Caring is a significant form of communication in health care which has been overshadowed by the dominant technological and medical models which emphasize efficacy and cure. In addition, care-givers are cautioned to not care "too much," for fear of burnout.

Caring has not previously been addressed as a communication phenomenon. The purpose of this research was to develop grounded theory regarding the nature of caring communication from the perspective of the care-giver, and to determine how caring is experienced by the care-giver.

A purposive sample of 33 nurses was interviewed and data was analyzed by constant comparative analysis as described by Glaser and Strauss. Five major categories emerged from the data: (a) form of caring, which included predispositional, relational, behavioral, and spiritual qualities; (b) contextual elements which included the intense nature of the health care context, team relationships, and working conditions, (c) effects on the care-giver, which included alchemical effects, increased motivation and reinforcement for caring, experience of personal loss, and the risk of emotional depletion; (d) qualities of the patient, which included opportunity to make a difference, responsiveness, interpersonal challenge, and source of inspiration; and finally (e) perceived effects on the patient, which included, inspired self-caring, healed the violence of loss, and promoted self-integrity.

Key properties were identified that distinguished caring centered involvements from destructive forms of "over-involvement". In addition, a model was developed for the effects of caring on the care-giver. This model describes how both individual and contextual factors contribute to the creation of meaning for the care-giver, resulting in experiences which are self-enhancing or potentially self-destructive.

Spiritual transcendence and aesthetic qualities were two key properties of caring, suggesting that the communication of caring takes place at the level of symbolic form. This form is symbolic of a greater unity understood in a spiritual sense.