Show simple item record Casarett, D Pickard, A Fishman, JM Alexander, SC Arnold, RM Pollak, KI Tulsky, JA
dc.coverage.spatial United States 2011-04-15T16:46:28Z 2010-03
dc.identifier.citation J Palliat Med, 2010, 13 (3), pp. 255 - 260
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.format.extent 255 - 260
dc.language eng
dc.language.iso en_US en_US
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
dc.description.version Version of Record en_US 2010-3-0 en_US
duke.description.endpage 260 en_US
duke.description.issue 3 en_US
duke.description.startpage 255 en_US
duke.description.volume 13 en_US
dc.relation.journal Journal of palliative medicine en_US
pubs.issue 3
pubs.organisational-group /Duke
pubs.organisational-group /Duke/Faculty
pubs.organisational-group /Duke/School of Medicine
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Community and Family Medicine
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Community and Family Medicine/Community and Family Medicine, Prevention Research
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Medicine
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Medicine/Medicine, General Internal Medicine
pubs.organisational-group /Duke/School of Medicine/Institutes and Centers
pubs.organisational-group /Duke/School of Medicine/Institutes and Centers/Duke Cancer Institute
pubs.organisational-group /Duke/School of Nursing
pubs.organisational-group /Duke/School of Nursing/School of Nursing - Secondary Group
pubs.publication-status Published
pubs.volume 13
dc.identifier.eissn 1557-7740

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