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诊断是医疗互动实践的重心,是医患会话整体结构的重要组成部分,是患者期待的决定性时刻。本阶段中患者参与程度低,医生权威性体现明显。准确的诊断能很好地解释患者疾病的原因,对诊断一致性意见的达成又是合理治疗建议给出的前提。文章基于真实医患语料,以会话分析为理论框架,考察诊断阶段的位置特征、互动方式以及医生不同诊断类型对患者回应的影响等。文章发现,诊断任务不是由医生单独完成,其需要患者的互动回应与配合。医生对简单告知式的高频使用会导致患者对非扩展型回应的高频使用。本研究可为促进医患互动实践提供语言学实证支持。
Diagnosis is the focus of medical interaction practice, an integral part of the overall structure of doctor-patient conversation, and the decisive moment for patients’ expectations. The degree of patient involvement in this stage is low, and the authority of the doctor is evident. Accurate diagnosis can well explain the reasons for the patient’s disease, and the consensus of diagnosis is the premise of reasonable treatment recommendations. Based on the real doctor-patient corpus and the conversation analysis as the theoretical framework, the paper examines the location characteristics of the diagnosis stage, the interaction modes and the influence of different diagnosis types on the patient’s response. The article found that the diagnostic tasks are not done by the doctor alone, which requires the patient’s interactive response and cooperation. The use of simple, informative HF use by doctors can lead to high-frequency patient use of non-expanding responses. This study can provide linguistic empirical support for promoting the interaction between doctors and patients.