Mutuality in Caregiving

ANS is currently featuring the article titled “Family Caregiver-Receiver Mutuality: A Concept Analysis” authored by Brennan P. Streck, MSN, RN, CNE; Diane Wind Wardell, PhD, RN, WHNP-BC and Geri LoBiondo Wood, PhD, RN, FAAN. We invite you to download this article at no cost while it is featured, and share your comments here! Brennan Streck shared this background information about this work for ANS blog readers!

This concept analysis came to be after I dove into the literature on caregiver-patient (often called caregiver-receiver, as in this paper) dyads. I am an oncology/stem cell transplant nurse by training. Anecdotally, my nursing and medical colleagues noticed that our patients with positive reflections of their caregivers and those who seem to have stable, fruitful relationships tended to have better outcomes. This phenomenon is well documented in the literature; many studies have found that social support is an integral part of healing. Thus, caregiver research has become more popular over the last decade or so. Caregivers are being considered for their potential role in patient outcomes now more than ever. Studies are evaluating whether some characteristics (either those that make up the caregiver or patient as individuals, or those which are dyadic in nature) are associated with better health outcomes.

At the top of the list of characteristics that may prove important is the obvious: the dyadic relationship. As nurses, we often witness the nuances of our patients’ personal lives. We sometimes notice when patients seem to have strong support systems while others do not, and when some patients and their caregivers have healthy/bonded relationships while others’ are tumultuous. In the ideal case scenario, a sick patient would recruit a caregiver to help them get through an illness. The relationship between patient and caregiver should benefit both people; it should be mutualistic. When it isn’t mutualistic, the relationship suffers, which can ultimately affect the health of both involved individuals. There is a term that describes the mutualistic relationship between patients and caregivers. I came across this term a few times while researching the phenomenon of the patient-caregiver relationship. That term was mutuality.

I decided to perform a concept analysis on mutuality because it is, for lack of a better explanation, a rather “flowery” concept. Many people may not truly know what it means, because it is a rather altruistic term that lives in a metaphysical space. However, if mutuality could be clearly and succinctly defined, then the odds of inclusion in future studies would be improved, and we (the research community) would reap the benefits of understanding how mutuality impacts dyadic relationships.

I’m passionate about its inclusion in future research because I think it may be an important concept for dyadic frameworks, and despite having a psychometric scale already developed to measure it, it had never been properly defined. Thus, I performed a wide concept analysis by sifting through interdisciplinary literature, categorizing definitions and attributes, and ultimately arriving at an empirically-supported definition. In doing so, I hoped I could highlight mutuality as a concept for inclusion in caregiver-receiver studies.