Cover not available
Part of
Relationships in Organized Helping: Analyzing interaction in psychotherapy, medical encounters, coaching and in social media
Edited by Claudio Scarvaglieri, Eva-Maria Graf and Thomas Spranz-Fogasy
[Pragmatics & Beyond New Series 331] 2022
► pp. 221–242

Practices of relationship building in Hungarian primary care

Communicative styles and intergenerational differences

| Eötvös Lorand University Budapest
| Ghent University

Using data from Hungarian primary-care consultations, we present linguistic features of relationship-building, focusing on the role of address forms and metapragmatic reflections. We also investigate intergenerational differences and different styles of managing doctor-patient relationships. Based on a range of evidence (discourse about doctor-patient communication in the public and in academia, participant observation of consultations, interviews with practitioners, analysis of instructional videos, questionnaire surveys), we discuss a change in doctor-patient communication at both macro (socio-cultural) and micro (interactional) levels. Factors influencing this process include general social change, digitisation and the communicative training of healthcare professionals. We conclude that physicians build different types of relationships with language, which hints at an overall shift in Hungarian society and in healthcare communication in general.

Keywords: relationship-building, primary care, metapragmatic reflection, attitude deixis, relationship styles
Article outline
  • 1.Introduction
  • 2.Relationship-building in doctor-patient consultation
  • 3.Data and methods
  • 4.Relationship-building in doctor-patient communication: Attitudinal deixis and metapragmatic actions
    • 4.1Attitudinal deixis
    • 4.2Metapragmatic comments and relationship-building
  • 5.Changes in relationship-building
    • 5.1Changes of communicative practice: Intergenerational aspect
    • 5.2Change in style: physician- and patient-centred communicative patterns
  • 6.Conclusions and limitations
  • Notes
  • References
Published online: 7 September 2022
DOI logo
https://doi.org/10.1075/pbns.331.10kun
References
Ainsworth-Vaugh, Nancy
2004 Claiming Power in Doctor-Patient Talk. Oxford: Oxford University Press.Google Scholar
Bartha, Csilla, and Ágnes Hámori
2010 “Stílus a szociolingvisztikában, stílus a diskurzusban [Style in sociolinguistics, style in discourse: Linguistic variability and the construction of social meaning in the “third wave” of sociolinguistics].” Magyar Nyelvőr 134 (3): 298–321.Google Scholar
Bálint, Katalin, Tamás Nagy, and Márta Csabai
2014 “The Effect of Patient-Centeredness and Gender of Professional Role Models on Trainees’ Mentalization Responses. Implication for Film-aided Education.” Patient Education and Counseling 97: 52–58. DOI logoGoogle Scholar
Beach, Wayne
2013 “Introduction.” In Handbook of Patient-Provider Interactions, ed. by Wayne Beach, 1–18. New York: Oxford University Press. DOI logoGoogle Scholar
Bigi, Sarah
2016 Communicating (with) Care. A Linguistic Approach to the Study of Doctor-Patient Interactions. Amsterdam: IOS.Google Scholar
Blommaert, Jan
2018 Durkheim and the Internet. On Sociolinguistics and the Sociological Imagination. London: Bloomsbury. DOI logoGoogle Scholar
Brown, Roger, and Albert Gilman
1960 “The Pronouns of Power and Solidarity.” In Style in Language, ed. by Thomas Sebeok, 253–276. Cambridge: MIT Press.Google Scholar
Bublitz, Wolfram, and Axel Hübler
(eds) 2007 Metapragmatics in Use. Amsterdam: Benjamins. DOI logoGoogle Scholar
Caffi, Claudia
2016 “Revisiting Metapragmatics: What Are We Talking About?” In Pragmemes and Theories of Language Use, ed. by Keith Allan, Alessandro Capone and Istvan Kecskes, 799–821. Heidelberg: Springer. DOI logoGoogle Scholar
