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Liu Y, Semino E, Rietjens J, Payne S. Cancer experience in metaphors: patients, carers, professionals, students - a scoping review. BMJ Support Palliat Care 2024:spcare-2024-004927. [PMID: 38744448 DOI: 10.1136/spcare-2024-004927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/17/2024] [Indexed: 05/16/2024]
Abstract
The use of metaphors to talk about cancer experiences has attracted much research and debate, especially in the case of military metaphors. However, questions remain about what metaphors are used by different populations for different aspects of the cancer experience. This scoping review aims to answer them.We searched PubMed, PsycINFO, CINAHL, Scopus and Web of Science databases. Eligible sources include peer-reviewed scientific research published in English between 2013 and 2023, investigating patterns of metaphor use from adult populations (age ≥18) for cancer-related topics, such as cancer itself, the general experience of being ill, treatment, and people and relationships.Out of 1929 articles identified, 30 met the criteria, spanning over different populations. While most papers focused on cancer in general, some focused on specific cancer types, such as breast cancer. Both spontaneous and elicited data were collected in ten languages: mostly English (N=12), Swedish (N=3) and Arabic (N=3). The identified metaphors were subsumed under various broad categories, including particularly violence and journey. Other categories include education and non-human animate entity for the cancer itself, confinement and deprivation and cleanliness for the general experience of being ill with cancer, Poison and gardening for cancer treatment, and distance for patients' social relationships.It was found that metaphors help to identify how patients describe experiences of vulnerability and empowerment. To provide patient-centred care, clinicians and researchers should avoid blanket conclusions about helpful or unhelpful metaphors, but consider the ways in which different metaphors are used by different populations in different contexts.
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Affiliation(s)
- Yufeng Liu
- Department of Linguistics and English Language, Lancaster University, Lancaster, UK
| | - Elena Semino
- Department of Linguistics and English Language, Lancaster University, Lancaster, UK
| | - Judith Rietjens
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
- Department of Design, Organisation and Strategy, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, the Netherlands
| | - Sheila Payne
- International Observatory on End of Life Care, Lancaster University, Lancaster, UK
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Llamas DM, Langan JC. Alternative Mental Health Interventions for Hispanic Women With Breast Cancer: A State of the Science Review. HISPANIC HEALTH CARE INTERNATIONAL 2024:15404153231226390. [PMID: 38258294 DOI: 10.1177/15404153231226390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Introduction: Current disadvantages in accessing healthcare services, particularly mental health resources, result in increased psychological dysfunction among Hispanic women with advanced breast cancer. Little is known about using alternative nonpharmacological therapies for Hispanic women experiencing psychological distress secondary to a breast cancer diagnosis. This state-of-the-science paper synthesizes current culturally appropriate alternative therapies that effectively address depressive symptoms, anxiety, and psychological distress among Hispanic women with breast cancer (HWBC). Methods: The search criteria included published articles that used alternative interventions to address psychological needs among HWBC. Ten studies met the inclusion criteria. Results: Four alternative interventions were identified in the literature that significantly met the cultural mental health needs of HWBC. Mindfulness and technology use were the two interventions most studied in this review. Conclusion: Evidence indicates that alternative therapies for mental health improve overall quality of life. Further research to attenuate psychological distress is needed to meet mental health needs among HWBC. Innovative methods such as the use of technology and mindfulness as well as integrating personalized care are crucial to address the cultural needs of HWBC.
