The Butterfly Effect of Presence: A New Academic Contribution to Mental Health Nursing in South Africa

Article: Conceptualisation of relational care through cultivating attentiveness: The butterfly effect in mental health nursing

Authors: Dr. Rudo Ramalisa-Budeli, Prof Emmerentia du Plessis, Dr Suegnèt Scholtz

Journal: International Journal of Africa Nursing Sciences

DOI: https://doi.org/10.1016/j.ijans.2026.101047

We are pleased to share the publication of our article in the International Journal of Africa Nursing Sciences, contributing to the growing scholarly discourse on relational care, attentiveness, and presence work in mental health nursing.

This article engages with the concept of attentiveness through a rigorous application of Walker and Avant’s concept analysis, positioning it as a foundational element of relational care. Importantly, the paper introduces the butterfly effect as a theoretical lens to illustrate how small, intentional acts of attentiveness can generate significant and transformative outcomes in patient care.

Advancing Presence Work in Nursing Scholarship

This publication contributes to the expanding body of academic work on presence in nursing, resonating with the scholarship of Kris Van der Cingel and Josephine G. Paterson. Within this discourse, attentiveness is conceptualised not merely as a skill, but as an ethical, relational, and practice-based stance that deepens authentic engagement between nurse and patient.

A South African Contribution

Situated within the South African mental health nursing context, this study reflects the realities of practice in resource-constrained environments. It highlights how nurses continue to cultivate attentiveness despite systemic challenges, reinforcing the importance of human connection in care delivery.

Key scholarly contributions

• Provides conceptual clarity on relational care through attentiveness

• Demonstrates theoretical novelty through the butterfly effect metaphor

• Grounds the concept in empirical insights from nurses’ lived experiences

• Offers a foundation for future research in nursing education, practice, and policy

Concluding reflection

As academics and practitioners, this publication underscores the importance of advancing theoretical and practice-based knowledge that centres human connection in healthcare. It is our hope that this work will stimulate further research, dialogue, and application of attentiveness and presence in nursing.