“Medikamente sind Bomben” – zum Metapherngebrauch von Lungentransplantations-Patienten mit guter oder ungenügender Compliance

Abstract

Objectives: Following organ transplantation, complex psychological processes take place. This study investigated patients’ use of metaphors relating to their experience of lung transplantation as well as differences in the use of these metaphors between patients with either high or low compliance.

Methods: Fourteen lung transplant recipients were interviewed about their experiences with the transplantations. Compliance was assessed by the physicians in charge. To identify pre- and unconscious representations, a qualitative metaphor analysis was performed. The interrater-reliability of the metaphor-categorical groups was Cohen's Kappa k = 0.8.

Results: Patients perceived their individual bodies/selves as a “container” that includes both material objects (such as the lung) and immaterial objects (such as thoughts about the donor, affects). The main difference between the compliance groups was that non-compliant patients experienced more distance to the transplanted lung. They did not conceive the lungs as contents of their body or self.

Conclusions: The results show that high compliance was associated with a successful integration of the transplant. This integration included the experience that the lung belongs to the recipient as a part of the body/self. Non-compliant patients were more likely to perceive the lungs as a foreign part. These psychological processes are partly of a conscious, but also partly of a pre- and unconscious nature.