KASMEJ
Kastamonu Medical Journal

Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

eISSN: 2757-9336
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
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.

Keywords : Brain death, coma, intensive care, metaphor, nurse

Download Article


1. Mayer SA, Shapiro JM, Gidwani UK, Oropello JM. Neurologic criticalcare. In: Mayer SA, ed. Mount Sinai Expert Guides: Critical Care. Wiley-Blackwell: 2021:293-298.
2. Karpenko A, Keegan J. Diagnosis of coma. Emerg Med Clin North Am.2021;39(1):155-172.
3. Giacino JT, Fins JJ, Laureys S, Schiff, ND. Disorders of consciousnessafter acquired brain injury: the state of the science. Nat Rev Neurol. 2014;10(2):99-114. doi: 10.1038/nrneurol.2013.279
4. Machado C, Korein J. Persistent vegetative and minimally conscious states.Rev Neurosci. 2009;20(3-4):203-220. doi: 10.1515/revneuro. 2009.20.3-4.203
5. Arsava EM, Demirkaya S, Dora B, et al. Türk Nöroloji Derneği beyinölümü tanı kılavuzu. 2014;20(3):101-104.
6. Drake M, Bernard A, Hessel E. Brain death. Surgical Clin North Am. 2017;97(6):1255-1273.
7. Starr R, Tadi P, Pfleghaar N, et al. Brain Death (Nursing) [Updated2024 Mar 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearlsPublishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568811/
8. Wijdicks EF, Varelas PN, Gronseth GS, Greer DM. Evidence-basedguideline update: determining brain death in adults: report of the qualitystandards subcommittee of the American Academy of Neurology. Neurol.2010;74(23):1911-1918. doi: 10.1212/WNL.0b013e3181e242a8
9. Arslan G. The impact of nurses’ ethical sensitivity levels on theirapproaches to ethical issues specific to intensive care. Master’s Thesis.Acıbadem Mehmet Ali Aydınlar University Institute of Health Sciences.Istanbul. 2017.
10. Ozden D, Karagozoglu S, Yildirim G, Tabak E. Intensive care nurses’opinions of futile treatment. Turkish J Res Develop Nursing. 2013;15(2):42-54.
11. Braine ME, Cook N. The Glasgow coma scale and evidence-informedpractice: a critical review of where we are and where we need to be. J ClinNursing. 2017;26(1-2):280-293.
12. Bhaskar S. Glasgow coma scale: technique and interpretation. Clin Surg.2017;2:1575.
13. Jain S, Iverson LM. Glasgow Coma Scale. [Updated 2023 Jun 12]. In:StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513298/
14. Puggina AC, Paes da Silva MJ, Schnakers C, Laureys S. Nursing careof patients with disorders of consciousness. J Neurosci Nursing. 2012;44(5):260-270. doi: 10.1097/JNN.0b013e3182666407
15. Neubauer BE, Witkop CT, Varpio L. How phenomenology can help uslearn from the experiences of others. Perspect Med Educ. 2019;8(2):90-97.doi: 10.1007/s40037-019-0509-2
16. Kocabıyık OO. Phenomenology and grounded theory: a comparison interms of some features. Trakya J Educ. 2016;6(1):55-66.
17. Schmitt R. Systematic metaphor analysis as a method of qualitativeresearch. Qualitative Rep. 2005;10(2):358-394. doi: 10.46743/2160-3715/2005.1854
18. Eraslan Capan B. The metaphorical perceptions of teacher candidatesregarding the concept of the gifted child. J Int Soc Res. 2010;3(12):140-154.
19. Gunes A, Firat M. Metaphor analysis research in open and distancelearning. Açıköğretim Uyg Araşt Derg. 2016;2(3):115-129.
20. Yildirim A, Simsek H. Qualitative research methods in social sciences. 5thed. Ankara: Seçkin Publishing: 2006.
21. Saban A. Mental images of pre-service teachers about the concept ofstudent. Turkish J Educ Sci. 2009;7(2):281-326.
22. Pearson A, Robertson-Malt S, Walsh K, Fitzgerald M. Intensive carenurses’ experiences of caring for brain-dead organ donor patients. J ClinNursing. 2001;10(1):132-139. doi: 10.1046/j.1365-2702.2001.00447.x
23. Andsoy II, Gul A. Knowledge and thoughts of nurses about brain deathand vegetative state. Med J Bakirkoy. 2018;14(1):1-7.
24. Gul S, Genc Kuzuca İ, Yalim NY. The ideas of nurses about the reflection ofethics education in their professional life. Turkish J Bioethics. 2016;3(2):85-97.
25. Victorino JP, Mendes K, Westin ÚM, Magro J, Corsi C, Ventura C.Perspectives toward brain death diagnosis and management of thepotential organ donor. Nursing Ethics. 2019;26(6):1886-1896. doi:10.1177/0969733018791335
26. Perdigon A, Griseida C, Strasser G. Dying process and nursing: a relationalapproach: theoretical reflections on assistance dealing with death. Physis.2015;25(2):485-500. doi: 10.1590/S0103-73312015000200009
27. Santos JL, Bueno SM. Educação para a morte a docentes e discentes deenfermagem: Revisão documental da literatura científica (Death educationfor nursing professors and students: A document review of the scientificliterature). Rev Esc Enferm USP. 2011;45(1):272-276. doi: 10.1590/s0080-62342011000100038
28. Sapulu Y. Evaluation of the knowledge, attitudes, and approaches ofnurses working in the intensive care unit towards organ/tissue donationand transplantation. Master Thesis, Haliç University Institute of HealthSciences Department of Surgical Nursing. Istanbul. 2011.
29. Jack BA, Mitchell TK, Cope LC, O’Brien MR. Supporting older peoplewith cancer and life-limiting conditions dying at home: a qualitative studyof patient and family caregiver experiences of hospice at home care. J AdvNursing. 2016;72(9):2162-2172.
30. Ozarslan AD. Medicalization of death and intensive care unit as aheterotopia. MSGSU Soc Sci. 2017;1(15):30-44.
31. Karaman A. The role of intensive care nurses in referring the families/relatives of brain-dead patients to organ donation. Master Thesis, IstanbulUniversity Institute of Health Sciences Department of Surgical DiseasesNursing. Istanbul. 2015.
32. Longuiniere ACF, Lobo MP, Leite PL, Barros RCS, Souza AN, Vieira SNS.Knowledge of critical care nurses about the process of brain death diagnosis.Rev Rene. 2016;17(5):691. doi: 10.15253/2175-6783.2016000500015
Article available in :
Volume 4, Issue 2, 2024
Page : 45-51
https://doi.org/10.51271/KMJ-0141
Article Information
Received : 21 Nis 2024
Accepted : 08 May 2024
Published : 07 Haz 2024
Corresponding Author :

Canan Kaş: Department of Midwifery, Faculty of Health Sciences, Kastamonu University, Kastamonu, Turkiye

[email protected]
Citation : Kaş C, Durmuş İskender M, Akın Eroğlu S. Perceptions of intensive care nurses on the concepts of brain death and coma: a metaphor analysis. Kastamonu Med J. 2024;4(2):45-51.

Read: 530
Cited: 0
Download : 275
_Footer