Theme-oriented discourse analysis of medical encounters
Theme-oriented discourse analysis of medical encounters
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DOI：
10.1111/j.1365-2929.2005.02171.x
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发表时间：
2005-06-01
影响因子：
6
通讯作者：
Sarangi, S
中科院分区：
文献类型：
--
作者：
Roberts, C;Sarangi, S
方法主题导向的话语分析着眼于语言如何构建专业实践。自然发生的相互作用的记录被转录并与人种学知识相结合。分析主题主要来自社会学和语言学，揭示了意义是如何在互动中协商的。谈话的细节特征，如语调和词汇的选择，会引发对正在发生的事情和正在谈论的事情的推断。这些影响了互动者如何判断对方和做出决定。互动也有更大的修辞模式，病人和医生都说服对方。例子两个设置被用来说明这种方法：遗传咨询和多语言地区的初级保健咨询。在遗传咨询中，互动是围绕着知道的风险和发生的风险之间的紧张关系组织的。这可能导致卫生专业人员与患者及其家属之间的“修辞决斗”。在跨文化的初级保健环境中，当解释过程不能被视为理所当然时，谈话本身可能是问题。在这种情况下，即使是广泛接受的良好实践模式也可能导致误解。结论通过话语分析，可以放慢受审查的谈话速度，以展示活动的解释过程和总体模式。话语分析师和卫生专业人员一起工作，可以以新的方式看待问题，并开发干预措施和工具，以更好地了解医疗生活中的沟通。
APPROACH Theme-oriented discourse analysis looks at how language constructs professional practice. Recordings of naturally occurring interactions are transcribed and combined with ethnographic knowledge. Analytic themes drawn primarily from sociology and linguistics shed light on how meaning is negotiated in interaction. Detailed features of talk, such as intonation and choice of vocabulary, trigger inferences about what is going on and being talked about. These affect how interactants judge each other and decisions are made. Interactions also have larger rhetorical patterns used by both patients and doctors to persuade each other.EXAMPLES Two settings are used to illustrate this approach: genetic counselling and primary care consultations in multilingual areas. In genetic counselling, interactions are organised around the tension between the risks of knowing and the risks of occurrence. This can lead to a 'rhetorical duel' between health professionals and patients and their families. In intercultural primary care settings, talk itself may be the problem when interpretive processes cannot be taken for granted. Even widely held models of good practice can lead to misunderstandings under these conditions.CONCLUSION Through discourse analysis, the talk under scrutiny can be slowed down to show the interpretive processes and overall patterns of an activity. Discourse analysts and health professionals, working together, can look at problems in new ways and develop interventions and tools for a better understanding of communication in medical life.