门诊会话中家属参与诊疗的作用研究

Study of Family Members’ Contributions in Chinese Outpatient Interaction

基于自然发生的医生-患者-家属互动的语料,使用会话分析和实证研究方法,对门诊会话中家属参与诊疗所采用的语言和话语策略及其社会语用功能进行了细致的分析,并从认知情态的视角加以阐释。研究发现,家属在诊疗过程中主要实现的功能有提供信息,分担责任;提出疑问,参与决策;提出话题,表示建议。这反映了医生-患者-家属基于对交际者认知状态以及认知地位的认识,实时监控并调整话语策略,来表达自己的认知立场,并对门诊交际和沟通提供一定的启示。

Based on the data from naturally occurring corpus of doctor-patient-family medical interactions, this paper presented an empirical analysis of socio-pragmatic functions of family members' contribution in outpatient interaction by employing different linguistic and discursive strategies, with an interpretation from the perspective of epistemics. It found that there were three functions, such as providing information, sharing responsibility;asking questions, participating in decision-making;proposing topics and suggestions. Doctors, patients and family members employed different linguistic and discursive strategies to express their epistemic stance on the basis of their understandings of the epistemic status of themselves and of their interlocutors, which provideed implications for outpatient communication.