Modes of relating in a caring conversation: a research synthesis on presence, touch and listening.

The purpose of this qualitative research synthesis was to develop an ontological and theoretical understanding of presence, touch and listening in a caring conversation. The material consisted of 28 articles published between 1989 and 1997 in caring and nursing journals. The examination was based on a qualitative research synthesis approach applied to each concept separately. The synthesis was summed up in a model encompassing two modes of relating in a caring conversation: a connection with high intersubjectivity and a contact with limited intersubjectivity. In a connection the nurse is listening, using caring and connective touch and is present as 'being with' the patient. In a contact, the nurse is hearing, using task orientated touch and is present as 'being there' for the patient. A connection is grounded in a mutual receiving which allows a high degree of intersubjectivity. The nurse and the patient are not only present to each other as roles but also as unique persons. Contact is grounded in the attentive attitude of the nurse and in the fact that the nurse and the patient are relying on roles which allow a limited intersubjectivity. The model provides a point of departure for clinical discussions among nurses as well as areas for further research in the field of nurse-patient communication.