Constructing Mutuality in Nurse–Woman–Relative Caring Relationships Informed by Human Caring Theory: A Substantive Theory From a Constructivist Grounded Theory Study

AIM: This study aimed to examine how mutuality is experienced, constructed and negotiated within caring relationships among nurses, women and relatives in women's health nursing. DESIGN: The study followed a theory-research-theory strategy, within which Charmaz's constructivist grounded theory methodology guided the empirical stage. METHOD: In the initial theoretical stage, the Human Caring Theory was used as a sensitizing theoretical lens. During the empirical stage, the study employed Charmaz's constructivist grounded theory methodology and included 14 nurses, 18 women and 18 relatives recruited from obstetric and gynaecological settings. Data were collected through observations and individual interviews and analysed through initial coding, focused coding, constant comparison, memo-writing and theoretical integration. In the final stage, only after the categories and their relationships had been developed from the data were they integrated into a context-sensitive substantive theory, subsequently named 'Constructing Mutuality in Caring Relationships'. RESULTS: Two core categories, six categories and 13 subcategories were identified in the constructivist grounded theory data analysis. Under the core category of 'nature of mutuality', categories included 'establishing and sustaining the caring connection', 'conditions shaping relational engagement', 'forms of mutuality' and 'perceived mutual healing and transformation'. Under the core category of 'unrealized caring experience' categories of 'relational disconnection' and 'consequences of relational challenges' were identified. The Constructing Mutuality in Caring Relationships theory was developed from data generated using constructivist grounded theory, resulting in a context-sensitive substantive theory. CONCLUSION: The findings suggest that mutuality in women's health nursing is a context-dependent relational process shaped by humanistic understanding, compassionate engagement and what participants described metaphorically as relational energy among nurses, women and relatives. Participants described two forms of mutuality-unconditional and partial-and indicated that the process could be initiated, sustained, constrained or remain unrealized. Unrealized caring experiences were perceived to be associated with relational disconnection and difficulties in communication, participation in care and well-being. Further research is needed to refine the Constructing Mutuality in Caring Relationships substantive theory and examine its transferability and practical usefulness across diverse women's health settings. PATIENT OR PUBLIC CONTRIBUTION: There is no patient or public contribution.