Power Relations in Older Adults’ Cognitive Interaction in Clinical Setting: A Multimodal Pragmatic Perspective

老年认知评估互动中的权势关系研究:基于多模态语用学视角

This study explored the construction of power relations in the cognitive assessment of older adults within the Chinese clinical context.Data is derived from audio and video recordings that nine older adults produced in the cognitive assessment of the Chinese version of the Montreal Cognitive Assessment-Basic(MoCA-B),which were then annotated and analyzed from a multimodal pragmatic perspective.The study reveals that examiners and older adults employed various speech acts to achieve distinct communicative goals,with power relations between them being reflected through these speech acts.Examiners tend to claim high power,utilizing discourse strategies such as request,interruption,evaluation,rhetorical questions,and directive speech acts.In contrast,older adults assert high power through directive speech acts,rhetorical questions,and interruptions.Both parties also exhibit low power by using confirming questions and explanations.Additionally,gestures,smiles,prosody features,and other non-verbal communicative resources are synergistically employed to exercise power.The interactive mechanism of constructing power relations reveals that age affects older adults’power relations construction even in a professional setting of the Chinese context.The negotiation between the advanced age of older adults and the expertise of examiners jointly shapes power relations in their interactions.

本研究主要考察临床语境下老年人进行认知评估时的权势关系建构问题。语料源自9名中国老年人在进行蒙特利尔认知评估(MoCA-B)(中文版)时的录音录像数据,研究通过多模态语用学视角进行注释和分析。结果发现,认知评估员和老年人在使用言语行为实现交际目标的过程中,双方的权势关系得以不断显现。评估员倾向于利用请求、打断、评价、反问和指令等话语策略来建构自己的高权势;而老年人则通过指令、反问和打断等话语策略来建构高权势。双方都会通过确认性问话和解释来建构自己的低权势。同时,双方协同调用手势、微笑、韵律特征等非言语交际资源来共同建构权势。研究结果表明,在医疗健康等专业机构的互动语境下,年龄也会对权势关系的建构产生影响。老年人的高龄和评估员的专业技能相互拉锯,共同影响双方在互动中的权势关系建构。