Abstract: Objectives: Following organ transplantation, complex psychological
processes take place. This study investigated patients' use of
metaphors relating to their experience of lung transplantation as well as
differences in the use of these metaphors between patients with either high or
low compliance. Methods: Fourteen lung transplant recipients were interviewed about
their experiences with the transplantations. Compliance was assessed by the
physicians in charge. To identify pre- and unconscious representations, a
qualitative metaphor analysis was performed. The interrater-reliability of the
metaphor-categorical groups was Cohen's Kappa k = 0.8. Results: Patients perceived their individual bodies/selves as a
"container" that includes both material objects (such
as the lung) and immaterial objects (such as thoughts about the donor,
affects). The main difference between the compliance groups was that
non-compliant patients experienced more distance to the transplanted lung. They
did not conceive the lungs as contents of their body or self. Conclusions: The results show that high compliance was associated
with a successful integration of the transplant. This integration included the
experience that the lung belongs to the recipient as a part of the body/self.
Non-compliant patients were more likely to perceive the lungs as a foreign
part. These psychological processes are partly of a conscious, but also partly
of a pre- and unconscious nature.
Keywords: Lung transplantation, compliance, organ integration, organ donor, unconscious representations, metaphor analysis
