Table 7.

Synthesis, including second- and third-order interpretations

Categories	Second-order interpretations	Third-order interpretations
Nurses' characterizations of relationships with patients	(a) Relationships are therapeutic or potentially therapeutic to the patient;
Nurses' strategies to build relationships with patients	(b) Nurses identify particular strategies that promote relationship: unique position, intimate knowledge, being ‘present’, nature of engagement;	(c) Some nurses use strategies to limit their emotional engagement with patients if their capacity to care is constrained by organizational conditions
Emotional impact of relationship on nurses Influencing factors	(d) Degree to which aspirations can be met dictates emotional impact: moral distress/satisfaction	(e) Organizational conditions at unit level strongly influence nurses' capacity to build and sustain therapeutic relationships