The Lived Meaning of Postoperative Pain Through Patient Metaphors in the Perianesthesia Setting: A Phenomenological Study.

PURPOSE: Postoperative pain is a multidimensional experience that may be difficult to express using conventional pain descriptors. Metaphorical expressions can reveal the physiological, psychological, social, and spiritual meanings embedded in patients' pain experiences and provide additional insight into postoperative pain. The purpose of this study was explore how surgical patients express postoperative pain through metaphors and to identify the underlying meaning domains reflected in these expressions. DESIGN: A descriptive phenomenological study. METHODS: The study included 88 patients who underwent surgery in the general surgery and urology clinics of a university hospital. Data were collected through face-to-face semi-structured interviews conducted approximately 24 hours after surgery between August 1 and December 1, 2023. Participants completed a demographic information form and responded to a metaphor-elicitation prompt ("Pain is like… because…"), followed by probing questions. Data were analyzed using Giorgi's descriptive phenomenological approach. Coding and categorization techniques derived from qualitative content analysis were used solely to facilitate the systematic organization of participants' metaphorical expressions. FINDINGS: Participants' mean age was 46.93 ± 16.35 years; 83.0% had previous surgical experience, and 73.9% reported prior negative pain experiences. Participants generated 91 metaphor statements representing 14 distinct metaphors. Analysis revealed four overarching meaning domains of postoperative pain: psychological, physiological, social, and spiritual. Psychological meanings emerged most prominently, reflecting fear, stress, anger, restlessness, and loss of control. Physiological meanings emphasized bodily threat and functional restriction, whereas social and spiritual meanings illustrated burden, helplessness, endurance, transformation, and existential meaning-making. Collectively, participants described postoperative pain as extending beyond physical discomfort to encompass emotional, social, and spiritual dimensions. CONCLUSIONS: Metaphorical expressions provide an additional perspective on how patients make sense of postoperative pain that extends beyond physical discomfort. The findings suggest that brief metaphor-based questions may complement conventional pain assessment by offering an additional perspective on how patients make sense of postoperative pain. Further research is needed to determine their feasibility and potential value for supporting patient-centered communication in perianesthesia nursing care.