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Piel J, Hörold M, Brandstetter S, Drewitz KP, Hrudey I, Schmitt R, Apfelbacher C. COVID-19 crisis management of German ICU clinicians in leadership - a metaphor analysis. Front Public Health 2023; 11:1160094. [PMID: 37663843 PMCID: PMC10470881 DOI: 10.3389/fpubh.2023.1160094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/19/2023] [Indexed: 09/05/2023] Open
Abstract
The COVID-19 pandemic coincided with an already long-standing crisis in health systems around the world characterized by economic pressure and increasing staff shortage. "Crisis" became a global metaphor to convey collective experiences of the COVID-19 threat. Little is known on how crisis metaphors influence thought and speech on crisis management and the challenging staff situation of intensive care unit (ICU) clinicians in leadership positions and how they act. Therefore, we were interested in (1) which metaphorical concepts ICU clinicians in leadership use to express experiences and strategies in dealing with coinciding crises, (2) how these change over time, and (3) how metaphors in speech reveal self-images of crisis management. We conducted a systematic metaphor analysis focusing on data from three participants of a qualitative interview study with twenty-four healthcare professionals in ICUs in Germany. The participants were interviewed at two time points between April 2020 and March 2021. We identified and reconstructed metaphorical concepts of three interviewees (ICU clinicians in leadership) with regard to the pandemic management, and developed a typology based on the dimensions of mood, modus operandi, location, and scope. The typology consists of eight self-images (protagonists) for the crisis management of ICU clinicians in leadership, such as the figure of the soldier ("to unite everyone behind this flag"), the distributor ("sometimes it is a crazy patchwork [wahnsinniges Gestückel]") or the critic ("we are the fool for everything"). They embody different qualities of a leader and refer to intra- and inter-role conflicts within multiple crisis conditions. Metaphor analysis reveals different self-images of ICU leadership clinicians in relation to crisis management. This illustrates that thinking and perceptions of crisis management may strongly differ between and within leaders and may change over the course of crises. Our findings highlight the need both to improve knowledge on challenges associated with leadership in crises and preparedness, and to support clinicians in their leadership by recognizing and addressing differences and changes in leaders' self-image.
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Affiliation(s)
- Julia Piel
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Madlen Hörold
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Susanne Brandstetter
- University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany
| | - Karl-Philipp Drewitz
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Ilona Hrudey
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Rudolf Schmitt
- Faculty of Social Sciences, University of Applied Sciences Zittau-Görlitz, Görlitz, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Giuliani A. Exploring pandemic metaphors in educational contexts: a survey on the language of teachers and educators in Reggio Emilia, Italy. Front Psychol 2023; 14:1192653. [PMID: 37260963 PMCID: PMC10227590 DOI: 10.3389/fpsyg.2023.1192653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 04/26/2023] [Indexed: 06/02/2023] Open
Abstract
This study aimed to explore how metaphors were used to interpret the pandemic and to address its challenges in primary and secondary schools in Reggio Emilia, Italy. A questionnaire was administered to educators and teachers to understand how languages, images, and metaphors were used by themselves and their students to talk about the pandemic and their experiences of living with it. The goal of the questionnaire was to guide critical reflection and encourage more informed language choices. While the existing literature points out the alleged overuse of war metaphors and military frames in public discourse, our findings show that war metaphors are relatively frequent, with other metaphorical frames widely used by teachers and educators to foster resilient attitudes in students. Moreover, in their professional contexts, teachers and educators mostly use metaphorical frames involving resilient attitudes. Our interpretation of the results supports the hypothesis that the purposeful use and deliberate production of metaphors support the choice of metaphors with positive, constructive implications. Finally, some implications of these findings on the theory of metaphor and the methodology of the research are discussed.
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Deng Y, Xie L, Wang L, Chen Y. Psychoanalysis of COVID-19 Patient Narratives: A Descriptive Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040712. [PMID: 37109670 PMCID: PMC10145710 DOI: 10.3390/medicina59040712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: COVID-19 patients are a psychologically vulnerable patient group who suffer from both physical symptoms and psychological problems. The present study is a psychoanalytic investigation of COVID-19 patients utilizing Lacan's desire theory. We aimed to explore the manner in which patients' desire is presented in their lived experience narratives and sought to discover factors which directly impacted on this process. Materials and Methods: In-depth semi-structural interviews were conducted with 36 COVID-19 patients in China. During each interview, participants narrated their lived experiences of COVID-19 infection. Emotions, metaphors, and behaviors in patient narratives were collated as the main points for psychoanalysis. Results: Our findings demonstrated that the desire for being a healthy person made patients emotionally sensitive to the social environment. Anxiety and obsessive behaviors emerged in the process, which reveals their desire for that which they lack. Furthermore, public fear with respect to COVID-19 was somehow converted to psychological pressure on COVID-19 patients. Thus, these patients attempted to "de-identify" their identity as "patients". Positive responses of COVID-19 patients to the external world included admiring medical personnel, government, and country, while negative responses included interpersonal conflicts or complaints about discrimination. Following the rules of the Other, COVID-19 patients were influenced by the Other's desire in constructing their own image of a healthy person. Conclusions: This study revealed COVID-19 patients' psychological need to rid themselves of the identity of "patient" at the individual and social level. Our findings have clinical implications in helping COVID-19 patients to reshape their identity and to live a normal life.
