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Qualitative Health Research
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Using Metaphor as a Qualitative Analytic Approach to Understand Complexity in Primary Care Research

Virginia Aita

University of Nebraska Medical Center, Omaha

Helen McIlvain

Research Division in the Department of Family Medicine at the University of Nebraska Medical Center, Omaha

Jeffrey Susman

Department of Family Medicine, University of Cincinnati, Ohio

Benjamin Crabtree

Department of Family Medicine, University of Medicine and Dentistry of New Jersey, New Brunswick

Metaphors offer exciting opportunities to identify and explore tacit knowledge and behavior that are embedded in complex organizations and shape health care practices. In this article, the authors explore the theoretical rationale, background, and advantages of using metaphor as an analytic strategy in qualitative health research. They used an analysis of 18practices in a comparative case study designed to explore office practice strategies for delivering cancer prevention services for illustrations. During the individual and comparative stages of the analysis process, researchers heeded the metaphors that they used in their descriptive language of practices. The authors explore examples showing how metaphors clarify unwritten assumptions, values, and motivators that shape variations in practice behavior.

Key Words: metaphor • qualitative health research • primary care • practice organization • values

Qualitative Health Research, Vol. 13, No. 10, 1419-1431 (2003)
DOI: 10.1177/1049732303255999
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