Clark, Herbert H.
1996 Using Language. Cambridge: CUP. DOI logoGoogle Scholar
Csabai, Márta, Ilona Csörsz, and Katalin Szili
2009 A gyógyító kapcsolat élménye. Kézikönyv és oktatólemez a kapcsolati készségek fejlesztéséhez. [The experience of a healing relationship. Handbook and educational CD-ROM for the development of relationship-oriented skills]. Budapest: Oriold és Társa Kiadó.Google Scholar
Csiszárik, Katalin, and Ágnes Domonkosi
2018 “A gyógyító-beteg viszonylat megszólítási változatai egy mozgásszervi rehabilitációs osztály gyakorlatközösségében. [Address form variants in healer-patient interactions in the practice community of a mosculoskeletal rehabilitation ward.]” Acta Universitas de Carolo Eszterházy Nominatae XLIV: 109–128.Google Scholar
Domonkosi, Ágnes
2010 Variability in Hungarian Address Forms. Acta Linguistica Hungarica 57: 29–52. DOI logoGoogle Scholar
2016 Perspective and Attitudinal Deixis in Hungarian. Jezyk, Komunikacja, Informacja / Language, Communication, Information 11: 86–98.Google Scholar
Eckert, Penelope
2006 “Communities of Practice.” In Encyclopedia of Language and Linguistics. Edited by Keith Brown, 683–85. Amsterdam: Elsevier. DOI logoGoogle Scholar
Gaal, Ilona
2016 “Az internet hatása az orvos–beteg viszonyra.” Orvosi Hetilap 157 (17): 680–684. DOI logoGoogle Scholar
Goffman, Erving
1959 The Presentation of Self in Everyday Life. London: Penguin.Google Scholar
1966 Behaviour in Public Places: Notes on the Social Organization of Gatherings. New York: The Free PressGoogle Scholar
Hall, Judith, Debra Roter, and Cynthia Rand
1981 “Communication of Affect between Patient and Physician.” Health and Social Behaviour 22 (1): 18–30. DOI logoGoogle Scholar
Hambuch, Anikó, Lőrinc Sárkányné, and Rita Kránicz
2018. “Veränderung der Kommunikationsmodelle im Gesundheitswesen und ihre Widerspiegelung in den Interaktionen mit Klienten [Change of communication models in healtcare and its reflection in interaction with clients].” In Fachbezogener Fremdsprachenunterricht – aktuelle Herausforderungen und zukünftige Chancen, ed. by Brigita Kacjan, 59–71. Ljubljana: The Slovene Association of LSP Teachers.Google Scholar
Harris, Roxy
2006 New Ethnicities and Language Use. Houndmills, Basingstoke: Palgrave MacMillan. DOI logoGoogle Scholar
Havas, Ferenc, Márta Csepregi, Nikolett Gulyás, and Szilvia Németh
2015 Typological Database of the Ugric Languages. Budapest: ELTE.Google Scholar
Heritage, John, and Douglas Maynard
2006 “Problems and Prospects in the Study of Physician-Patient Interaction: 30 Years of Research.” Annual Review of Sociology 32 (1): 351–74. DOI logoGoogle Scholar
Koerfer, Armin, Thomas Reimer, and Christian Albus
2018 “Beziehung aufbauen [Constructing relationships]." In Kommunikative Kompetenz in der Medizin: Ein Lehrbuch zur Theorie, Didaktik, Praxis und Evaluation der ärztlichen Gesprächsführung, ed. by Armin Koefer, and Christian Albus, 814–851. Mannheim: Verl. für Gesprächsforschung.Google Scholar
Kuna, Ágnes
2016 “Person Deixis and Self-Representation in Medical Discourse. Usage Patterns of First Person Deictic Elements in Communication by Doctors.” Language, Communication, Information 11: 99–121.Google Scholar
Kuna, Ágnes and Ágnes Domonkosi
2020 “Social Meanings of the Hungarian Politeness Marker tetszik in Doctor-Patient Communication.” Acta Universitatis Sapientiae Philologica? 12 (3): 88–104. DOI logoGoogle Scholar
Kuna, Ágnes, and Ágnes Domonkosi
2022 “Társas deixis és a kapcsolatépítés az orvos-beteg interakcióban [Social deixis and relationship building in physician-patient interaction].” In A deixis a magyar nyelvben. [Deixis in Hungarian] ed. by Krisztina Laczkó, and Szilárd Tátrai. Budapest: Eötvös Collegium.Google Scholar
