醫(yī)患話語中的重復(fù)
發(fā)布時(shí)間：2019-02-08 20:51
【摘要】：學(xué)者們從不同的角度對重復(fù)進(jìn)行了研究,但較少從語篇理解和加工的角度分析重復(fù)對于交際雙方社會(huì)關(guān)系的影響。醫(yī)患關(guān)系一直是人們關(guān)注的社會(huì)焦點(diǎn)問題,雙方的交際涉及心理因素,因此,從語篇理解和加工的角度,本文以在三家甲級醫(yī)院實(shí)地采集共計(jì)約25小時(shí)的醫(yī)患對話錄音轉(zhuǎn)寫為語料,以會(huì)話分析和批評性話語分析理論為框架,通過定性和定量分析相結(jié)合的方式,對醫(yī)患話語中醫(yī)生和患者雙方重復(fù)使用的形式和功能進(jìn)行描寫和分析,從話語產(chǎn)出和理解的角度分析雙方對于重復(fù)使用的不同,探討醫(yī)患雙方各自的心理過程和心理圖示,以及其對于雙方社會(huì)關(guān)系構(gòu)建的影響。 本文首先將醫(yī)患對話中重復(fù)從修辭行為和結(jié)構(gòu)兩個(gè)角度分類,并對雙方的重復(fù)進(jìn)行形式化描寫,發(fā)現(xiàn)醫(yī)患在重復(fù)使用的不同。在修辭行為上,醫(yī)生涉及所有共計(jì)十一種修辭行為,而患者主要集中在癥狀上；在結(jié)構(gòu)重復(fù)上,醫(yī)生更傾向使用全部重復(fù)及連續(xù)重復(fù),而患者大多使用補(bǔ)充重復(fù)和間隔重復(fù)。在功能上,醫(yī)生的重復(fù)用于明確問題尋求準(zhǔn)確信息,解釋治療方案以期患者同意,確認(rèn)信息和要求患者更細(xì)致的描述,而患者的重復(fù)用于詳細(xì)描述癥狀引起醫(yī)生重視,評價(jià)醫(yī)生先前的治療,要求更多解釋及尋求醫(yī)生的確認(rèn)。 然后從話語理解和產(chǎn)出的角度揭示了雙方在局部連貫和整體連貫兩方面上的不同。在在局部連貫上,醫(yī)生大量的全部重復(fù)和連續(xù)重復(fù)使用,反映出其采用直接匹配和尋找己知和未知信息的方式,在話題內(nèi)部和醫(yī)患對話不同階段使用平行處理模式和非循環(huán)式處理模式；而患者的補(bǔ)充重復(fù)和間隔重復(fù),反映其采用重新恢復(fù)已知信息的方式,使用串行處理模式和循環(huán)式處理模式。在整體連貫上,醫(yī)生為自上而下的心理模式,而患者為自下而上的心理模式。 最后由于話語理解和加工上的不同,導(dǎo)致雙方對于醫(yī)患對話中兩者間社會(huì)關(guān)系的期待(傳統(tǒng)的家長主義和消費(fèi)主義)也不同,進(jìn)而引起了兩者交流的障礙。若患者不配合醫(yī)生自上而下的處理模式和演繹式陳述方式,或醫(yī)生不考慮患者自下而上的處理模式和歸納式表達(dá)方式,兩者交流便會(huì)出現(xiàn)障礙。 從重復(fù)這一言語行為入手,分析雙方在語篇理解和加工上的不同,進(jìn)而反映兩者社會(huì)關(guān)系的構(gòu)建,在語篇、心理和社會(huì)三個(gè)層面逐一探討,不僅加深了對于重復(fù)本身的理解,并且嘗試性探索了以往批評性話語分析直接從語篇層面到社會(huì)層面卻忽略交際雙方心理因素的研究,為理解醫(yī)患社會(huì)關(guān)系提供了新的視角。
[Abstract]:Scholars have studied repetition from different perspectives, but have rarely analyzed the impact of repetition on social relations between communicative and communicative parties from the perspective of discourse comprehension and processing. The relationship between doctors and patients has always been the focus of attention. The communication between the two sides involves psychological factors. Therefore, from the perspective of text understanding and processing, Based on the data collected in three A-grade hospitals for about 25 hours of doctor-patient dialogue recording, and using the theory of conversational analysis and critical discourse analysis as the framework, this paper combines qualitative and quantitative analysis. This paper describes and analyzes the forms and functions of repeated use by doctors and patients in doctor-patient discourse, analyzes the differences between the two sides in terms of utterance output and understanding, and probes into the psychological process and psychological diagrams of both doctors and patients. And its influence on the construction of bilateral social relations. This paper first classifies the repetition in doctor-patient dialogue from two aspects of rhetorical behavior and structure, and formalizes the repetition of both sides, and finds out the difference of the repeated use between doctors and patients. In rhetorical behavior, doctors involve all 11 rhetorical behaviors, while patients mainly focus on symptoms. In structural repetition, doctors tend to use total repetition and continuous repetition, while most patients use complementary repetition and interval repetition. Functionally, the doctor's repetition is used to identify the problem, to seek accurate information, to explain the treatment plan with the patient's consent, to confirm the information and to require a more detailed description of the patient, while the repeated use of the patient's repetition to describe the symptoms attracts the attention of the doctor. Evaluate the doctor's previous treatment, ask for more explanation and seek doctor's confirmation. Then it reveals the differences between the two sides in local coherence and global coherence from the perspective of discourse comprehension and output. In local coherence, doctors use a large amount of complete repetition and continuous reuse, reflecting the use of direct matching and searching for self-knowledge and unknown information. Using parallel processing mode and non-circular processing mode in different stages of topic and doctor-patient dialogue; The complementary repetition and interval repetition of the patient reflect the way of restoring the known information, the serial processing mode and the cyclic processing mode. In overall coherence, the doctor is a top-down mental model, while the patient is a bottom-up psychological model. Finally, due to the differences in discourse comprehension and processing, the expectation of social relations between the two parties (traditional paternalism and consumerism) is different, which leads to the obstacles of communication between the two parties. If the patient does not cooperate with the top-down treatment model and the deductive statement, or the doctor does not consider the bottom-up treatment model and the inductive expression, the communication between the two will be hindered. Starting with the speech act of repetition, this paper analyzes the differences between the two sides in the comprehension and processing of the text, and then reflects the construction of the social relations between the two parties. In the discourse, the psychological and social aspects are discussed one by one, which not only deepens the understanding of the repetition itself. It also tries to explore the previous studies of critical discourse analysis from the discourse level to the social level, but neglects the psychological factors of both sides of communication, which provides a new perspective for the understanding of doctor-patient social relations.
