Perceptions of intensive care nurses on the concepts of brain death and coma: a metaphor analysis

Abstract

Aims: Intensive care nurses take active roles in the treatment and care practices of patients who are in critical condition and who develop neurological problems such as coma and brain death. Nurses need to have knowledge about the subject and take precautions against ethical problems. This study aimed to determine the perceptions of intensive care nurses about the concepts of brain death and coma through metaphors. Metaphor analysis was used as a qualitative research method. Methods: Using content analysis, 20 intensive care nurses produced 20 different metaphors for the question, “Coma is similar to ..., because ...”. Nurses mostly likened the concept of a “coma” to a “plant”, “stay together”, and “deep sleep”. They also produced 20 different metaphors for the question, “Brain death is similar to ..., because…”. Results: Nurses mostly likened the concept of brain death to a “plant”, “absolute death”, and a “coma”. Brain death and a coma were common to three of the metaphors produced by nurses (“uncertainty/unresponsiveness”, “death/eternity”, and “permanent breakdown” metaphors). The answers given to the questions about the concepts of brain death and a coma were “uncertainty/unresponsiveness”, “death/eternity”, and “permanent breakdown” metaphors. The nurses confused the concepts of a coma and brain death with each other and had similar perceptions of the two concepts. Conclusion: Three of the metaphors produced by nurses were common “uncertainty/unresponsiveness”, “death/eternity”, and “permanent breakdown”. Metaphors produced by the nurses regarding the concept of brain death were categorized as disaster and support.