ArgLab awarded FCT Research and Development project - METACARE

Evidence-based metaphors for diabetes care

R&D project PTDC/FER‐FIL/28278/2017 (2018-2021)

Metaphors are crucial instruments of communication, especially in chronic care communication. They can make technical or unfamiliar concepts familiar, and thus can be used for explaining medical notions or promoting adherence, compliance, or lifestyle changes. However, at the same time, they can be sources of misunderstanding and confusion. Choosing the most effective metaphors thus becomes a fundamental clinical challenge for chronic care.

The growing need of evidence-based metaphors is the challenge that this project addresses. The goal is to develop a theoretical model of metaphor interpretation and a coding scheme for evaluating metaphor effectiveness. We will apply theoretical advances to the analysis of a corpus of Italian and Portuguese doctor-patient interviews in diabetes care. The metaphors used in doctor-patient interactions will be subjected to a twofold analysis. On the one hand, their effects on the medical communication will be classified considering their role in promoting understanding or causing misunderstanding, communicative gaps, or lack of understanding. On the other hand, the metaphors used will be analyzed considering their relations with the interlocutors’ common knowledge and the reasoning underlying the speaker’s use of a specific metaphor.  

            The project has three objectives, two theoretical and one practical. First, a pragmatic and functional theory of metaphor interpretation will be developed, filling a gap in the literature of philosophy of language. The idea is to conceive metaphors as the object of a process of best explanation of meaning, in which the various presumptions concerning the possible function of the metaphor in the given dialogue, language use, beliefs and values are assessed. This model is aimed at pointing out the role of context and common knowledge in metaphor understanding. The second objective is to develop a coding scheme for capturing degrees of misunderstanding in dialogues, addressing a crucial problem in communication and discourse studies. The communicative effectiveness of a metaphor will be evaluated based on how the interlocutor replies to the metaphorical utterance (the interlocutor’s uptake of the utterance). The empirical goal, concerning the area of communication in diabetes care, is to provide an evidence-based corpus of effective (and ineffective) metaphors concerning diabetes, in which they are also classified and assessed based on the theoretical advances, pointing out whether, why, and how they can be the source of understanding and misunderstanding.  The output is an instrument that will be used in doctors’ training and communication courses (also offered to patients). The theoretical insights and empirical instruments developed can be applied to several other areas of communication.  

             All team members are expert in the theoretical and applicative aspects of the project, and each one is specializing and has achieved excellent outcomes in a specific area of the work plan.