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Affiliation(s)
- Diana M Llamas
- Trudy Busch Valentine School of Nursing, Saint Louis University, Saint Louis, MO, USA
| | - Joanne C Langan
- Trudy Busch Valentine School of Nursing, Saint Louis University, Saint Louis, MO, USA
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Jing Y, Jiang G. "No man is an island": How Chinese netizens use deliberate metaphors to provide "depression sufferers" with social support. Digit Health 2024; 10:20552076241228521. [PMID: 38303971 PMCID: PMC10832413 DOI: 10.1177/20552076241228521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 02/03/2024] Open
Abstract
Objective Online social support provides a way to positively influence depression sufferers. In the present study, we aim to analyze how social support in Chinese online depression communities is communicated through the lens of deliberate metaphor theory (DMT) to deepen the understanding of the under-researched complicated, emotionally laden, and culture-related concepts of this experience. Methods We collected data (n = 3546 comments) from the Warm Supporting section of the Depression Super Topic, a major Chinese online depression community on Weibo. The data were analyzed using a metaphorical analysis with the Metaphor Identification Procedure Vrije Universiteit and a thematic analysis. Results Our findings identify two themes: deliberate metaphors (DMs) of depression and DMs of social environment for depression sufferers. The former conceptualizes future expectations without depression (as rosy images; victorious battles; the beaten black dog); disorder (as subtle objects; subjective initiative events); depression sufferers (as valuable objects; important roles); and present life with depression (as optional events; spiritual practices; fragile objects). The latter conceptualizes social connection (as solid objects; nonessentials); individuals in the social environment (as energetic objects; vicious roles); and prejudice (as colored objects). Conclusions The findings suggest that DMs as important online social support resources, helping to express empathy and normalize depression with more common-sense, and non-judgmental concepts. Additionally, in DMs, Chinese netizens navigate the intricate intersection of medical and moral perspectives on depression and its recovery, leveraging both aspects to offer comprehensive social support. "Confucian-based" elements are embedded in culture-related social support expressions in DMs. In practice, our findings contribute to tailored and appropriate health interventions for depression.
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Affiliation(s)
- Youping Jing
- College of Foreign Languages and Cultures, Xiamen University, Xiamen, Fujian, China
| | - Guiying Jiang
- College of Foreign Languages and Cultures, Xiamen University, Xiamen, Fujian, China
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Pfeifer VA, Weihs KL, Lai VT. Narratives about Cancer: What Metaphors can tell us about Depressive Symptoms in Breast Cancer Patients. HEALTH COMMUNICATION 2023:1-11. [PMID: 37559183 PMCID: PMC10853478 DOI: 10.1080/10410236.2023.2245989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Metaphors are pervasive in cancer discourse. However, little is known about how metaphor use develops over time within the same patient, and how metaphor use and its content relate to the mental health of the patient. Here, we analyzed metaphor use in personal essays written by breast cancer patients shortly after the time of diagnosis and nine months later, in relation to their depressive symptoms at both time points. Results show that metaphor use can provide important insight into a patient's current mental state. Specifically, patients who had no change in their depressive symptom levels used metaphors more densely after nine months. In addition, metaphor valence in the later essay was associated with depressive symptoms at study entry and nine months after. Lastly, we observed a shift in metaphor reference pattern for different symptom trajectories, such that those who recovered from initially elevated depressive symptoms used fewer self-referencing metaphors and more cancer-referencing metaphors in their later essay. Our work suggests that metaphor use reflects how a patient is coping with their diagnosis.
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Affiliation(s)
| | - Karen L. Weihs
- Psychiatry, University of Arizona Cancer Center, Tucson, AZ
| | - Vicky T. Lai
- Psychology Department, University of Arizona, Tucson, AZ
- Cognitive Science Program, University of Arizona, Tucson, AZ
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Rasmussen MT, Brøgger MN, Matthiesen SS, Møller JE. "I Surrendered": Metaphors in Residents' Stories about Communication Challenges. HEALTH COMMUNICATION 2023; 38:1612-1620. [PMID: 34979846 DOI: 10.1080/10410236.2021.2023265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
It is well-known that communication with patients can be challenging for residents. Although some studies have focused on residents' experiences of communication challenges, few, if any, have investigated the language residents use when describing such challenges. In this study, we explore the metaphors residents use when asked to share stories about challenging communication situations. Metaphor has been the focus of research in a variety of health-related disciplines; here, we use it to gain an understanding of why these situations are seen as challenging. Methodologically, we draw on metaphor-led discourse analysis, which facilitates a systematic approach to the identification and analysis of metaphors. The empirical material consists of 138 Danish residents' 259 narratives about communication challenges. We identified more than 700 metaphors used in connection with accounting for communication challenges with patients. The metaphors are primarily driven by vehicles belonging to four groups, namely: "Location," "Movement," "Games and play," and "Battle and warfare." We discuss the implications of these metaphors in relation to residents' conceptualizations of communication and challenges.
