3. Results Spiritual pain care was

3. Results Spiritual pain care was included in communication and care. Therefore, characteristics other than spiritual pain care were shown in Table 1 in this study. Categories are shown in ˂ ˃, sub-categories in [ ], and open codes in { }below. The narrative central to the category was shown in italics. 3.1. Characteristics of Communication One category was extracted as a characteristic of HPN communication: ˂Communication by HPN to support patients approaching a natural death>. This was composed of two sub-categories. 1) [HPN sharing meaningful time with the patient] was composed of eight open codes: {HPN creates a place where patients can talk about what they want to}; {HPN intentionally makes time to be together with patients}; {HPN gauges the pace and timing at which a patient wants to talk}; {HPN has a sense of proper distance from the patient, not too close or far}; {HPN sits and listens to patients carefully with eye contact}; {HPN listens to patients patiently without interrupting, even if it takes time}; {HPN listens to patients with an open mind, without being skeptical}; and {HPN shares time with patients in silence}. “Whenever I talk with a patient, however busy or rushed I am, I sit and make eye contact, and listen without interrupting to what the patient wants to say. There are often times just looking at the patient while waiting for the patient to speak, restraining myself even if I have something to say.” “It was difficult before because I couldn’t judge what would be a good distance from the patient. Now I can maintain a good sense of distance while matching the timing and pace of the patient’s speaking.” “Sometimes both of us are silent. This is nothing to be afraid of, because it is important time with the patient.” 2) [HPN’s continual attempts to know the world in which the patient lives] was composed of two open codes: {HPN tries to know the patient’s suffering and pain} and {HPN builds up relationships with patients}. “There are many people here in the hospital who can’t let go of life, and are bitter wondering why they must suffer, when they’ve tried so hard. Some people also suffer from the pain of symptoms. I want to know such patient’s pain and suffering up to the end. I think it’s important to continue trying to know the patient. So naturally I come to know the patient and family well.”