The patient's use of metaphor within a palliative care setting: theory, function and efficacy. A narrative literature review.

BACKGROUND The modes of communication which patients use are seen as important within the sphere of palliative care and have been the focus of much research. AIM This literature review aims to identify and analyse one particular mode of patient expression, namely that of the figure of speech (trope) 'metaphor', and ask questions regarding metaphor's therapeutic usefulness when engaging with the life-limited patient. DATA SOURCES The investigation revolves around a literature review of academic papers which focus on the metaphorical ways in which patients speak of their condition. RESULTS This paper provides the theoretical foundations for the patient's metaphoric utterances. It also delineates the variety and diversity of metaphors used by patients and categorises them into broad groupings which encompass metaphors of war, journeying, personhood, the natural world and existential concepts. CONCLUSIONS The papers reviewed suggest that metaphoric communication allows sensitive subjects to be dealt with and provides benefits for patients. The results suggest that engaging with patients at the metaphoric level enables them to create new ways of viewing their situation and opens up the possibilities of new coping strategies. Finally, some developmental trajectories emanating from the reviewed papers are suggested, which will allow the efficacy of metaphor to be explored further within a palliative care setting.