患者就诊原因表述中对就医必要性的观照  

Orientating towards Doctorability in Patients'Accounting for Medical Visit

作　　者：刘钦宇 于国栋[1] 

机构地区：[1]中国海洋大学

出　　处：《外国语文研究(辑刊)》2024年第3期55-70,共16页

基　　金：国家社会科学基金项目“门诊医患冲突与和谐医患沟通的多模态会话分析研究”(批准号:23BYY168;负责人:于国栋)的阶段性成果;中央高校基本科研业务费专项“门诊互动中患者忧虑表述的会话分析研究”(项目编号:202461091;负责人:刘钦宇)的阶段性成果。

摘　　要：患者就诊原因是医患交际的核心之一,围绕患者就诊原因所开展的良好且有效的沟通不仅有助于医疗服务的顺利开展,而且有利于和谐医患关系的建构。为了探究我国门诊医患交际中患者就诊原因表述的执行方式和互动过程,我们选择了近6小时的患者初诊语料,采用会话分析的研究方法对语料进行了细致观察与科学分析。研究发现患者表述就诊原因时可以从两个维度合理化其就医决策:(1)呈现症状多样性;(2)呈现症状细节。两者均属于患者的个人病痛经历和体验,侧重个人生活世界的忧虑,均体现患者对就医必要性的观照。这一发现与国外同类研究发现不同,表明我国患者表述就诊原因时并不会降低其在就医决策上的责任,也并不避讳个人主体性,践行我国以患者为中心的医学服务理念。Patients'reason for the visit is at the core of doctor-patient interaction,and efficient communication about that can not only facilitate medical services but also contribute to constructing a harmonious doctor-patient relationship.To explore the effective manner and procedure of patients'accounting for the visit in China's outpatient consultations,we conducted a conversation analytic study based on a nearly 6-hour collection of communication between first-visit patients and doctors.It was found that patients can legitimise their visits in two ways:1)presenting diverse symptoms;2)presenting detailed experience of the symptoms.The orientation towards doctorability revolves around patients'symptoms,namely their personal experiences of pain and illness,stressing patients'lifeworld concerns.This finding differs from similar studies abroad,indicating that when accounting for the visit,Chinese patients do not diminish their responsibility or agency in seeking medical care.This phenomenon reflects the“patient-centered”medical service philosophy in China.

关 键 词：就诊原因 医患交际 会话分析 就医必要性 

分 类 号：R197.3[医药卫生—卫生事业管理]