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Article published In:
Chinese Language and Discourse
Vol. 9:1 (2018) ► pp.75–95

医患互动研究

回顾与展望

| Institute for Medical Humanities, Peking University

医患互动历来被认为是医疗保健与健康传播的核心，近年来逐渐成为人文社科跨学科研究热点。目前国际范围内医患互动研究已经取得了一定的成果，但同时也展现出新的问题和挑战。本文对过去50年间的海内外医患互动研究进行了梳理和回顾，旨在呈现主要研究方法与视角、发展阶段、以及重要发现与成果。文章分别回顾了国外和国内医患互动研究，分析了国内研究尚存在的不足，并基于此对未来研究提出了建议和展望。主要发现有：（1）国外医患互动研究从1960年代起步，研究视角和方法呈现多元化趋势，相关研究可以被细化分类为：宏观“行为”研究、微观“话语”研究和会话分析研究。（2）国内相关研究始于1980年代后期，经历了萌芽、起步和成熟等三个发展阶段；语言学视角下的相关研究独树一帜，做出独特的贡献。（3）对比发现，国内研究在研究范式、内容和方法等方面有待进一步完善。本文希望能够为相关领域的研究者提供参考，助力学界围绕医患互动展开更深入、系统、具体的理论和实践探讨。

Keywords: 医患互动, 医患交流, 医患会话, 会话分析
Article outline
  • 1.引言
  • 2.国外医患互动研究动态回顾
    • 2.1来自医学学科的宏观“行为”研究
    • 2.2来自社会学和语言学的微观“话语”研究
    • 2.3国外会话分析视角下的医患会话研究
  • 3.国内医患互动研究动态回顾
    • 3.1国内医患交流研究概况
    • 3.2国内语言学视角下的医患会话研究概况
    • 3.3国内相关研究的不足
  • 4.医患互动研究前景展望
    • 4.1研究范式从“论说型为主”转向“实证型为主”
    • 4.2研究内容从“宏观交流”转向“微观话语”研究
    • 4.3研究方法从“定量研究”转向“定性、定量混合研究”
  • 5.结语
  • References

Article language: Chinese

Published online: 27 August 2018
DOI logo
https://doi.org/10.1075/cld.00007.li
References

