High school students' perspectives on childhood cancer: A metaphorical analysis

To explore high school students' perceptions of childhood cancer through metaphor analysis and to describe the cognitive, emotional, and social dimensions of these perceptions.

This descriptive qualitative study used metaphor analysis informed by Conceptual Metaphor Theory. Participants were 245 students aged 14-17 from two public high schools. Data were collected with a written metaphor elicitation form containing four prompts: "A child diagnosed with cancer is like … because …," "Society's perception of children with cancer is like … because …," "Being friends with a child with cancer is like … because …," and "A child fighting cancer is like … because …." The 980 metaphor responses were analyzed inductively using Braun and Clarke's thematic analysis.

Four themes were identified: (1) fragility and vulnerability, (2) uncertainty and fear, (3) struggle and resilience, and (4) social isolation and stigmatization. Metaphors such as "flower," "butterfly," and "glass" portrayed children with cancer as fragile, while "tunnel," "maze," and "infinity" depicted the illness as uncertain and unpredictable. "Lion," "warrior," and "marathon runner" represented these children as resilient, and "caged bird," "aquarium," and "alien" pointed to perceived social isolation and stigmatization.

Participants' metaphorical representations of childhood cancer extended beyond its medical dimension to emotional and social meanings. These findings may inform future school-based awareness efforts and nursing communication with school communities.