| Components of relatedness |
Caring, support, trust, depth of relationship and acceptance. |
| Benefits of relatedness |
Understanding each other, understanding roles, understanding the situation and problems to be solved, increased autonomy in the relationship, feeling supported, open communication, increased influence, enjoyment of the relationship, taking responsibility and better outcomes.
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| Enablers of relatedness |
Having a relationship with the same person (for example seeing the same doctor on each visit), collaborative behaviours, competency in relatedness, feeling supported, proactivity (for example home visits, calling a patient who does not come for an appointment), regularity and frequency of meetings and accessibility (for example being able to contact when needed) |
| Barriers to relatedness |
Resources (described in theme 5). Avoidance of difficult emotions associated with relationships, for example patients described how shame about the illness, guilt about being a burden and fears about rejection lead to deliberate distancing from others. Carers described disappointment, sadness, frustration, guilt, shame and anger associated with the relationship with the patient. Staff described sometimes how being unable to provide adequate care for a patient that they cared about (normally because of lack of resources) leads to feelings of shame in the staff involved. Lack of support. For example staff reported feeling blamed by people higher up in the hierarchy, rather than being supported by them to form closer relationships with patients. Fears about managing boundaries. For example staff reported a fear of families or patients become dependent or ‘spoiled’ if they showed too much care. Relatedness not being valued. For example staff described a task-oriented system, where relationships mattered less than tasks, routines and targets. Few staff discussed the benefits of a therapeutic alliance with patients.
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