References

Bales, R
1950 Interaction Process Analysis: A Method for the Study of Small Groups. Reading, MA: Addison-Wesley.Google Scholar
Beck, R. S., Daughtridge, R., & Sloane, P. D.
2001 Physician-Patient Communication in the Primary Care Office: A Systematic Review. Journal of the American Board of Family Practice 151: 25–38.Google Scholar
Bourdieu, P
1991 Language and Symbolic Power. Cambridge, MA: Harvard University Press.Google Scholar
Boyd, E., & Heritage, J.
2006 Taking the history: questioning during comprehensive history-taking. In J. Heritage & D. W. Maynard (Eds.), Communication in Medical Care: Interactions between Primary Care Physicians and Patients (pp. 151–184). Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Byrne, P. S., & Long, B. E. L.
1976 Doctors Talking to Patients: A Study of the Verbal Behaviours of Doctors in the Consultation. London: Her Majesty’s Stationery Office. Centers For Disease Control and Prevention 2001 HealthComm Key: Unlocking the Power of Health Communication Research (Vol. 20011).Google Scholar
Charon, R., Greene, M., & Adelamn, R.
1994 Multi-dimensional interaction analysis: a collaborative approach to the study of medical discourse. Social Science & Medicine 39(7): 955–965. DOI logoGoogle Scholar
Drew, P
2006 Misalignments in “after-hours” calls to a British GP’s practice: a study in telephone medicine. In J. Heritage & D. W. Maynard (Eds.), Communication in Medical Care: Interactions between Primary Care Physicians and Patients (pp. 416–444). Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Frankel, R. M.
1984 From sentence to sequence: understanding the medical encounter through microinteractional analysis. Discourse Processes 7(2): 135–170. DOI logoGoogle Scholar
Gill, V. T., & Maynard, D. W.
2006 Explaining illness: patients’ proposals and physicians’ responses. In J. Heritage & D. W. Maynard (Eds.), Communication in Medical Care: Interactions between Primary Care Physicians and Patients (pp. 115–150). Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Gu, Y
1996 Doctor-patient interaction as goal directed discourse. Journal of Asian Pacific Communication 71 156–176.Google Scholar
1997 Five ways of handling a bedpan: a tripartite approach to workplace discourse. Text 71: 457–475.Google Scholar
Halkowski, T
2006 Realizing the illness: patients’ narratives of symptom discovery. In J. Heritage & D. W. Maynard (Eds.), Communication in Medical Care: Interactions between Primary Care Physicians and Patients (pp. 86–114). Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Heath, C
2006 Body work: the collaborative production of the clinical object. In J. Heritage & D. W. Maynard (Eds.), Communication in Medical Care: Interactions between Primary Care Physicians and Patients (pp. 185–213). Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Heritage, J., & Maynard, D. W.
2006a Problems and Prospects in the Study of Physician-Patient Interaction: 30 Years of Research. Annual Review of Sociology 321: 351–374. DOI logoGoogle Scholar
(Eds.) 2006b Communication in Medical Care: Interactions between Primary Care Physicians and Patients. Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Heritage, J., & Robinson, J. D.
2006 Accounting for the visit: giving reasons for seeking medical care. In J. Heritage & D. W. Maynard (Eds.), Communication in Medical Care: Interactions between Primary Care Physicians and Patients (pp. 48–85). Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Korsch, B., & Negrete, V.
1972 Doctor-patient communication. Scientific American 227(2): 66–74. DOI logoGoogle Scholar
Maynard, D. W., & Frankel, R. M.