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Ortega P, Cisneros R, Park YS. Spanish medical jargon: A new metric for improving patient-centered communication with Spanish-speaking patients. PATIENT EDUCATION AND COUNSELING 2023; 109:107644. [PMID: 36689885 DOI: 10.1016/j.pec.2023.107644] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/16/2022] [Accepted: 01/18/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Reducing medical jargon improves patient-centered communication, which is a core objective of medical Spanish courses. We aimed to develop a reliable methodology for identifying and classifying Spanish medical jargon. METHODS Fourth-year medical students in a medical Spanish course recorded themselves explaining diagnosis, treatment, and follow-up care during ten clinical scenarios. We developed a stepwise process for identifying and classifying Spanish medical jargon in the recording transcripts. Two reviewers scored jargon, unexplained jargon, and non-Spanish (neologisms/English) word counts. We evaluated jargon metric correlations with other course performance data. RESULTS We identified 439 Spanish jargon words and 134 non-Spanish words across 480 transcripts. Mean Spanish jargon per minute was 6.57, and 30% was classified as unexplained. Overall inter-rater reliability was excellent (interclass correlation=0.88). Students with post-course Spanish proficiency of "very good" or higher had less unexplained jargon in follow-up care transcripts (P < 0.05); other course outcomes did not correlate with jargon findings. CONCLUSION A Spanish medical jargon metric can be reliably used to evaluate student communication skills in a medical Spanish course. Next steps include engaging patient perspectives and exploring strategies to automate jargon analysis. PRACTICE IMPLICATIONS Spanish medical jargon adds a previously unexplored dimension to the assessment of Spanish-language patient-centered communication.
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Affiliation(s)
- Pilar Ortega
- Department of Medical Education, University of Illinois College of Medicine, Chicago, IL, USA; Department of Emergency Medicine, University of Illinois College of Medicine, Chicago, IL, USA.
| | - Rafael Cisneros
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Yoon Soo Park
- Department of Medical Education, University of Illinois College of Medicine, Chicago, IL, USA
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Montali L, Brooker J, Camussi E, Davenport P, Ronco E, Shand L, Zulato E, Knight T. The interplay between ovarian cancer and social relationships: an analysis of patients' metaphors. Psychol Health 2023:1-20. [PMID: 36803125 DOI: 10.1080/08870446.2023.2180149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVE Research showed that ovarian cancer poses unique challenges to patients' care experiences and that patients' social networks could affect their care path significantly. The present study aimed to analyse the metaphors that patients used to signify the impact of the illness on their social relationships and the role of relationships in dealing with cancer. DESIGN Following a qualitative description approach we conducted 38 semi-structured interviews with Australian (14) and Italian (24) women diagnosed at different stages of ovarian cancer. RESULTS The analysis identified four themes bringing together the meanings expressed by participants' metaphors: Lack of comprehension and communication; Isolation, marginalisation, and self-isolation; Discrepancy between the private and public self; and Social relationships as empowerment resources. CONCLUSION The polysemic nature of patients' metaphors captures both the empowering and especially disempowering role of social relationships in dealing with ovarian cancer. Results also show that metaphors are used to make sense of the impact of ovarian cancer on social relationships and to express different strategies for managing patients' networks.
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Affiliation(s)
- Lorenzo Montali
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Joanne Brooker
- Cairnmillar Institute, Melbourne, Victoria, Australia
- Szalmuk Family Psycho-Oncology Unit, Cabrini Health, Melbourne, Victoria, Australia
| | | | | | - Elisabetta Ronco
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Lyndel Shand
- Deakin University, Melbourne, Victoria, Australia
| | - Edoardo Zulato
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Tess Knight
- Cairnmillar Institute, Melbourne, Victoria, Australia
- Deakin University, Melbourne, Victoria, Australia
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Nyblom S, Molander U, Benkel I. Metaphors in End-of-Life Dreams in Patients Receiving Palliative Care: A Secondary Qualitative Study. Am J Hosp Palliat Care 2023; 40:74-78. [PMID: 35469441 DOI: 10.1177/10499091221090625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Metaphors are used by patients and professionals in the discourse of disease and can facilitate conversations about difficult topics. There is little information about metaphors present in patients' end-of-life dreams. Objective: Identify and interpret metaphors in end-of-life dreams, directly reported by patients in palliative care. Design: A qualitative study with a secondary analysis of transcribed face-to-face interviews with patients. Setting/Participants: The study includes 25 patients with end-stage disease receiving advanced end-of-life palliative care. In total, 41 interviews were performed. Results: Metaphors applicable to 3 themes were found: the journey toward death, the inevitability of death and death itself. The underlying meaning of the metaphors is often related to topics and emotions commonly relevant in dialogue with patients near death. Patients, however, often seemed unaware of the meaning of their dream metaphors. Conclusion: Metaphors pertaining to death are present in end-of-life dreams in patients with end-stage disease. We hypothesize that encouraging patients to talk about their dreams can expose metaphors that could facilitate end-of-life discussions.