【學(xué)位授予單位】：南京理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：H15
本文編號(hào)：2418781
[Abstract]:Scholars have studied repetition from different perspectives, but have rarely analyzed the impact of repetition on social relations between communicative and communicative parties from the perspective of discourse comprehension and processing. The relationship between doctors and patients has always been the focus of attention. The communication between the two sides involves psychological factors. Therefore, from the perspective of text understanding and processing, Based on the data collected in three A-grade hospitals for about 25 hours of doctor-patient dialogue recording, and using the theory of conversational analysis and critical discourse analysis as the framework, this paper combines qualitative and quantitative analysis. This paper describes and analyzes the forms and functions of repeated use by doctors and patients in doctor-patient discourse, analyzes the differences between the two sides in terms of utterance output and understanding, and probes into the psychological process and psychological diagrams of both doctors and patients. And its influence on the construction of bilateral social relations. This paper first classifies the repetition in doctor-patient dialogue from two aspects of rhetorical behavior and structure, and formalizes the repetition of both sides, and finds out the difference of the repeated use between doctors and patients. In rhetorical behavior, doctors involve all 11 rhetorical behaviors, while patients mainly focus on symptoms. In structural repetition, doctors tend to use total repetition and continuous repetition, while most patients use complementary repetition and interval repetition. Functionally, the doctor's repetition is used to identify the problem, to seek accurate information, to explain the treatment plan with the patient's consent, to confirm the information and to require a more detailed description of the patient, while the repeated use of the patient's repetition to describe the symptoms attracts the attention of the doctor. Evaluate the doctor's previous treatment, ask for more explanation and seek doctor's confirmation. Then it reveals the differences between the two sides in local coherence and global coherence from the perspective of discourse comprehension and output. In local coherence, doctors use a large amount of complete repetition and continuous reuse, reflecting the use of direct matching and searching for self-knowledge and unknown information. Using parallel processing mode and non-circular processing mode in different stages of topic and doctor-patient dialogue; The complementary repetition and interval repetition of the patient reflect the way of restoring the known information, the serial processing mode and the cyclic processing mode. In overall coherence, the doctor is a top-down mental model, while the patient is a bottom-up psychological model. Finally, due to the differences in discourse comprehension and processing, the expectation of social relations between the two parties (traditional paternalism and consumerism) is different, which leads to the obstacles of communication between the two parties. If the patient does not cooperate with the top-down treatment model and the deductive statement, or the doctor does not consider the bottom-up treatment model and the inductive expression, the communication between the two will be hindered. Starting with the speech act of repetition, this paper analyzes the differences between the two sides in the comprehension and processing of the text, and then reflects the construction of the social relations between the two parties. In the discourse, the psychological and social aspects are discussed one by one, which not only deepens the understanding of the repetition itself. It also tries to explore the previous studies of critical discourse analysis from the discourse level to the social level, but neglects the psychological factors of both sides of communication, which provides a new perspective for the understanding of doctor-patient social relations.
【學(xué)位授予單位】：南京理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：H15
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