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ABSTRACT
Background: Metaphorical language has long been used by patients and providers to explain health experiences. Still, some studies indicate that metaphors can be counterproductive and inhibit patients’ willingness to try new treatments, especially those that are unfamiliar, complex, or stigmatized. This is particularly complex in integrative settings where conventional medicine providers (family medicine physicians) offer patients complementary and alternative therapies, like acupuncture. To fully determine the potential translational value of metaphor, scholars argue that we must ‘prepare, test, and practice’ metaphors that represent both patients’ and providers’ preferences.
Method: We conducted a thematic analysis, informed by metaphor theory, of 32 interview transcripts from physicians (N = 15) and patients (N = 17) in which they described patient-provider communication experiences for a study on acupuncture integration. We separated thematic analyses by group, keeping in mind that providers and patients may gravitate toward different metaphorical language.
Results: Patients and providers used metaphor to explain (1) why they accept acupuncture as a treatment (by validating acupuncture as a viable treatment option); (2) why the body needs acupuncture (by illustrating an unhealthy state of the body); and (3) how acupuncture affects the body (by highlighting the healthier state of the body as a result of acupuncture).
Conclusions: This study provides both physician- and patient-generated metaphorical explanations of acupuncture treatment, thereby illustrating how conventional medicine physicians and patients make sense of a traditionally Eastern medical practice by using concepts familiar to them. The results could be used to develop interventions or translational tools.
Disclosure statement
No potential conflict of interest was reported by the authors.
Notes on contributors
Carla L. Fisher, PhD is an associate professor at the University of Florida, Full Member of the UF Health Cancer Center, and Affiliate Faculty with UF's Center for Arts in Medicine. She directs the Family·Health·Lifespan Communication Lab where she leads research to help facilitate healthy communication practice at home and in the clinical setting. Fisher’s research collaborations has garnered more than $2 million in grant funding including federal awards from the National Cancer Institute (NCI), National Institute of Environmental Health Sciences (NIEHS), and National Institute on Aging (NIA). She has published more than 50 journal articles and chapters in research books including two books, one of which is on her mother-daughter communication and breast cancer risk and coping research program for which she has received multiple national research awards.
Christy J. W. Ledford, PhD, is an associate professor in the Department of Family Medicine at Uniformed Services University of the Health Sciences. She serves as Director, Research Programs, for her department and as Research Director for the Military Primary Care Research Network. As a health communication scientist, she seeks to integrate communication principles into medical education and practice. Christy's research focuses on how patients and physicians negotiate emerging evidence together. After a career in public relations, Christy earned her PhD in health communication from George Mason University, where she taught interpersonal and organizational communication before transitioning to medical education in 2011.
Dr. Paul Crawford completed his Doctorate of Medicine degree at the Penn State College of Medicine and residency training in Family Practice at the Eglin Regional Hospital, Eglin AFB, He is board certified in Family Medicine. He completed a family medicine faculty development fellowship at the University of North Carolina-Chapel Hill in 2007. He was part of a team to stand up a new Family Medicine residency at Nellis AFB, NV. While Associate Program Director and Program Director, Col Crawford five times successfully achieved maximum length program certification from the Accreditation Council for Graduate Medical Education. The Uniformed Services University recognized him with promotion to the academic rank of Professor of Family Medicine in 2016 and an Outstanding Preceptor award in 2012. He has presented internationally and nationally at many medical conferences, published >60 articles in multiple medical journals, edited for three different national groups, and served on the board of directors of two national organizations. He was awarded the US Air Force Physician Educator of the year in 2014.