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Affiliation(s)
- Stina Nyblom
- Palliative Centre, 56749Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ulla Molander
- Palliative Centre, 56749Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Inger Benkel
- Palliative Centre, 56749Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Chen JJ, Roldan CS, Nichipor AN, Balboni TA, Krishnan MS, Revette AC, Chen AB, Hertan LM. Prognostic Understanding and Goals of Palliative Radiotherapy: A Qualitative Study. J Pain Symptom Manage 2022; 64:567-576. [PMID: 36007684 DOI: 10.1016/j.jpainsymman.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 01/04/2023]
Abstract
CONTEXT There is a paucity of data describing patients' expectations of goals of palliative radiotherapy (RT) and overall prognosis. OBJECTIVES To explore patients' perceptions of and preferences for communication surrounding goals of palliative RT and cancer prognosis. METHODS We conducted a qualitative study utilizing semi-structured interviews with seventeen patients with either bone or lung metastases receiving their first course of palliative RT at a comprehensive cancer center. All patient interviews were recorded, transcribed verbatim, and thematically analyzed. RESULTS Themes of goals of palliative RT centered on either restoration, such as through improving quality of life or minimizing pain, or on a desire to combat cancer by eliminating tumor. While most patients perceived that palliative RT would palliate symptoms but not cure their cancer, some patients believed that the goal of palliative RT was to cure. Themes that emerged surrounding patients' understanding of prognosis and what lies ahead included uncertainty and apprehension about the future, a focus on additional treatment, and confronting mortality. Most patients preferred to receive information about goals of treatment and prognosis from their doctors, including radiation oncologists, rather than other members of the medical team. Patients also expressed a desire for written patient education materials on palliative RT. CONCLUSION Unclear perceptions of goals of treatment and prognosis may motivate some patients to pursue unnecessarily aggressive cancer treatments. Patients desire prognostic information from their doctors, including radiation oncologists, who are important contributors to goals of care discussions and may improve patient understanding and well-being by using restorative rather than combat-oriented language.
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Affiliation(s)
- Jie Jane Chen
- Department of Radiation Oncology (J.J.C.), University of San Francisco, San Francisco, California, USA
| | - Claudia S Roldan
- Northwestern Feinberg School of Medicine (C.S.R.), Chicago, Illinois, USA
| | - Alexandra N Nichipor
- Psychosocial Oncology and Palliative Care (A.N.N.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Tracy A Balboni
- Department of Radiation Oncology (T.A.B., M.S.K.), Dana-Farber Cancer Institute/ Brigham and Women's Cancer Center, Boston, Massachusetts, USA
| | - Monica S Krishnan
- Department of Radiation Oncology (T.A.B., M.S.K.), Dana-Farber Cancer Institute/ Brigham and Women's Cancer Center, Boston, Massachusetts, USA
| | - Anna C Revette
- Survey and Data Management Core (A.C.R.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Aileen B Chen
- Department of Radiation Oncology (A.B.C.), MD Anderson Cancer Center, Houston, Texas, USA
| | - Lauren M Hertan
- Department of Radiation Oncology (L.M.H.), Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
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Almegewly WH, Alsoraihi MH. "Your Ovaries Are Expired, Like an Old Lady" Metaphor Analysis of Saudi Arabian Women's Descriptions of Breast Cancer: A Qualitative Study. Front Psychol 2022; 13:924934. [PMID: 35941947 PMCID: PMC9356377 DOI: 10.3389/fpsyg.2022.924934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/17/2022] [Indexed: 11/15/2022] Open
Abstract
Background Assessing and understanding the language that women use to express physical, emotional, and social concerns of breast cancer experiences can often be overlooked, even though there is evidence that effective communication between cancer patients and health care providers improves quality of life. This study aims to assess the use of metaphors in conceptualizing breast cancer experience lived by Saudi Arabian women. Materials and Methods This is an interpretative phenomenological qualitative study, a purposeful sample of 18 breast cancer patients at an oncology outpatient's clinic in Saudi Arabia were invited to engage in face-to-face interviews. Data was analyzed using Metaphor Identification Procedure (MIP). Results Four themes were constructed: dark hidden force, battling imminent death, dreaming and awakening calls, and inner and outer transformation. Conclusion Identifying metaphors may be beneficial toward improving communication between health care providers and breast cancer patients, who often experience difficulties expressing their needs.
