Exploring Mutuality in Nurse–Care Recipient Relationships in a Primary Care Setting: A Qualitative Descriptive Study

Background: In primary care (PC), nurses ensure continuity and person-centered care, fostering long-term relationships with patients and caregivers. How mutuality, a relational process closely linked to patient-centered communication, develops in this context remains underexplored. Aims: To describe the characteristics of mutuality and explore how it develops in the relationships between nurses and care recipients in a PC setting. Method: A qualitative descriptive study was conducted in a PC setting. Participants included 14 nurses trained in Family and Community Nursing and 27 care recipients (patients and family caregivers). Data were collected between May and July 2024 through semistructured interviews. A total of 28 interviews were conducted, including both individual and dyadic interviews with patients and caregivers. Data were analyzed using framework analysis, guided by a conceptual framework on mutuality in the nurse–patient relationship. The framework focused on influencing factors, the mutuality process, and outcomes. Results: Findings from 28 interviews revealed that mutuality was influenced by both organizational and personal factors. Nursing care delivery models that ensured continuity of care and nurse autonomy supported trust, stable, and long-term relationships. The process of mutuality unfolded progressively through three dimensions: (1) building and going beyond the formal encounter, (2) being a consistent point of reference, and (3) deciding and sharing care. Mutuality emerged as a co-constructed relationship, shaped by clear communication, trust, and shared responsibilities, with informal caregivers recognized as integral participants. Outcomes included strengthened professional identity and satisfaction for nurses and improved emotional well-being, self-care, and self-efficacy for care recipients. Conclusion: In PC, mutuality transforms task-oriented interactions into meaningful, trust-based relationships, enhancing patient-centered communication and shared decision-making. Care continuity and autonomy, combined with investment in relational skills, are essential to sustain mutuality, improve communication, and enhance care quality.