2006 Ondiagnostic rationality: bad news, good news, and the symptom residue. In J. Heritage & D. W. Maynard (Eds.), Communication in Medical Care: Interactions between Primary Care Physicians and Patients (pp. 248–278). Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Mishler, E
1984 The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex.Google Scholar
Ong, L. M. L., DE Haes, J. C. J. M. Hoos, Hoos, A. M., & Lammes, F. B.
1995 Doctor-Patient Communication: A Review of the Literature. Social Science Medicine 401: 903–918. DOI logoGoogle Scholar
Perakyla, A
2006 Communicating and responding to diagnosis. In J. Heritage & D. W. Maynard (Eds.), Communication in Medical Care: Interactions between Primary Care Physicians and Patients (pp. 214–247). Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Robinson, J. D.
2006 Soliciting patients’ presenting concerns. In J. Heritage & D. W. Maynard (Eds.), Communication in Medical Care: Interactions between Primary Care Physicians and Patients (pp. 22–47). Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Roter, D. L., & Hall, J. A.
1989 Studies of Doctor-patient Interaction. Annual Review Public Health 101: 163–180. DOI logoGoogle Scholar
Roter, D
1977 Patient participation in the patient-provider interaction: the effects of patient question asking on the quality of interaction, satisfaction and compliance. Health Education Monographs 5(4): 281–315. DOI logoGoogle Scholar
Roter, D., & Larson, S.
2001 The relationship between residents’ and attending physicians’ communication during primary care visits: an illustrative use of the Roter Interaction Analysis System (RIAS). Health Communication 131: 33–48. DOI logoGoogle Scholar
Sacks, H
1992 Lectures on Conversation. Vol. 1. Fall 1964-Spring 1968. Oxford: Basil Blackwell.Google Scholar
Schiavo, R
2014 Health Communication: From Theory to Practice (2 ed.). San Francisco: Jossey-Bass.Google Scholar
Sidnell, J., & Stivers, T.
(Eds.) 2013 The Handbook of Conversation Analysis. West Sussex: Wiley-Blackwell.Google Scholar
Sorjonen, M., Raevaara, L., Haakana, M., Tammi, T., & Perakyla, A.
2006 Lifestyle discussions in medical interviews. In J. Heritage & D. W. Maynard (Eds.), Communication in Medical Care: Interactions between Primary Care Physicians and Patients (pp. 340–378). Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Stivers, T
2006 Treatment decisions: negotiations between doctors and patients in acute care encounters. In J. Heritage & D. W. Maynard (Eds.), Communication in Medical Care: Interactions between Primary Care Physicians and Patients (pp. 279–312). Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Strong, P
1979 The Ceremonial Order of the Clinic. London: Routledge.Google Scholar
Thompson, T. L., Robinson, J. D., Anderson, D. J., & Federowicz, M.
2007 Where have we been and where can we go? In K. B. Wright & S. C. Moore (Eds.), Applied Health Communication: A Sourcebook. Cresskill, NJ: Hampton Press.Google Scholar
Waitzkin, H
2001 At the Front Lines of Medicine. Lanham, MD: Rowman & Littlefield.Google Scholar
West, C
1984 Routine Complications: Troubles with Talk between Doctors and Patients. Bloomington: Indiana University Press.Google Scholar
2006 Coordinating closings in primary care visits: producing continuity of care. In J. Heritage & D. W. Maynard (Eds.), Communication in Medical Care: Interactions between Primary Care Physicians and Patients (pp. 379–415). Cambridge: Cambridge University Press. DOI logoGoogle Scholar
Wright, K. B., Sparks, L., & O’Hair, H. D.
2008 Health Communication in the 21st Century. Malden, MA: Blackwell Publishing.Google Scholar
陈海庆, & 李慧祯
2011 言语行为视阈下医患会话权势不对等关系探析. 《中国海洋大学学报》(社会科学版), 89–94.Google Scholar
陈冉
2014 戈夫曼互动理论视角下的医患会话研究. Unpublished 硕士, 西南大学.Google Scholar
关琳瑶
