The influences of Thai Buddhist culture on cultivating compassionate relationships with equanimity between nurses, patients and relatives : a grounded theory approach

Thai Buddhist people, especially elderly patients, usually apply Buddhist teachings to deal with illness and death. This grounded theory research was developed to explore the influences of Buddhist culture on nurse-patient-relative relationships in Thailand. The purposes were to highlight the importance of the spiritual dimension in nursing care and examine ways in which nurses can use Buddhist principles to improve nursing care. Seventeen registered nurses, 14 patients and 16 relatives were purposely selected. The semi-structured interviews and audio tape recording took place in Thailand from October 2003 to March 2004. Three steps of analysis: open, axial and selective coding (Strauss & Corbin, 1998) were conducted. "The Cultivation of Compassionate Relationships with Equanimity between Nurses, Patients and Relatives" emerged as the basic social process, which were composed of the three co-processes including: 1) facing suffering/understanding the nature of suffering, 2) applying Dhamma (Buddhist beliefs and practices), personal/local wisdom, and traditional healing, and 3) embodying compassion with equanimity. Such relationships showed influences of Buddhism and Thai culture, and highlighted patient-relative centred care. Personal, professional and organisational factors as well as cultural and religious aspects that promote and inhibit compassionate relationships are discussed. Implications are discussed for nursing practice, education, management and research.