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作者 Park, Yujong
書名 Analyzing medical discourse: The organization of doctor-patient interaction in Korean primary care settings
國際標準書號 9781109236668
book jacket
說明 350 p
附註 Source: Dissertation Abstracts International, Volume: 70-07, Section: A, page: 2303
Advisers: Charles Goodwin; John Heritage
Thesis (Ph.D.)--University of California, Los Angeles, 2009
This dissertation used observations of participants' actual conduct during medical encounters as a basis for theorizing the grammar and social organization of actions in Korean primary care settings during different phases of the visits mainly by employing the theoretical orientations and techniques of conversation analysis. The arguments are based on the observation of sixty primary care visits collected in Korea. Chapter 1 introduces prior research on doctor patient interaction and its value for medical care as well as research, reviews the theoretical and methodological concepts of conversation analysis and also describes the data used for the current study. Chapter 2 examines the opening minutes of the collected consultations. The chapter describes how two solicitation turn designs ('where does it hurt?' type and 'name of patient + topical marker') accomplish different actions, which display different preferences for the type of action that could follow and deployed to open different visit types. Chapter 3 looks specifically at the orderly ways in which doctors' questions and patients' responses are organized and understood. It provides a sequential analysis of one form of Korean grammar---yes/no interrogatives---and how language structures interact (especially final evidential suffixes) in creating discourse that is in accordance with the goals of the encounter. This chapter argues that contrary to initial expectations, doctors use unmarked negative questions more frequently than those with committal or connective suffixes; when these resources are employed they doubly re-inforce the project at hand. Chapter 4 first analyzes repetition practices that the doctors employ in third position that project their diagnostic hypothesis through being produced by switching the polarity of the question. Additionally, the chapter provides analysis of exact repetition leading to revisions of a previous response as used in these primary care visits. Chapter 5 deals with the structural organization of closings in Korean primary care and describes the doctors' embodied orientation toward the computer record as a constraining force. The analysis provided in this chapter suggests that the tension between efficiency and soliciting a full spectrum of patients' concerns should be solved in the future for effective healthcare in the Korean context. The final chapter, Chapter 6, concludes the dissertation with a summary and discussion of the organizational structures and practices that have been examined and presents the social and linguistic conclusions that can be drawn from this study, as well as a series of recommendations for physicians and patients alike, in order to provide them with necessary tools to overcome the trouble that may arise. In sum, the dissertation illustrates how the currently described Korean primary care is from the beginning to the end monotopically organized; overwhelmingly oriented to the treatment of one main problem. On the practical level, the dissertation can provide important suggestions for education of primary care interaction in Korea. Theoretically, the findings lends further evidence to the theory of social action as best interpreted as dialectical, local and jointly achieved, by examining elements of grammar, sequence, embodied conduct, and surrounding environment in Korean primary care encounters
School code: 0031
Host Item Dissertation Abstracts International 70-07A
主題 Speech Communication
Education, Health
0459
0680
Alt Author University of California, Los Angeles
記錄 14 之 578
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