the obligation to protect the patient's dignity by alleviating his/her suffering. This obligation comes to the fore at the first meeting through the carer's promise of a caring relationship. The obligation to the other can remain in force as long as the patient is allowed to remain intangible.
The study represents basic scientific research. The yield of knowledge of this study, a pattern of thought for the creation of a caring relationship, has implications for both systematic and clinical caring science. The pattern of thought is not to be seen as a theory of a caring relationship but it presents the evidence for the basic assumptions of the ideal model by presenting the theoretical core of the patterns of thoughts in a new shape. The heuristic value of the study lies in indicating the direction for reflection and novel departures in the caring reality.