Japanese doctor-patient discourse : an investigation into cultural and institutional influences on patient-centred communication
This thesis investigates how Japanese doctors create and maintain patient-centred consultations through their verbal interaction with patients, and the extent to which features of Japanese interpersonal communication influence the institutional discourse. Audio recordings of 72 doctor-patient interactions were collected at the outpatient department of a Japanese teaching hospital. All consultations involved new cases. There were two kinds of consultations: a preliminary history-taking interview with an intern and a diagnostic consultation given by an experienced doctor. After transcribing the recordings sequences of the discourse were analysed qualitatively on a turn-by-turn basis and a corpus of the data was analysed quantitatively to establish frequencies of discourse features related to patientcentredness. A review of literature (Chapter 2) establishes the standard structure of medical consultations and the relationship of the doctor and patient during consultations in terms of the asymmetry of speaking initiative according to consultation phases. The second part of Chapter 2 is an examination of Japanese communication style, attested to be influenced by culturally specific norms of behaviour that are demonstrable
Holst, Mark Anthony
discourse analysis ; doctor-patient communication ; cross-cultural communication ; language and culture
Japanese doctor-patient discourse : an investigation into cultural and institutional influences on patient-centred communication. This thesis investigates how Japanese doctors create and maintain patient-centred consultations through their verbal interaction with patients, and the extent to which features of Japanese interpersonal communication influence the institutional discourse. Audio recordings of 72 doctor-patient interactions were collected at the outpatient department of a Japanese teaching hospital. All consultations involved new cases. There were two kinds of consultations: a preliminary history-taking interview with an intern and a diagnostic consultation given by an experienced doctor. After transcribing the recordings sequences of the discourse were analysed qualitatively on a turn-by-turn basis and a corpus of the data was analysed quantitatively to establish frequencies of discourse features related to patientcentredness. A review of literature (Chapter 2) establishes the standard structure of medical consultations and the relationship of the doctor and patient during consultations in terms of the asymmetry of speaking initiative according to consultation phases. The second part of Chapter 2 is an examination of Japanese communication style, attested to be influenced by culturally specific norms of behaviour that are demonstrable
japanese doctor patient discourse investigation cultural institutional influence patient centred communication investigates japanese doctor create_maintain patient centred consultation verbal_interaction patient extent feature japanese interpersonal communication influence institutional discourse audio record doctor patient interaction collect department japanese teaching hospital consultation involve new case two_kind consultation preliminary history taking interview diagnostic consultation give experienced doctor transcribe recording sequence discourse analyse qualitatively turn turn basis corpus_data analyse quantitatively establish frequency discourse feature related review_literature establishes standard structure medical consultation relationship doctor patient consultation term asymmetry speak initiative accord consultation phase second_part examination japanese communication style attest influence culturally_specific norm behaviour demonstrable