Healthcare Provider Analogies as Memorable Messages

Abstract

Healthcare providers must explain medical information to patients in a way that patients can understand. Provider use of analogies is one strategy that may help patients better understand medical information. The present study, guided by a memorable message framework, investigated whether participants remembered any analogies used by their healthcare providers, and included a content analysis of the function the analogies served, the types of analogies participants remembered, and the body systems associated with the health issues that were described. Almost one-quarter of participants recalled an analogy used by a provider. The most frequently recalled analogies functioned to describe health conditions or phenomena, followed by elements of the body, and treatments or something external to the body. Analogies were most frequently used to describe health issues associated with the cardiovascular system, musculoskeletal system, digestive system, dental, eye, or skin issues, or the nervous system. The analogies were categorized as mechanical, a feeling or experience, random object, structure, food, nature, war/battle, or medical/body. Provider analogies may be a type of memorable message for some patients. Providers could consider using suitable analogies to explain health issues when communicating with patients, and be trained in effective use of analogies.

Acknowledgments

I wish to express my appreciation to Dr. Evan K. Perrault for the guidance he provided while completing this project, and to Mia I. Switzer and Greg Hildenbrand, for their help with coding responses and resolving coding agreements.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

¹ Only percent agreement is reported for “Medical/Body Part” because it was an infrequently occurring code. Kappa is not an ideal measure for infrequently occurring codes because it favors even distribution of data across categories, resulting in high percent agreement and low reliability (Feng, 2015; Zhao et al., 2013).

² Intercoder reliability for each category for function: round 1- κ = .51-.65 (75–93% agreement), round 2- κ = .49-.60 (75–93% agreement), round 3- κ = .68-.78 (85–93% agreement) except treatment/external (88% agreement; infrequently occurring code), and final round after training- κ ≥ .69 (85–94% agreement); for body system: round 1- κ > .78 except reproductive (97% agreement; one person coded and other did not, so kappa is not adequate), round 2- κ ≥ .64 (95–100% agreement) except urinary (95% agreement; one person coded and other did not, so kappa is not adequate), and final round after training- κ > .75; for analogies: round 1- κ = .46–1.00 (87–100% agreement), round 2- κ = .40–1.00 (78–100% agreement) except animal/nature (93% agreement; infrequently occurring code), and final round after training- κ ≥ .65 (86–99% agreement) except medical/body part (98% agreement; infrequently occurring code.)

³ Race/ethnicity was presented in a “select all that apply” format, so the percentages add to more than 100%, and the Ns add up to more than the total number of participants.

⁴ D&C stands for dilation and curettage

⁵ Though not prompted in the survey, some participants mentioned that the analogy was helpful (n= 16, 6.6%) or unhelpful (n= 4, 1.7%). For example, “My physical therapist, when explaining shoulder squeezes, has me imagine squeezing a pencil between my back muscles. It helps immensely;” and “I recall one doctor indicating that my condition, an abscess, was like a small version of a canyon. It was a terrible analogy.”

Additional information

Funding

This work was supported by the Charles J. Stewart Doctoral Fellowship Award, and the Purdue University Lamb School Doctoral Grant.