This study examines the use of metaphors in Chinese doctor-patient interactions by combining Conceptual Integration Theory (CIT) and Frame Semantics (FS). Against the particular cultural context of Confucian ethics blended with modern medical practices in China, we investigated the role of metaphors in forming perceptions of doctor-patient relationships and physicians’ professional identities. Based on a mixed-method approach consisting of 263 questionnaires and 20 interviews, our analysis identified different sets of metaphors with important cognitive and cultural implications. Positive metaphors (e.g. Angel in white and Health engineer) were rated consistently highly by both groups and increased trust and cooperation, anchored by culturally stable cognitive frames. However, negative metaphors (e.g. Butcher or Foe) developed dynamically in response to negative medical experiences from the main group of patients, and reflected emotional tensions and relational breakdowns. Doctors tended to interpret the metaphors alike, as their common training and codes of practice gave them clear clues as to what was meant. Patients, however, showed a wider variation since interpretations expanded out of personal experience. By integrating Conceptual Integration Theory with Frame Semantics, this research demonstrates how some metaphors are culturally stable and context-sensitive, and provides a two-layer model that can be used to inform metaphor-aware communication training with patients and to cross-cultural comparisons within healthcare.
Yang et al. (Wed,) studied this question.