Identifying Metaphors Used by Clinicians That Help Patients Conceptualize Complex Cardiac Device Data for Managing Their Health

Abstract

Metaphors are used to conceptualize one thing in terms of another that is more familiar or concrete. The use of metaphors in patient-provider communication has helped providers generate empathy and explain concepts effectively, improving patient satisfaction and understanding of health-related concepts. With advances in technology, concepts related to health monitoring have become increasingly complex, making the potential for using metaphors in health communication at its highest relevancy. With the increase in health data there is a need to improve tools to help people understand complex information. Ethical considerations, such as possible misinterpretation of health data, as well as the potential to widen disparities because of factors such as health literacy, must be addressed. Metaphors are powerful tools that can make explanation of information accessible, accurate, and effective for people who are monitoring their data. The current research aims to contribute design recommendations for using metaphors in communication between clinicians and patients for monitoring biventricular (BiV) pacing, a complex device data element used in the monitoring of patients with heart failure (HF) who have cardiac resynchronization therapy (CRT) devices. The overarching goal is to understand this process such that it can be applied to broader communication needs in health informatics. The study addresses the following aims: Aim 1: Identify metaphors clinicians use to conceptualize BiV pacing for CRT devices using semi-structured interviews with clinician experts. Aim 2: Identify metaphors that help patients conceptualize BiV pacing for CRT devices using semi-structured interviews with patients, and exploring the metaphors identified in Aim 1. Aim 3: Develop design recommendations for health informatics interventions using an understanding of metaphors that help patients understand BiV pacing for CRT devices. Themes from analysis of Aims 1 and 2 contribute to recommendations for the use of metaphors in health informatics interventions. The purpose of this work is to contribute to an in-depth understanding of metaphors in a specific health informatics context. Importantly, this research applies methods and principles from the field of health communication to address a communication-related issue in health informatics.