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Affiliation(s)
- Wafa Hamad Almegewly
- Department of Community Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Maha Hamed Alsoraihi
- Department of Applied Linguistics, College of Languages, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Fernandez JR, Richmond J, Nápoles AM, Kruglanski AW, Forde AT. Everyday discrimination and cancer metaphor preferences: The mediating effects of needs for personal significance and cognitive closure. SSM Popul Health 2022; 17:100991. [PMID: 35005182 PMCID: PMC8715368 DOI: 10.1016/j.ssmph.2021.100991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 11/20/2022] Open
Abstract
Metaphors are often used to describe cancer experiences (e.g., battle, journey). Few studies explore how social threats (e.g., discrimination) shape metaphor preferences. We examined the relationship between discrimination and preferences for cancer battle metaphors (i.e., concrete, action-based) versus journey metaphors (i.e., open-ended, reflective) and mediating effects of needs for personal significance and cognitive closure. We also stratified the analysis when discrimination was/was not attributed to race and by racial/ethnic group. Four-hundred twenty-seven U.S. participants completed an online survey. Items included everyday discrimination, need for personal significance, need for cognitive closure, and preference for cancer scenarios using battle or journey metaphors. Multigroup structural equation modeling examined: serial mediation (i.e., discrimination predicting metaphor preference via needs for personal significance and cognitive closure) stratified by discrimination attribution; and single mediation (i.e., discrimination predicting need for cognitive closure via need for personal significance) stratified by racial/ethnic group. Discrimination was associated with battle metaphor preferences through serial mediation when discrimination was not attributed to race (β = 0.02, 95% CI [0.01,0.05]). Discrimination was directly associated with journey metaphor preferences (β = -0.20, 95% CI [-0.37,-0.06]) and the serial mediation was nonsignificant when discrimination was attributed to race. The single mediation model varied across racial/ethnic groups and was strongest for Non-Hispanic White participants (β = 0.17, 95% CI [0.07,0.30]). Discrimination may shape cancer metaphor preferences through needs for personal significance and cognitive closure, yet these relationships differ based on whether discrimination is attributed to race and racial/ethnic group. Given that the U.S. health system often focuses on battle metaphors when framing cancer treatment and screenings, individuals who prefer journey metaphors (i.e., those who experienced more frequent racial discrimination in the present study) may experience a systematic disadvantage in cancer communication. A more careful consideration of cultural, racial, and ethnic differences in metaphor use may be a crucial step towards reducing cancer disparities.
