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


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.
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Accepted for publication: 2024-01-19
Peer reviewed: Yes

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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.


Copyright (c) 2024 Aslı Tok Özen, Özlem Bulantekin Düzalan, Betül Yalçın

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Declaration of Conflicting Interest

There are no conflicts of interest to disclose.


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.


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