2014 哈医大四所附属医院医患纠纷实证分析. Unpublished 硕士, 黑龙江大学.Google Scholar
韩素萍
2002 谈妇产科临床医患交流技能. 南京医科大学学报(社会科学版) (04), 336–337.Google Scholar
胡燕
2016 门诊会话中医生和患者礼貌策略的对比分析. 医学与哲学 (B)(05), 82–85.Google Scholar
胡燕, & 董方莉
2016 基于Fairclough三维分析模式的门诊医患会话批评性研究. 医学与哲学 (B)(03), 86–89.Google Scholar
黄雪薇, 王秀利, 张瑛, 吕保祥, & 李廷杰
2003 癌症患者的信息需求——医患交流满意度及影 响因素分析. 中国心理卫生杂志 (11), 760–762.Google Scholar
贾玉勤
2007 谈交流原则在医患沟通中的运用. 中国卫生质量管理 (02), 41–42.Google Scholar
李本现, & 闵绥艳
2012 跨文化医患交流中社会文化规约负迁移现象研究. 求医问药(下半 月) (07), 21–22.Google Scholar
李芳
2016 医患交流权力协商话语的交际民族志考察, 北京大学.Google Scholar
李海富
2014 门诊儿科医生身份话语构建的实证研究. Unpublished 硕士, 西南大学.Google Scholar
李慧祯
2011 言语行为视野下医患会话权势不对等关系研究. Unpublished 硕士, 大连理工大学.Google Scholar
李庆明, & 刘冰琳
2015 概念整合理论视域下医用委婉语对缓解医患矛盾的作用. 西安交通大 学学报(社会科学版) (05), 116–119.Google Scholar
李伟, & 李玉明
1991 从现代人本主义心理学看医患思想交流. 中国社会医学 (03), 35–36.Google Scholar
李小红, 佘文静, 韩字研, & 雷海科
2012 妇科内分泌专家门诊医患交流质量的现状调查. 中国 循证医学杂志 (06), 642–646.Google Scholar
李新华, & 孙琦
2004 注重医患交流能力的培养. 中国现代医学杂志 (18), 149–150.Google Scholar
梁峰霞
2004 浅析临床医学语言的语境. 医院管理论坛 (04), 43–46.Google Scholar
刘宝军, 江雪梅, 曹丹, 王亚丽, 王丽娥, & 汪荷
2004 谈门诊医疗服务过程中的医患交流. 现 代医院管理 (03), 31–32.Google Scholar
刘蓉, 贺长春, 贺咏宁, 钟丹, 黄宇清, & 胡晓媛
2009 现代医学模式下医患交流实践教学探讨. 南方医科大学学报 (12), 2467–2469.Google Scholar
刘兴兵
2008a 当代国外医患会话研究综述. 医学与哲学, 29(4), 19–21.Google Scholar
2008b 中国当代医患会话研究综述. 中国社会医学杂志, 25(1), 4–6.Google Scholar
刘兴兵, 刘琴, 邵艳, & 何承全
2007 使用批评话语分析研究中国医患会话. 中国医学伦理学 (05), 24–28.Google Scholar
陆苇
1998 口腔正畸临床医患间的语言交流. 中国医学伦理学 (04), 31–32.Google Scholar
罗茜
2015 基于系统功能语法语气系统的汉语医患会话人际意义研究. Unpublished 博士, 西南 大学.Google Scholar
马骏驰, 胡建, & 顾卫平
2008 浅谈口腔医学生实习中的医患交流学习. 卫生职业教育 (24), 129–130.Google Scholar
牛利
2014 医患门诊会话结构研究. Unpublished 博士, 华中师范大学.Google Scholar
彭红, & 李永国
2007 失语:医患交往中的沉默现象反思. 医学与哲学(临床决策论坛版) (10), 72–74.Google Scholar
彭云鹏
2012 医学情景跨文化交际能力研究. Unpublished 博士, 上海外国语大学.Google Scholar
冉素娟
2004 加强“医患交流” 改善医患关系. 中国卫生事业管理 (02), 115–116.Google Scholar
沙鑫家, 朱文忠, & 王云
2003 加强医患交流的几点建议. 医学与哲学 (06), 19.Google Scholar
2003 加强医患交流的几点建议. 医学与哲学 (06), 19.Google Scholar
佘文静, 韩字研, & 李小红
2012 女性不孕症门诊医患交流质量的现状调查. 实用妇产科杂志 (02), 147–149.Google Scholar
孙维权
1987 影响医-患交流的有关因素研究. 国外医学(社会医学分册) (01), 64–65.Google Scholar
谈澍
2007a 社区全科医生的医患交流技巧. 中国民康医学 (14), 572–580.Google Scholar
2007b 社区全科医生的医患交流技巧. 中国民康医学 (14), 572–580.Google Scholar
谭晓风
2016 功能语言学视域下的门诊医患会话研究. 南京医科大学学报(社会科学版) (03), 233–238.Google Scholar
2017 医患会话的医生多重身份建构研究. 医学与哲学(A) (09), 40–42.Google Scholar
王桂荣, 徐远红, & 邹旭丹
2012 医患网络交流对SCI患者的影响. 中国康复(04), 279.Google Scholar
王茜, 隆娟, & 崔婉星
2012 关于我国医患会话研究的思考. 医学与哲学(A) (10), 14–17.Google Scholar
王强, 周桂桐, & 张毅
2009 开设《中医临床接诊与医患交流学》实训课程的体会. 天津中医药 大学学报 (04), 210–212.Google Scholar
温玉娟
2013 医患会话中作为语用策略的模糊限制语. Unpublished 硕士, 太原理工大学.Google Scholar
文红
2012 医患问答言语行为的策略性分析. 安徽卫生职业技术学院学报 (06), 96–97.Google Scholar
夏欧东, 邱学文, & 余喜
2009 医学生医患沟通交流技能培养模式初探. 中国高等医学教育 (10), 122–123.Google Scholar
杨石乔
2008 交流的无奈——试析《掷铁饼者》中的医患“沉默”. 医学与哲学(人文社会医学 版) (05), 80–81.Google Scholar
2010 基于语料库的汉语医患会话修正研究. Unpublished 博士, 上海外国语大学.Google Scholar
杨子, 王雪明, & 伍娜
2018 第三方陪同就诊的会话特征分析. 语言教学与研究 (01), 101–112.Google Scholar
于国栋
2009 产前检查中建议序列的会话分析研究. 外国语(上海外国语大学学报) (01), 58–62.Google Scholar
于河, 刘建平, & 王思成
2010 应用定性研究方法描述中医医患交流过程. 北京中医药大学学报 (11), 732–736.Google Scholar
余芬
2012 医患对话中的语气与权势研究. Unpublished 硕士, 中南民族大学.Google Scholar
占伊扬
2003 浅谈老年医学医患临床交流技巧. 南京医科大学学报(社会科学版) (01), 77–78.Google Scholar
张萍
2012 医患沟通短信交流平台的创建和运用. 光明中医 (10), 2127–2128.Google Scholar
张永良
1983 论医患的思想交流. 医学与哲学 (02), 37–40.Google Scholar
郑兴华, 沈晖, 席静, 李里, & 肖轶雯
1996 浅谈医患的交流技巧及其心理基础. 医学教育 (02), 28–31.Google Scholar
周湘涛
2006 加强医患沟通的意义探析. 锦州医学院学报(社会科学版) (02), 14–16.Google Scholar
朱耀明
2007 浅谈医疗活动中的医患沟通与交流. 继续医学教育 (29), 27–29.Google Scholar
邹素
2015 批评话语分析视阈下网络空间医患问答中的权势关系探究. 太原城市职业技术学院 学报 (02), 188–190.Google Scholar
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