Metaphors that shape parents’ perceptions of effective communication with healthcare practitioners following child death: a qualitative UK study

Abstract

ObjectivesTo offer an interpretation of bereaved parents’ evaluations of communication with healthcare practitioners surrounding the death of a child.DesignInterpretative qualitative study employing thematic and linguistic analyses of metaphor embedded in interview data.SettingEngland and Scotland.Participants24 bereaved parents (21 women, 3 men)MethodsParticipants were recruited through the True Colours Trust website and mailing list, similar UK charities, and word of mouth. Following interviews in person or via video-conferencing platforms (Skype/Zoom), transcripts first underwent thematic and subsequently linguistic analyses supported by Nvivo. A focused analysis of metaphors used by the parents was undertaken allow in-depth interpretation of how they conceptualised their experiences.ResultsThe findings illuminate the ways parents experienced communication with healthcare practitioners surrounding the death of a child. They show how their evaluations of effective care relate to the experience of the bereavement itself, as expressed through metaphor. We identified three broad themes: (1) Identity (2) Emotional and Physical Response(s) and (3) Time. Successful communication from healthcare practitioners takes account of parents’ experiences related to these themes.ConclusionsThis study suggests that healthcare practitioners when communicating with bereaved parents need to recognise, and seek to comprehend, the ways in which the loss impacts upon an individual’s identity as a parent, the ‘physical’ nature of the emotions that can be unleashed, and the ways in which the death of a child can alter their metaphorical conceptions of time.Strengths and limitations of the studyThis interpretative qualitative study contributes to the growing literature on the experience of parental bereavement through its focus on the use of metaphor in parents’ accounts of child loss.The metaphor analysis afforded a focus not only on the content of the interviews, but also on the language that was used to express this content, providing more depth and nuance to the interpretation of the findings.Participants were all UK-based and self-selecting which could limit transferability.