Metaphoric perceptions of individuals with diabetes in Turkey: A content analysis
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Keywords

Turkey
metaphor
diabetes mellitus
people with diabetes
nursing care
qualitative research

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Tok Özen, A., Bulantekin Düzalan, Özlem, & Yalçın, B. (2024). Metaphoric perceptions of individuals with diabetes in Turkey: A content analysis. Belitung Nursing Journal, 10(1), 31–40. https://doi.org/10.33546/bnj.3081
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Accepted for publication: 2024-01-19
Peer reviewed: Yes

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Abstract

Background: The diagnosis of diabetes mellitus adversely impacts the quality of life due to treatment, changes in daily life, functional disability, and emerging complications. Using metaphors to convey perceptions of diseases and life experiences is crucial for understanding healthcare behaviors.

Objective: This study aimed to explore the metaphorical perceptions of “diabetes” and “being a person with diabetes” within a sample group of individuals with diabetes in Turkey.

Methods: A qualitative design was employed to investigate the metaphoric perceptions of 72 people with diabetes. Data were collected face-to-face between 15 May and June 2023 using a semi-structured questionnaire. Data were analyzed using content analysis.

Results: From the statements of the individuals with diabetes in the sample, seven metaphoric themes related to diabetes – “pain and distress, helplessness and hopelessness, instability, attention and sensitivity, captivity, positive outlook and acceptance, deprivation” – and six metaphoric themes concerning being a person with diabetes – “suffocation and distress, helplessness, powerlessness and disappointment, captivity, attention and sensitivity, guilt, and being worn out” - were identified. Commonly recurring sub-themes with negative connotations included “darkness, well, convict, prison, captivity, microbe, infectious disease, a hot flush, guilt, clouding life, and being ruined.” Some positively framed statements included “friend, traffic sign, and driving a car.”

Conclusion: The majority of patients in the study used negative metaphors, with fewer expressing positive sentiments regarding the necessity of accepting and paying attention to the disease. Defining individuals’ metaphorical perceptions of their disease may enable the provision of better quality and holistic care. Nurses, in particular, play a crucial role in facilitating behavioral changes for patients with diabetes to achieve self-management.  

https://doi.org/10.33546/bnj.3081
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Copyright (c) 2024 Aslı Tok Özen, Özlem Bulantekin Düzalan, Betül Yalçın

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

There are no conflicts of interest to disclose.

Acknowledgment

The authors thank all the participants who gave their time during data collection and responded frankly to the questions.

Authors’ Contributions

The authors confirm their contributions to the paper as follows: ATÖ, ÖBD, and BY planned and designed the study; scanned the literature, collected and analyzed the data, and wrote all parts of the manuscript. All authors agreed to the final version of the article.

Data Availability

The data generated during the study are available from the corresponding author upon reasonable request.

Declaration of Use of AI in Scientific Writing

There is nothing to declare.


References

AbuAlhommos, A. K., Alturaifi, A. H., Al-Bin Hamdhah, A. M., Al-Ramadhan, H. H., Al Ali, Z. A., & Al Nasser, H. J. (2022). The health-related quality of life of patients with type 2 diabetes in Saudi Arabia. Patient Preference and Adherence, 1233-1245. https://doi.org/10.2147/PPA.S353525

American Diabetes Association. (2023). Standards of care in diabetes—2023 abridged for primary care providers. Clinical Diabetes, 41(1), 4-31. https://doi.org/10.2337/cd23-as01

Arda Sürücü, H., & Büyükkaya Besen, D. (2018). Predictors of empowerment in individuals with type 2 diabetes mellitus. Journal of Transcultural Nursing, 29(6), 506-513. https://doi.org/10.1177/1043659617750259

Ardahan, M., Muslu, L., & Gunbayi, I. (2018). Metaphors as artefacts for adults with type 2 diabetes mellitus according to their professional cultures. Journal of Pakistan Medical Association, 68(2), 334-339.

