Caring and Comfort Metaphors Used by Patients in Critical Care

Abstract

Objective: To examine the meaning of metaphors used by critical care patients about their ventilator weaning experience. Design: Grounded theory. Population, Sample, Setting: In 1992–1993, from a population of mechanically ventilated patients, a convenience sample of 20 adult patients was recruited from one 14-bed multispecialty ICU in a 740-bed teaching hospital in eastern Canada. Methods: Transcripts of interviews were reviewed from the 20 original study transcripts, of which 18 included one or more metaphors for a total of 70. All were coded and classified with sub-themes analyzed for implicit meanings. Findings: Four categories of metaphors were Physical Discomfort, Nurse Caring, Altered Self, and Patient Work. Data provide the elements for a mid-range theory of caring. Conclusions: Metaphors provide vivid images of significant patient concerns and are a way for people to express meaning and feeling. Clinical Implications: People communicate about their inner world through language. Examining patients' metaphors is a valuable approach to understanding the experiential world of patients in critical care so that nursing actions can be directed toward personal needs which may not be expressed openly. Providing interventions aimed at these personal needs will help patients find suitable levels of physical and emotional comfort.