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Can metaphors and analogies improve communication with seriously ill patients?

dc.contributor.author Casarett, David
dc.contributor.author Pickard, Amy
dc.contributor.author Fishman, Jessica M
dc.contributor.author Alexander, Stewart C
dc.contributor.author Arnold, Robert M
dc.contributor.author Pollak, Kathryn I
dc.contributor.author Tulsky, James A
dc.coverage.spatial United States
dc.date.accessioned 2011-04-15T16:46:28Z
dc.date.issued 2010-03
dc.identifier https://www.ncbi.nlm.nih.gov/pubmed/19922170
dc.identifier.uri https://hdl.handle.net/10161/3369
dc.description.abstract OBJECTIVE: It is not known how often physicians use metaphors and analogies, or whether they improve patients' perceptions of their physicians' ability to communicate effectively. Therefore, the objective of this study was to determine whether the use of metaphors and analogies in difficult conversations is associated with better patient ratings of their physicians' communication skills. DESIGN: Cross-sectional observational study of audio-recorded conversations between patients and physicians. SETTING: Three outpatient oncology practices. PATIENTS: Ninety-four patients with advanced cancer and 52 physicians. INTERVENTION: None. MAIN OUTCOME MEASURES: Conversations were reviewed and coded for the presence of metaphors and analogies. Patients also completed a 6-item rating of their physician's ability to communicate. RESULTS: In a sample of 101 conversations, coders identified 193 metaphors and 75 analogies. Metaphors appeared in approximately twice as many conversations as analogies did (65/101, 64% versus 31/101, 31%; sign test p < 0.001). Conversations also contained more metaphors than analogies (mean 1.6, range 0-11 versus mean 0.6, range 0-5; sign rank test p < 0.001). Physicians who used more metaphors elicited better patient ratings of communication (rho = 0.27; p = 0.006), as did physicians who used more analogies (Spearman rho = 0.34; p < 0.001). CONCLUSIONS: The use of metaphors and analogies may enhance physicians' ability to communicate.
dc.language eng
dc.language.iso en_US
dc.publisher Mary Ann Liebert Inc
dc.relation.ispartof J Palliat Med
dc.relation.isversionof 10.1089/jpm.2009.0221
dc.subject Adult
dc.subject Aged
dc.subject Aged, 80 and over
dc.subject Communication
dc.subject Cross-Sectional Studies
dc.subject Female
dc.subject Humans
dc.subject Male
dc.subject Metaphor
dc.subject Middle Aged
dc.subject Physician-Patient Relations
dc.subject Terminally Ill
dc.subject Young Adult
dc.title Can metaphors and analogies improve communication with seriously ill patients?
dc.type Journal article
duke.contributor.id Alexander, Stewart C|0298835
duke.contributor.id Pollak, Kathryn I|0218322
duke.contributor.id Tulsky, James A|0113874
dc.description.version Version of Record
duke.date.pubdate 2010-3-0
duke.description.issue 3
duke.description.volume 13
dc.relation.journal Journal of palliative medicine
pubs.author-url https://www.ncbi.nlm.nih.gov/pubmed/19922170
pubs.begin-page 255
pubs.end-page 260
pubs.issue 3
pubs.organisational-group Basic Science Departments
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Cancer Institute
pubs.organisational-group Faculty
pubs.organisational-group Institutes and Centers
pubs.organisational-group Medicine
pubs.organisational-group Medicine, General Internal Medicine
pubs.organisational-group Nursing
pubs.organisational-group Population Health Sciences
pubs.organisational-group School of Medicine
pubs.organisational-group School of Nursing
pubs.publication-status Published
pubs.volume 13
dc.identifier.eissn 1557-7740


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