老年认知障碍患者医患会话中的打断行为研究

A Study of Interruption Behaviors of Elderly Patients with Cognitive Impairment in Physician-patient Conversations

文章以我国华南地区老年认知障碍人群为研究对象,通过对真实医疗门诊的录音录影观察和分析,探究医患陪多方会话中患者的打断行为特征。研究表明,即使在认知能力受损的情况下,部分患者依旧可以做出成功打断行为。然而,患者打断医生与打断陪同的方式不尽相同,前者多出现合作性打断,而后者则可能出现冲突性打断。此外,患者的不成功打断多与对话轮转换误判、自身话语组织困难以及多模态交际能力下降有关。对认知障碍人群打断行为的研究,可以为我国现阶段改善门诊医患沟通、维系患者与外界交流、辅助患者认知康复等课题提供意见与建议。

This study focuses on the interruption in behaviors of cognitively impaired elderly people in physician-caregiver-patient conversation.The data we used were collected during the memory consultation in a hospital in southern China.We start with a theoretical and epistemological reflection on the notion of interruption before conducting a multimodal analysis of the characteristics of patients'interruptions.The results reveal that despite cognitive impairment,some patients still retain the ability to interrupt their interlocutors but in different ways.It is essentially a cooperative interruption between physician and patient and an intrusive interruption between caregiver and patient.We observe that unsuccessful interruption on the part of the patient is strictly related to the misinterpretation of the TRP,formulation difficulties and deterioration of the interactive multimodal capacity.The study of interruption behaviors in cognitively impaired individuals may provide suggestions and recommendations for physician-caregiver-patient communication,maintenance of communication between patient and the outside world,and cognitive rehabilitation.