Abstract
This study examines the use of metaphors in Chinese doctor-patient interactions by combining Conceptual Integration Theory (CIT) and Frame Semantics (FS). Against the particular cultural context of Confucian ethics blended with modern medical practices in China, we investigated the role of metaphors in forming perceptions of doctor-patient relationships and physicians’ professional identities. Based on a mixed-method approach consisting of 263 questionnaires and 20 interviews, our analysis identified different sets of metaphors with important cognitive and cultural implications. Positive metaphors (e.g. Angel in white and Health engineer) were rated consistently highly by both groups and increased trust and cooperation, anchored by culturally stable cognitive frames. However, negative metaphors (e.g. Butcher or Foe) developed dynamically in response to negative medical experiences from the main group of patients, and reflected emotional tensions and relational breakdowns. Doctors tended to interpret the metaphors alike, as their common training and codes of practice gave them clear clues as to what was meant. Patients, however, showed a wider variation since interpretations expanded out of personal experience. By integrating Conceptual Integration Theory with Frame Semantics, this research demonstrates how some metaphors are culturally stable and context-sensitive, and provides a two-layer model that can be used to inform metaphor-aware communication training with patients and to cross-cultural comparisons within healthcare.
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Data availability
The derived dataset supporting the findings of this study is publicly available on ScienceDB at https://www.scidb.cn/s/UJr673. The shared dataset contains only de-identified, extracted questionnaire responses in the form of 5-point Likert-scale numerical ratings (1–5) on metaphors of doctors and the doctor–patient relationship. No personal identifiers or demographic variables (e.g., names, sex/gender, age, contact details) are included in the public dataset. The original consent forms and raw questionnaires containing identifiable information are not publicly available due to ethical and privacy restrictions, but are held securely by the research team in accordance with the ethics approval.
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Youwen Yang (first author) contributed to conceptualization, methodology, supervision, ethics approval coordination, and substantive feedback and revision of the manuscript. Wenbin Wang (second author and corresponding author) contributed to study design, data curation, formal analysis, interpretation of findings, visualization, manuscript drafting, journal correspondence, and responses to editorial requirements. Meirongzi Xu (third author) contributed to methodology development, theoretical framing support, participant liaison, questionnaire distribution, interview coordination, data organization, and manuscript revision. Wenbin Wang and Meirongzi Xu jointly developed the questionnaire and interview protocol. All authors approved the final manuscript.
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This study was conducted in accordance with the Declaration of Helsinki and its later amendments. Ethical approval was granted by the Ethics Committee of the School of Foreign Languages, Hubei University of Technology (Approval No. HBUTSFL20250115) on 2025-01-15. The committee confirmed that the research posed minimal risks to participants and excluded vulnerable populations (e.g., minors). All raw and identifiable materials (e.g., signed consent forms and original questionnaires containing personal identifiers) will be stored in encrypted form for three years from the date of publication and permanently destroyed thereafter.
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Written informed consent was obtained from all participants in February 2025. The consent form detailed the research purpose, procedures, potential risks/benefits, and participants’ right to withdraw at any time without penalty, and to request withdrawal of their raw identifiable data within 30 days of publication; such requests would be handled where feasible. The publicly shared dataset contains only de-identified, derived numerical responses.
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Yang, Y., Wang, W. & Xu, M. Framing medical encounters through metaphor: a cognitive and cultural account of Chinese doctor–patient discourse. Humanit Soc Sci Commun (2026). https://doi.org/10.1057/s41599-026-06932-7
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DOI: https://doi.org/10.1057/s41599-026-06932-7