Arora, T., Chen, M. Z., Omar, O. M., Cooper, A. R., Andrews, R. C., & Taheri, S. (2016). An investigation of the associations among sleep duration and quality, body mass index and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. Therapeutic Advances in Endocrinology and Metabolism, 7(1), 3-11. https://doi.org/10.1177/2042018815616549

Bakan, G., Azak, A., & Özdemir, Ü. (2017). Diabetes and socio-cultural approach. Journal of Kesit Academy, 3(12), 180-195.

Buyukozturk, S., Kılıc Cakmak, E., Akgun, O. A., Karadeniz, S., & Demirel, F. (2013). Scientific research methods. Ankara, Turkey: Pegem Academy.

Canpolat, Ö., Ekenler, Ş., & Polat, Ü. (2022). Barriers and facilitators in diabetes self-management [in Turkish]. SDU Medical Faculty Journal, 29(1), 143-148. https://doi.org/10.17343/sdutfd.1008149

Fioretti, C., & Mugnaini, C. (2022). Living with type 1 diabetes mellitus in emerging adulthood: A qualitative study. British Journal of Health Psychology, 27(4), 1226-1240. https://doi.org/10.1111/bjhp.12596

Ide, N., LoGerfo, J. P., & Karmacharya, B. (2018). Barriers and facilitators of diabetes services in Nepal: A qualitative evaluation. Health Policy and Planning, 33(4), 474-482. https://doi.org/10.1093/heapol/czy011

International Diabetes Federation. (2017). IDF 2017 diabetes atlas. https://diabetesatlas.org/atlas/eighth-edition/

International Diabetes Federation. (2021). IDF 2021 diabetes atlas. https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf

Istek, N., & Karakurt, P. (2018). A global health problem: type 2 diabetes and self-care management. Journal of Academic Research in Nursing (JAREN) 4(3), 179-182. https://dx.doi.org/10.5222/jaren.2018.63634

Ji, X., Gao, H., Sun, D., Zhuang, J., Fang, Y., Wang, K., & Ahmadizar, F. (2023). Trajectories of cognition and daily functioning before and after incident diabetes. Diabetes Care, 46(1), 75-82. https://doi.org/10.2337/dc22-1190

Jing, X., Chen, J., Dong, Y., Han, D., Zhao, H., Wang, X., Gao, F., Li, C., Cui, Z., & Liu, Y. (2018). Related factors of quality of life of type 2 diabetes patients: A systematic review and meta-analysis. Health and Quality of Life Outcomes, 16, 189. https://doi.org/10.1186/s12955-018-1021-9

Khandelwal, D., Dutta, D., Chittawar, S., & Kalra, S. (2017). Sleep disorders in type 2 diabetes. Indian Journal of Endocrinology and Metabolism, 21(5), 758-761. https://doi.org/10.4103%2Fijem.IJEM_156_17

Mogre, V., Johnson, N. A., Tzelepis, F., & Paul, C. (2019). Barriers to diabetic self‐care: A qualitative study of patients’ and healthcare providers’ perspectives. Journal of Clinical Nursing, 28(11-12), 2296-2308. https://doi.org/10.1111/jocn.14835

Mohseni, M., Shams Ghoreishi, T., Houshmandi, S., Moosavi, A., Azami-Aghdash, S., & Asgarlou, Z. (2020). Challenges of managing diabetes in Iran: Meta-synthesis of qualitative studies. BMC Health Services Research, 20, 1-12. https://doi.org/10.1186/s12913-020-05130-8

Pal, K., Dack, C., Ross, J., Michie, S., May, C., Stevenson, F., Farmer, A., Yardley, L., Barnard, M., & Murray, E. (2018). Digital health interventions for adults with type 2 diabetes: qualitative study of patient perspectives on diabetes self-management education and support. Journal of Medical Internet Research, 20(2), e40. https://doi.org/10.2196/jmir.8439

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia: Wolters Kluwer Health.

