医患的错位:基于一位农村老年女性的叙事研究

Doctor-patient-Dislocation: A Narrative Analysis Based on an Elderly Rural Woman

以广东省某地级市三甲医院骨科为研究场所,用参与式观察法研究真实情境下骨科门诊及病房的医患交际。通过叙事重现一位农村老年女性分别与主管医生、住院医生及实习医生在病房沟通的主要场景,分析患者与医生在沟通过程中展现的冲突,归纳出医患沟通中存在以下三种错位现象,即:因果错位——患者注重结果,而医生强调解释原因;立场错位——患者是疾病的承受者,而医生是客观信息的提供者与传达者;信息错位——患者“输入”信息滞后,而医生急于“输出”信息。

The Doctor-patient-Communication(DPC) in the orthopaedic department was studied in a tertiary hospital of a prefecture-level city in Guangdong province through participant observation in real situation. This paper represents the main scenes of communication among a rural elderly woman and the attending doctor, resident doctor and the intern in the ward, as well as analyses the conflicts between patients and doctors in the communication process, and finally sums up three kinds of dislocations in doctor-patient-communication: causual dislocation, which means patients paymuch attention to the results while doctors emphasize in explaning the reasons;positional dislocation, that is patients are the bearers of the diseases while doctors are the providers and transmitters of objective medical information;informational dislocation, namely there is usually “input” delay in patients when receiving medical information while doctors are eager to offer information “output” during doctor-patient-communication.