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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/2684
標題: | 醫病溝通中之協商:以北台灣之眼科醫師為例 Politeness in Medical Communication: A Study Based on an Ophthalmology Clinic in Northern Taiwan |
作者: | Hsueh-Min Hsu 許學旻 |
指導教授: | 蘇以文(I-Wen Su) |
關鍵字: | 醫病言談,醫病溝通,醫師病人陪同者溝通,醫病三方溝通,禮貌, medical discourse,doctor-patient communication,doctor-patient-companion communication,triadic medical communication,politeness, |
出版年 : | 2017 |
學位: | 碩士 |
摘要: | 本研究主要關注於醫病溝通間醫師、病人與陪同者相互協商與共同建構的溝通過程。由於權力的不同導致在看診時,參與者為了達到各自的溝通目的而使用不同的禮貌策略,當有陪同者在現場時,會使問診過程更加複雜。本論文希望藉由臨床上實際醫病溝通的語料,提供一個增進醫病關係的切入點,從語言學觀點探討增進醫病溝通的可能。
醫病溝通相關研究在西方已蓬勃發展數十年,台灣的醫學教育與體系也是承襲西方醫學,然而,醫病問診中因為醫師與病人地位不平等或是權力的拉鋸,是影響醫病溝通的因素。在醫師的角度,希望能給予病患最好的治療,並增加病人遵醫囑的接受度,對於患者而言,他們想要選擇偏好的治療,或是對於病況有疑問能得到解答,雙方透過溝通來達到交換資訊與達到共同決策的目的。 本研究採用質化的方式分析語料,藉由醫病與陪同者間一步步共同構築而成的協商來探究參與者實際的溝通目的,本研究在北部一間醫學中心的眼科門診執行,總共有45位患者參與本研究,16位男性,29位女性,陪同者共有5位,2位妻子、1位先生、2位女兒與1位兒子。在台灣的社會與文化背景中,從Brown及Levinson (1978)的禮貌模型出發,著重在三個禮貌策略:直接提出要求、使用第一人稱複數來涵蓋所有參與者、避免正面回答,因為在問診過程中,參與者在給予意見與提出要求時,會為了要保護對方或自己的正反面子而會有所調整。若陪同者加入,他們會替病人問問題或是提出要求,整個問診過程會因為角色與溝通目的的不同而有所改變及調整。 本研究的目標是希望能呈現醫師與病人因為權力不平等,進而影響他們為了達到溝通目的時所使用的不同禮貌策略,透過實際語料的分析,加上台灣特殊的文化背景,提供醫療服務人員與患者一個不同的視角,從語言學的角度剖析醫病協商的現況與重要性,以期在未來達到更平等更和諧的醫病溝通與醫病關係。 This study investigates face-to-face doctor-patient communication and aims to provide a linguistic viewpoint of doctor-patient relationships. It illustrates doctor-patient communication as a negotiated and co-constructed process between the doctor, patients, and patients’ companions. Due to their power asymmetry, the participants use different politeness strategies to achieve their communicative goals. When the patients’ companions are present, the consultation is more complex. Researches related to doctor-patient communication have increased in the past few decades in the West. Medical education and system in Taiwan have also adapted accordingly. Studies have shown that communication between doctors and patients is influenced by their institutional power asymmetry. From a doctor's point of view, the purpose is to provide the best medical treatment for the patients. On the other hand, patients want to choose their preferred treatments. The doctor and patient parties exchange information and reach their decisions through communication. In this study, we analyze qualitatively how the doctor, the patients, and their companions co-construct communication during their negotiations. This research is conducted in an eye clinic in a medical center in Northern Taiwan. There are in total 45 patients (16 males and 29 females), and 5 companions (2 wives, 1 husband, 2 daughters, and 1 son) in this study. We explore the data by referring to Brown and Levinson’s (1978) politeness model, specifically bald recommendations, collaborative plural, and hedges under Taiwanese social and cultural factors. During the consultations, when the participants give advice or make requests, they try to protect each other’s positive or negative faces. If the family companions join the consultation, they may raise questions or make requests for the patients. The consultation is different depending on the participants involved. This research shows how the power asymmetry between the doctor and patients affects the way they use politeness strategies to achieve their communicative goals. Finally it also allows us to understand the importance of doctor-patient negotiation to create more equal and harmonious doctor-patient relationships in Taiwan. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/2684 |
DOI: | 10.6342/NTU201704175 |
全文授權: | 同意授權(全球公開) |
顯示於系所單位: | 語言學研究所 |
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