Pratte, R. (1981). Metaphorical models and curriculum theory. Curriculum Inquiry, 11(4), 307-320. https://doi.org/10.1080/03626784.1981.11075264

Preechasuk, L., Sriussadaporn, P., & Likitmaskul, S. (2019). The obstacles to diabetes self-management education and support from healthcare professionals’ perspectives: A nationwide survey. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 12, 717-727. https://doi.org/10.2147/DMSO.S195916

Pyatak, E. A., Spruijt-Metz, D., Schneider, S., Hernandez, R., Pham, L. T., Hoogendoorn, C. J., Peters, A. L., Crandall, J., Jin, H., & Lee, P.-J. (2023). Impact of overnight glucose on next-day functioning in adults with type 1 diabetes: An exploratory intensive longitudinal study. Diabetes Care, 46(7), 1345-1353. https://doi.org/10.2337/dc22-2008

Rama Chandran, S., Jacob, P., & Choudhary, P. (2020). A systematic review of the effect of prior hypoglycaemia on cognitive function in type 1 diabetes. Therapeutic Advances in Endocrinology and Metabolism, 11, 2042018820906017. https://doi.org/10.1177/2042018820906017

Rashidi, M., & Özcan, Ş. (2022). The effect of self-management training given to individuals with type 2 diabetes using oral antidiabetics on diabetes control and quality of life [in Turkish]. Turkish Journal of Diabetes Nursing, 2(2), 9-17. http://dx.doi.org/10.29228/tjdn.64328

Rinker, J., Dickinson, J. K., Litchman, M. L., Williams, A. S., Kolb, L. E., Cox, C., & Lipman, R. D. (2018). The 2017 diabetes educator and the diabetes self-management education national practice survey. The Diabetes Educator, 44(3), 260-268. https://doi.org/10.1177/0145721718765446

Rooney, M. R., Fang, M., Ogurtsova, K., Ozkan, B., Echouffo-Tcheugui, J. B., Boyko, E. J., Magliano, D. J., & Selvin, E. (2023). Global prevalence of prediabetes. Diabetes Care, 46(7), 1388-1394. https://doi.org/10.2337/dc22-2376

Rossi, M. G. (2016). Metaphors for patient education. A pragmatic-argumentative approach applying to the case of diabetes care. Rivista Italiana di Filosofia del Linguaggio, 10(2), 34-48. https://doi.org/10.4396/20161205

Saban, A., Koçbeker, B. N., & Saban, A. (2006). An investigation of the concept of teacher among prospective teachers through metaphor analysis. Educational Sciences: Theory & Practice, 6(2), 509-522.

Sinnenberg, L., Mancheno, C., Barg, F. K., Asch, D. A., Rivard, C. L., Horst-Martz, E., Buttenheim, A., Ungar, L., & Merchant, R. (2018). Content analysis of metaphors about hypertension and diabetes on Twitter: exploratory mixed-methods study. JMIR Diabetes, 3(4), e11177. https://doi.org/10.2196/11177

Stuckey, H., & Peyrot, M. (2020). Living with diabetes: Literature review and secondary analysis of qualitative data. Diabetic Medicine, 37(3), 493-503. https://doi.org/10.1111/dme.14255

Tanriverdi, H., & Kahraman, C. O. (2018). Metaphor analysis. In Ş. Arslan (Ed.), Research methods in social sciences. Education Publishing House.

Terry, G., Hayfield, N., Clarke, V., & Braun, V. (2017). Thematic analysis. In C. Willig & W. S. Rogers (Eds.), The SAGE handbook of qualitative research in psychology (2nd ed., pp. 17-37). SAGE Publishers.

Trikkalinou, A., Papazafiropoulou, A. K., & Melidonis, A. (2017). Type 2 diabetes and quality of life. World Journal of Diabetes, 8(4), 120-129. https://doi.org/10.4239%2Fwjd.v8.i4.120

Turkish Society of Endocrinology and Metabolism. (2022). Diabetes mellitus and its complications diagnosis, treatment and follow-up guide [in Turkish]. Turkey: Turkish Society of Endocrinology and Metabolism. https://file.temd.org.tr/Uploads/publications/guides/documents/diabetes-mellitus_2022.pdf

Wu, F.-L., Tai, H.-C., & Sun, J.-C. (2019). Self-management experience of middle-aged and older adults with type 2 diabetes: A qualitative study. Asian Nursing Research, 13(3), 209-215. https://doi.org/10.1016/j.anr.2019.06.002


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