会话分析 ：医生在医患对话中使用的修补形式 = Conversation analysis : repair initiations by doctors in medical consultations

• Main Author: 许吟蔚 Koh, Natalie Yin Wei
• Other Authors: Lim Ni Eng
• Format: Final Year Project
• Language: Chinese
• Published: Nanyang Technological University 2021
• Subjects: Humanities::Language::Chinese
• Online Access: https://hdl.handle.net/10356/146909
• Institution: Nanyang Technological University

人与人之间在交谈的过程中会完成一些会话目的。在医生与病人的问诊过程中，双方也不例外。医疗咨询其中一个重要的环节，就是病史采集。透过这个环节，医生不仅能采集病人的病史，还能了解病人平时的生活习惯、及所有与病人的病情相关的资讯。病人也能借此机会，向医生透露与病情有关的信息，进一步了解医生的解决方案。 病史采集的过程出现了一个现象：医生在问了病人一个问题之后，会选择性的针对病人的回应开启修补机制。通过会话分析，笔者发现医生透过这样的互动手法能达到的效果，是提供病人一个可确认自己的答案、或再补充自己的答案，分享更多超出问题范围的信息、或是让病人有机会调整不实回答，给予更属实的答复的机会。医生针对病人的答案开启修补，透过病人对此的回应获取更多讯息，有助于提高诊断准确率，更准确地诊断病因。 本论文将以会话分析的方式探讨医生经常在什么序列环境使用以下的互动手法——“带有语气词的重复病人的答案”、“不带语气词的重复病人的答案”、及“重组病人的答案”。另外，本文也将探讨医生能如何在不确定病人回应的真实性的情况下，以这三种主要的修补形式提供病人确认或修正答案的机会，以及病人在进行修补时所做出的各种回应。 People seek to achieve conversational aims in their day-to-day conversation, and this is no exception for doctors and patients in medical consultations as well. History-taking is an important component in medical consultations. Besides the retrieval of medical history from patients, doctors also get a chance to understand a patient’s lifestyle habits and any information relating to their existing and past medical conditions. Patients can also make use of this opportunity to reveal any information concerning their medical conditions, in light of understanding the doctor’s approach to their medical conditions. During history-taking, doctors tend to initiate repair by repeating patients’ answers selectively after asking them a question, with or without modifying their answers. This provides an opportunity for patients to confirm or elaborate on their answer in the next turn, and reveal more information about their medical conditions, as well as modify their answer to a more accurate reflection of what they experienced. Through repair initiation, doctors can make a more accurate diagnosis with more information at hand, thereby increasing the probability of accurately diagnosing the patient. This thesis aims to explore the circumstances under which doctors use these three main types of repair initiations: “repetition with modal particle”, “repetition without modal particle”, as well as “modified repeats”, to attain more information from patients in medical consultations, as well as the different types of repairs done by the patients. Through an analysis of the doctors’ repair initiations, we would be able to gain a better understanding of how doctors can use this method to retrieve more information from patients regarding their medical conditions when in doubt of the accuracy of patients’ responses to their questions.