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Affiliation(s)
- Jessica R. Fernandez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Jennifer Richmond
- Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Anna M. Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Arie W. Kruglanski
- Department of Psychology, University of Maryland, College Park, College Park, MD, USA
| | - Allana T. Forde
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Larson KL, Jewell GD, Maldonado MF, Braxton ME, Johnson LA. Call the Rezadora: Aiding Latino Families at the End of Life. HISPANIC HEALTH CARE INTERNATIONAL 2021; 20:147-155. [PMID: 34219506 DOI: 10.1177/15404153211028992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The rezadora, a lay spiritual leader, provides support to Latino families as they provide end-of-life (EOL) care for loved ones. The purpose of this study was to learn about the work of the rezadora in Guatemala as a resource for Latinos with serious illness in the United States. METHODS An ethnographic exploratory case study was conducted during summer 2018 in rural Guatemala. We interviewed three rezadoras who resided in two villages. The study yielded two cases, the single case and the paired case, which allowed for a holistic view of how the rezadora serves the community. RESULTS Content and thematic analysis led to two themes: Essence of being called and Power of prayerful song. Essence of being called was represented by the prominence of the rezadora and their perpetual faith work. Power of prayerful song was characterized through the mission, customs, and the presence of the rezadora. A good death was aided by the rezadora in this context. CONCLUSIONS As the Latino population ages in place, the need for palliative and EOL care services will increase. Lay spiritual leaders could enhance the palliative care teams in these communities and improve the quality of life for Latinos with serious illness.
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Affiliation(s)
- Kim L Larson
- College of Nursing, East Carolina University, Greenville, NC, USA
| | | | | | | | - Lee Ann Johnson
- School of Nursing, University of Virginia, Charlottesville, VA, USA
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Tate T. Your Father's a Fighter; Your Daughter's a Vegetable: A Critical Analysis of the Use of Metaphor in Clinical Practice. Hastings Cent Rep 2020; 50:20-29. [PMID: 33095486 DOI: 10.1002/hast.1182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There are two widespread beliefs about the use of metaphors in clinical medicine. The first is that military metaphors are harmful to patients and should be discouraged in medical practice. The second is that the metaphors of clinical practice can be judged by and standardized in reference to neutral criteria. In this article, I evaluate both these beliefs, exposing their shared flawed logic. This logic underwrites the false empiricist assumptions that metaphorical language and literal language are fundamentally distinct, play separate roles in communication, and therefore can be independently analyzed, systematized, and prescribed. Next, using the resources of ordinary language philosophy, I lay out a theoretical view of medical metaphors that is grounded in metaphor use within clinician-patient relationships. Finally, drawing on the work of philosopher Max Black, I diagram a practical conceptual framework for clinicians to use when they consider whether a metaphor is appropriate for a specific patient encounter.
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Farrell MJ. The Combative Language of Cancer: A Plea for an Armistice. J Clin Oncol 2020; 38:3449-3451. [PMID: 32749943 DOI: 10.1200/jco.20.01146] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Matthew J Farrell
- Providence St Vincent Medical Center, Internal Medicine Residency Program, Portland, OR
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Magaña D. Cultural competence and metaphor in mental healthcare interactions: A linguistic perspective. PATIENT EDUCATION AND COUNSELING 2019; 102:2192-2198. [PMID: 31272798 DOI: 10.1016/j.pec.2019.06.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 06/10/2019] [Accepted: 06/12/2019] [Indexed: 05/25/2023]
Abstract
OBJECTIVES The aim of this study is to understand how Spanish-speaking patients conceptualize mental health issues. This study uses a linguistic perspective to focus on how 23 Mexican-origin patients and their doctor talk about mental health during psychiatric interviews conducted in Spanish and how they negotiate cultural barriers. METHODS This work analyzes when the doctor and his patients reference metaphors (e.g. feeling "empty," feeling "low"). Metaphors are pervasive in all cultures and languages and reveal important information about people's attitudes and feelings about a range of conditions and circumstances. RESULTS This work demonstrates the role of metaphor and linguistic analysis in uncovering culturally based constructions of mental health. The results reveal that the doctor and patients reference different sets of metaphors, which, at times, causes miscommunication. CONCLUSIONS Practitioner awareness of how patients use metaphorical expressions in health is crucial for promoting advanced cultural and linguistic competence and ultimately, patient-centered care. PRACTICE IMPLICATIONS The main findings have implications for health communication with minority groups such as Spanish-speaking Latinos/as in the United States. Practitioners working with Spanish-speaking patients should be familiar with how Latinos/as conceptualize health and how to avoid or repair confusion caused by cultural barriers.
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Affiliation(s)
- Dalia Magaña
- Department of Literature, Languages & Cultures, School of Social Sciences, Humanities & Arts, University of California, Merced, 5200 N. Lake Road, Merced, CA 95343, USA.
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