Endometriosis, as a widespread gynecological condition, affects an estimated 1 in 10 women and yet has a worldwide average diagnosis length of 7.5 years. Causing incapacitating pain, among other associated manifestations, the condition severely impacts on women’s lives. This article uses online survey data to investigate how pre-diagnosis endometriosis pain is conceptualized and articulated in order to explore communication challenges reported in early consultations that can potentially be seen to play a role in diagnosis delay. The findings of this study indicate that women feel that they do not have the appropriate tools to describe their pain and, in many instances, feel dismissed therefore prolonging diagnosis. The article finds that the majority of the pain descriptors identified use elaborate metaphorical scenarios to convey the intensity of the pain and concludes with some reflections on the issue of metaphorical language in endometriosis pain communication practices while calling for interdisciplinary work in order to devise appropriate tools for endometriosis pain communication.

This work explores disempowerment caused by discourses surrounding the life altering gynaecological disease of endometriosis. Despite affecting 1 in 10 women, the worldwide average diagnosis time is 7.5 years and it is mainly diagnosed when exploring infertility rather than complaints about incapacitating pain and other associated manifestations. The aim of this paper is to identify dis/empowerment caused by discourses in the health-care and social environment of women as manifested in their accounts of endometriosis experiences. Having been informed and shaped by a corpus analysis of online forum data, this work explores accounts collected through interviews with women who have endometriosis using discourse analytical tools. Through an examination of the dialectics between micro-level language choices inscribing agency, or lack of, and macro-level discourses in the contexts in which women interact, the findings indicate that disempowerment is mostly a consequence of the perceived lack of agency over achieving diagnosis and knowledge of the condition in order to understand and learn coping strategies. The article concludes with implications for Endometriosis communication practices and suggestions for broader enquiries in the field.

Objectives. Endometriosis is a long-term condition in which endometrial-like tissue grows outside of the womb, causing intense chronic pain. Previous work has demonstrated the physical and emotional impact on women who live with endometriosis, and metaphors can play an influential role in communicating the experience of pain, but there exists little understanding of the role and impact of such language for women with endometriosis. Design. A qualitative, semi-structured interview design. Methods. Conceptual Metaphor Theory (CMT) and Interpretative Phenomenological Analysis (IPA) were utilized in a mixed-methods study to examine the prevalence, types, and meaning of metaphors and metaphor use as a health communication strategy. Twenty-one women aged between 23 and 53 years (mean age 36.1 years) with endometriosis took part in audio-recorded interviews. Results. The women reported experiencing symptoms for an average of 11 years before receiving a formal diagnosis of endometriosis, and the mean age of diagnosis was 27.6 years. Seven distinct conceptual metaphors were identified in 221 metaphorical expressions used across all participants, with most common ones referring to pain as physical properties of elements such as temperature and pressure, physical damage, and an external attacker. IPA revealed three themes pertaining to the feeling of vulnerability and helplessness, pain being incomprehensible, and a drive to manage and conceal pain simultaneously. Conclusions. This study demonstrates the power of language in facilitating understanding and empathy in the listener, alongside the challenge of communicating endometriosis pain to others. Imagery-based techniques may assist in adaptation to, interpretation, and acceptance of pain to reduce pain-related distress. Statement of contribution What is already known on this subject? Endometriosis is a debilitating gynaecological condition causing incapacitating pain that is reportedly difficult to describe. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

The present paper investigates the sense making practices of participants in interaction within the context of reception studies of advertising and explores the cognitive nature of intertextuality and interdiscursivity as evidence of conceptual integration. The paper argues that sense making, through its intertextual and interdiscursive nature, is a carrier of attitudinal disposition which is manifested in the lexical selection of evaluative items arising from conceptual integration. The data examined for this study were collected from informants in focus groups when discussing a series of printed adverts that make reference to works of art. The results of the analysis indicate that intertextuality and interdiscursivity can be seen as constituting evidence of the conceptual phenomena of blending theory in sense making from where evaluative disposition emerges. They further suggest that both are processes in the audience’s sense making process rather than merely a feature of texts.

No abstract

Introduction: In the context of the complex medical, social, and economic factors that contribute to endometriosis diagnosis delay and its consequent impact on quality of life, this report focuses on patient-practitioner pain communication and examines the role of language in doctor-patient communication. Our study explored what patients and doctors consider challenging and effective in endometriosis pain communication. It further examined what commonly used metaphors by patients could be suggestive, or not, of endometriosis to doctors.Method: A United Kingdom-based qualitative (open-ended question) survey with women with endometriosis (n131) and semi-structured telephone interviews with general practitioners (GPs) (n11). Survey and interview data were analyzed thematically.Results: Both women and GPs reported the Numeric Rating Scale (NRS) to be insufficient as a standalone tool for communicating endometriosis related pain. Both also found descriptions of the quality, location, and impact on daily life of pain to more effective means of communicating pain symptoms. When presented with common metaphorical expressions surveyed women used to describe their pain, not all GPs recognized such metaphors as indicative of possible endometriosis. Further, some GPs reported some of the expressions to be indicative of other pathologies.Conclusion: Findings reveal the importance of language in pain communication and the need for additional tools to help women and doctors find the most effective way to communicate the experience and elicit appropriate investigative care. They also show the need for further investigation into how metaphor can be effectively used to improve patient-practitioner communication of endometriosis related pain.

No abstract

In this article, I explore clichés as socio-cognitive resources that enable the expression of attitudinal positioning in interaction. I examine a corpus of 150 clichés collected from a variety of publicly available sources and illustrate their function by exploring how they are used to convey evaluation in institutional meetings. By co-deploying the attitude system of the appraisal framework with socio-cognitive discourse analysis tools, I argue that clichés can be used to provoke evaluation through the socio-cognitive resources they evoke given the shared knowledge contained within them. The findings indicate that the majority of evaluative instances relate to performance or ability of human entities by reference to basic aspects of human experience contained in the socio-cognitive representations evoked. The article also finds that the provoked attitudinal values work in a cumulative way to create a flow of evaluative patterns, which, in turn, contributes to our understanding of the interpersonal function they perform, i.e. persuade, urge action and save face. The paper argues that the co-deployment of both approaches allows the investigation of clichés as resources for covertly expressing evaluation by reference to knowledge shared by the interlocutors.