医患冲突性话语会话分析

发布时间：2018-04-23 15:19

本文选题：冲突话语 + 会话分析　；参考：《华中师范大学》2017年硕士论文

【摘要】：冲突话语是常见的生活现象。人们交流越发紧密,交流中潜在的冲突也越发明显。话语冲突已引发不少学者关注,研究遍布各种语境,日常话语冲突和机构性、半机构性话语冲突研究都取得不小成就。医患话语冲突属于机构性话语冲突。近年来,医患冲突日益严峻,基于医患交流模式的研究硕果累累。但由于医患冲突的发生展开十分迅速并具有私隐性,难以记录,因此专注于医患冲突话语的研究仍然不足。本文着手于医患话语冲突的结构分析,研究医患话语冲突怎样开始、进行和结束,如何争夺、控制和放弃话轮。探讨医患在言语冲突过程中所采用的规则和会话管理技巧,试图更好地了解医患话语冲突。本文以会话分析为理论框架,对医患话语冲突进行了实证性研究,对5部医疗电视剧中的医患话语冲突部分进行了转写。语料共计23033字,含118段医患冲突会话片段。本文运用了定量分析法和定性分析法来分析医患双方在冲突各环节所占比列和对会话管理策略的偏好。研究发现,医患冲突话语的整体结构可分为3个部分:起始、对抗和结束。冲突的起始部分尤为重要。一段冲突是否能达成是由冲突的起始部分决定的。医患冲突的起始部分包含三种结构:表态vs否定表态,指令vs拒绝,疑问vs反对。作为机构性会话中弱势的一方,患者更容易成为冲突的发起者。冲突的对抗部分始于第三个话轮,一直持续到冲突结束之前。医患冲突话语的对抗形式复杂,持续多个话轮。冲突过程的结构主要有直接否定,反问,重复和打断四种模式,各种模式有其变体。话轮争夺在冲突过程中尤为激烈。通常而言,医患交流中,由于双方的权势不等,医生打断病人话语的现象要远高于病人打断医生话语。但在冲突话语中,病人打断医生的次数更多。结束冲突表示当前的冲突无法继续,冲突并不一定得到解决,只是暂时放下。医患冲突的结束主要有四种模式:双方和解,一方妥协,一方战胜和冲突未解决。各有其变体。而相较而言,出于职业要求,为了保持自己的社会地位和冲突扩大,医生更乐于发出结束冲突的信号。在冲突超出控制的时候,医生多选择离开冲突地点,以此中断冲突。本文运用会话分析理论,试图丰富医患冲突性话语的研究。由于医患会话属于机构性话语,本文也可给其它机构性话语提供研究参考。对医患话语冲突的了解有助于减少现实生活中的医患冲突。
[Abstract]:Conflict discourse is a common phenomenon in life. People communicate more closely, and the potential conflicts in communication become more obvious. Discourse conflict has attracted the attention of many scholars and has made great achievements in the study of everyday discourse conflict, institutional conflict and semi-institutional discourse conflict. Doctor-patient discourse conflict belongs to institutional discourse conflict. In recent years, the conflicts between doctors and patients are becoming more and more serious, and the research based on the mode of communication between doctors and patients has been fruitful. However, due to the rapid development of doctor-patient conflict and its privacy, it is difficult to record, so the research on the discourse of doctor-patient conflict is still insufficient. This paper begins with the structural analysis of the doctor-patient discourse conflict, and studies how to start, carry out and end the doctor-patient discourse conflict, and how to compete, control and give up the turn of discourse. This paper probes into the rules and conversational management skills adopted by doctors and patients in the process of speech conflict in order to better understand the conflict between doctors and patients. Based on the theoretical framework of conversational analysis, this paper makes an empirical study on the doctor-patient discourse conflict, and rewrites the doctor-patient discourse conflict part of five medical TV dramas. The corpus consists of 23033 words, including 118 segments of doctor-patient conflict conversation. In this paper, quantitative analysis and qualitative analysis are used to analyze the proportion of doctors and patients in each link of the conflict and their preference for conversation management strategies. The study found that the overall structure of the doctor-patient conflict discourse can be divided into three parts: beginning, confrontation and ending. The beginning of the conflict is particularly important. Whether a conflict can be achieved or not is determined by the initial part of the conflict. The beginning of a doctor-patient conflict consists of three structures: declaration versus negation, command vs rejection, doubt versus opposition. As a weak party in institutional conversation, the patient is more likely to be the initiator of the conflict. The confrontation part of the conflict begins in the third turn and continues until the end of the conflict. The conflict between doctors and patients is complicated in form of confrontation, and lasts many rounds. There are four modes of conflict process: direct negation, counterquestion, repetition and interruption. The fight for turn of words is particularly fierce in the course of the conflict. In general, doctors interrupt patients more frequently than patients in doctor-patient communication because of the unequal power between the two sides. But in conflict discourse, patients interrupt doctors more often. Ending the conflict means that the current conflict cannot continue, that the conflict is not necessarily resolved, but that it is simply put aside for the time being. There are four modes to end the doctor-patient conflict: reconciliation, compromise, victory and unresolved conflict. Each has its variants. Doctors, by contrast, are more willing to signal an end to conflict in order to maintain their social status and expand their conflicts for professional reasons. When the conflict is out of control, doctors often choose to leave the conflict site to break the conflict. This paper tries to enrich the study of doctor-patient conflict discourse by using conversational analysis theory. Because doctor-patient conversation belongs to institutional discourse, this paper can also provide reference for other institutional discourse. Understanding the conflicts between doctors and patients helps to reduce the conflicts between doctors and patients in real life.
【学位授予单位】：华中师范大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：H136

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