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Affiliation(s)
- Yu Deng
- College of Language Intelligence, Sichuan International Studies University, Chongqing 400031, China
| | - Luxue Xie
- School of English Studies, Sichuan International Studies University, Chongqing 400031, China
| | - Li Wang
- Science and Education Department, Chongqing Public Health Medical Center, Chongqing 400036, China
| | - Yaokai Chen
- Department of Infection Diseases, Chongqing Public Health Medical Center, Chongqing 400036, China
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Palese A, Visintini E, Bressan V, Fonda F, Chiappinotto S, Grassetti L, Peghin M, Tascini C, Balestrieri M, Colizzi M. Using Metaphors to Understand Suffering in COVID-19 Survivors: A Two Time-Point Observational Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1390. [PMID: 36674143 PMCID: PMC9859410 DOI: 10.3390/ijerph20021390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Accumulating evidence indicates that the COVID-19 pandemic carries risks to psychological health and represents a collective traumatic experience with consequences at the social, economic, and health levels. The primary aim of this study was to collect ongoing COVID-19 survivors’ pandemic-related experiences as expressed through the use of metaphors; the secondary aim was to explore socio-demographic variables associated with the metaphor orientation as negative, positive or neutral. An observational follow-up survey was conducted and reported according to the STROBE guidelines. Patients ≥ 18 years, who were treated for COVID-19 during the first wave (March/April 2020) and who were willing to participate in a telephone interview were involved and asked to summarize their COVID-19 experience as lived up to 6 and 12 months in a metaphor. A total of 339 patients participated in the first (6 months) and second (12 months) data collection. Patients were mainly female (51.9%), with an average age of 52.9 years (confidence interval, CI 95% 51.2−54.6). At 6 months, most participants (214; 63.1%) used a negative-oriented metaphor, further increasing at 12 months (266; 78.5%), when they used fewer neutral-/positive-oriented metaphors (p < 0.001). At the 6-month follow-up, only three individual variables (female gender, education, and experiencing symptoms at the COVID-19 onset) were significantly different across the possible metaphor orientation; at 12 months, no individual variables were significantly associated. This study suggests increasingly negative lived experiences over time and the need for personalized healthcare pathways to face the long-term traumatic consequences of COVID-19.
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Affiliation(s)
- Alvisa Palese
- School of Nursing, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Erica Visintini
- School of Nursing, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Valentina Bressan
- School of Nursing, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Federico Fonda
- School of Nursing, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Stefania Chiappinotto
- School of Nursing, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Luca Grassetti
- Department of Economics and Statistics (DIES), University of Udine, 33100 Udine, Italy
| | - Maddalena Peghin
- Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, 33100 Varese, Italy
| | - Carlo Tascini
- Infectious Diseases Division, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
| | - Marco Colizzi
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
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Deng Y, Yang J, Wang L, Chen Y. The Road Less Traveled: How COVID-19 Patients Use Metaphors to Frame Their Lived Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315979. [PMID: 36498049 PMCID: PMC9740225 DOI: 10.3390/ijerph192315979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 05/14/2023]
Abstract
Metaphor provides an important intellectual tool for communication about intense disease experiences. The present study aimed to investigate how COVID-19-infected persons metaphorically frame their lived experiences of COVID-19, and how the pandemic impacts on their mental health burden. In-depth semi-structured interviews were conducted with 33 patients afflicted with COVID-19. Metaphor analysis of patient narratives demonstrated that: (1) COVID-19 infection impacted patient conceptualization of themselves and the relationship between the "self" and the body, as well as social relationships. (2) Metaphors relating to physical experience, space and time, and integrative behaviors tended to be used by COVID-19 patients in a negative way, whereas war metaphors, family metaphors, temperature metaphors, and light metaphors were likely to express positive attitudes. (3) Patients preferred to employ conventional metaphors grounded on embodied sensorimotor experiences to conceptualize their extreme emotional experiences. This study has important implications with respect to the therapeutic function of metaphors in clinical communication between healthcare professionals and COVID-19 patients.
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Affiliation(s)
- Yu Deng
- College of Language Intelligence, Sichuan International Studies University, Chongqing 400031, China
| | - Jixue Yang
- School of English Studies, Sichuan International Studies University, Chongqing 400031, China
- Zengcheng Experimental School of Guangzhou Zhixin Middle School, Guangzhou 511300, China
| | - Li Wang
- Science and Education Department, Chongqing Public Health Medical Center, Chongqing 400036, China
| | - Yaokai Chen
- Department of Infection Diseases, Chongqing Public Health Medical Center, Chongqing 400036, China
- Correspondence:
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Abstract
OBJECTIVE This study, which aims to reveal the metaphorical perceptions of social media users regarding the term, COVID-19, is in accordance with the phenomenological method. METHOD The phenomenological method was used in this study. In July 2020, a total of 125 social media users voluntarily participated in this research study and were asked to derive metaphors regarding the concept of COVID-19. RESULTS With the participation of social media users, metaphors about COVID-19 were determined. These metaphors, which were provided completely voluntarily in response to social media posts, reveals that the participants approached the COVID-19 phenomenon with a variety of meanings. CONCLUSIONS When the metaphors derived by the participants are examined through different categories, it can be seen that a variety of metaphors are produced and almost all of them attribute negative meanings to COVID-19. A significant part of the metaphors evoke disasters and unexpected events. The absence of more hopeful metaphors regarding the end of the pandemic, may stem from the fact that this study took place during the middle of the pandemic, when discussions of the "new normal" were being made just after the first wave.
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