急诊室第三方陪同就诊的话轮转换分析

A study of the third-party’s turn-taking in doctor-patient interaction in the emergency room

本文基于会话分析理论,对急诊科医-患-陪三方会话进行转写,采用定性和定量相结合的方法,分析第三方陪同人员的话轮分配和会话序列结构。研究发现了一种新的自我选择获取话轮方式——先于指定发言人发言;第三方的介入旨在缓解病患对症状表述不清、医生疏于对病患进行心理安抚的状况。第三方通过前扩展、插入扩展和后扩展来建构其会话序列,发挥安抚患者情绪、重述医生观点、缓解医患关系及提升就诊效率的作用。本研究的理论价值在于提出“先于指定发言人发言”这一类型,丰富自我选择获取话轮的方式,实践价值在于有利于推动医-患-陪三方的良性沟通。

Based on the transcription of the triadic interaction among doctors,patients,and thirdparty participants in the emergency room,this paper aims to study the third-party’s turn-taking and sequence organization in terms of conversation analysis.Through qualitative and quantitative analysis,it is found that the third-party participants could take the floor in a new manner—speaking ahead of the selected speaker.Their involvement could provide the doctors with the patients’additional symptoms and reassure the patients.The third-party participants build their sequence through pre-expansion,insert expansion and post-expansion,which perform functions such as comforting the patients,improving doctor-patient relationships and facilitating the process of medical consultation.The present study theoretically enriches the manners of floortaking and practically facilitates efficient triadic interaction.