Navigating between Compassion and Uncertainty – Psychiatric Nurses’ Lived Experiences of Communication with Patients Who Rarely Speak

Figures & data

Table 1. Example of the thematic structural analysis.

Meaning unit	Condensation	Sub-theme	Theme
It is much more challenging with those (the silent patients) who have difficulties in expressing themselves, because then it is up to you, and you need to decide if you want to view them as a subject or an object.	Make a deliberate decision about how to view the person	Remaining in a “not-knowing” position	Giving space for the unspoken narrative to unfold
It’s not only with your gaze, but also how you approach the patient and what you express with your body. You need to be responsive to what the other is comfortable with, when coming to closeness, touch and a proper distance. You can’t just step over his borders and think that you know what he needs – even if you want to do good	Being responsive in order to avoid being intrusive	Striving to reduce differences in power
There is also this dimension, when you just spend time and do things together. Then I usually have this ordinary everyday talk. Even if he doesn’t answer I can still… have a conversation when I do my tasks, and he is there with me, without having to give me a lot of answers. (…) I confirmed that person by sitting down, like ”you are worth being a part of a community”…	Spending time together in silence, and confirming the other person’s value	Strengthening patients’ experiences of value and dignity through involvement

Table 2. Overview of themes and subthemes.

Theme	Sub-theme
Giving space for the unspoken narrative to unfold	Acknowledging communicative actions. Striving to reduce differences in power. Strengthening patients’ experiences of value and dignity through involvement. Sharing time. Being compliant with the patient’s needs and personal preferences.
Remaining in uncertainty	Remaining in a “not-knowing” position. Approaching patients’ behaviours as messages rather than problems.
Being in reflective vigilance	Being attentive to one’s own non-verbal expressions. Being able to bridle oneself. Being reflective with peers.