Kuna, Ágnes, and Ágnes Hámori
. (forthc.). “Metapragmatics and Reflections in Support of Knowledge Transfer and Common Ground in Doctor-Patient Interaction”. In A Pragmatic Agenda for Healthcare: Fostering Inclusion and Active Participation through Shared Understanding ed. by Sarah Bigi, and Maria Grazia Rossi Amsterdam Benjamins
2019 “’Hallgatom, mi a panasz?’ A metapragmatikai reflexiók szerepei és mintázatai az orvos-beteg interakciókban.” ['I am listening, what is the complaint?' The roles and patterns of metapragmatic reflexions in doctor-patient interactions.]" In Kontextualizáció és metapragmatikai tudatosság, [Contextualization and metapragmatic awareness] ed. by Laczkó Krisztina, and Tátrai Szilárd, 260–83. Eötvös Collegium, Budapest.Google Scholar
Kuna, Ágnes, and Claudio Scarvaglieri
2019 “Intergenerational Changes of Relationship Management in Primary Care.” Presenation at the IIEMCA, Mannheim (July 2–5, 2019).Google Scholar
Kuna, Ágnes, and Zsuzsa Kaló.
2014 “Az orvos-beteg kommunikáció a családorvosi gyakorlatban.” [Doctor-patient communication in primary care]." In Tudomány, technolektus, terminológia. A tudományok, szakmák nyelve, [Terminology. Language of the sciences, professions], ed. by Ágnes Veszelszki, and Klára Lengyel, 117–130. Budapest.Google Scholar
Levinson, Stephen
1983 Principles of Pragmatics. Cambridge: CUP. DOI logoGoogle Scholar
Linke, Angelika, and Juliane Schröter
2017 “Sprache in Beziehungen – Beziehungen in Sprache: Überlegungen zur Konstitution eines Linguistischen Forschungsfeldes [Language in relationshiops – relationships in language: Reflexions on research domain of linguistics].” In Sprache und Beziehung, ed. by Angelika Linke, and Juliane Schröter, 1–32. Berlin, Boston: de Gruyter.Google Scholar
Locher, Miriam, and Richard Watts
2008 “Relational Work and Impoliteness: Negotiating Norms of Linguistic Behaviour.” In Impoliteness in Language, edited by Miriam A. Locher and Derek Bousfield, 77–100: de Gruyter.Google Scholar
Lucy, John
1993 “Reflexive Language and the Human Disciplines.” In Reflexive Language: Reported Speech and Metapragmatics, ed. by Lucy, John, 9–33. Cambridge: CUP. DOI logoGoogle Scholar
Málovics, Éva, Beáta Vajda, and Péter Kuba
2009 “Paternalizmus vagy közös döntés? Páciensek az orvos–beteg kommunikációról. [Paternalism or shared decision making. Patient about doctor-patient interaction]” In A szolgáltatások világa, [The world of services], ed. by Erzsébet Hetesi, Zoltán Majó, and Miklós Lukovics, 250–264. Szeged: JATEPress.Google Scholar
Marshall, Steve
2021 “Navigating COVID-19 Linguistic Landscapes in Vancouver’s North Shore: Official Signs, Grassroots Literacy Artefacts, Monolingualism, and Discursive Convergence.” International Journal of Multilingualism, 1–25. DOI logoGoogle Scholar
Mayring, Philipp
2010 Qualitative Inhaltsanalyse: Grundlagen und Techniken [Qualitative content analysis. Basics and technique.]. Weinheim: Beltz.Google Scholar
Meskó, Bertalan
2014 The Guide to the Future of Medicine. Technology and the Human Touch. Budapest: Webicina.Google Scholar
Mundwiler, Vera, Judith Kreuz, Daniel Müller-Feldmeth, Martin Luginbühl, and Stefan Hauser
2019 “Quantitative und qualitative Zugänge in der Gesprächsforschung: Methodologische Betrachtungen am Beispiel einer Studie zu argumentativen Gruppendiskussionen. [Quantitative and qualitative approaches in conversation research: Methodological observations based on the example of group discussions].” Gesprächsforschung (20): 323–83.Google Scholar
Norrby, Catrin, and Camilla Wide
(eds) 2015 Address Practice as Social Action: European Perspectives. Houndsmills, Basingstoke: Palgrave Macmillan.Google Scholar
Pilling, János
(ed) 2004 Orvosi kommunikáció [Medical Communication]. Budapest: Medicina Könyvkiadó.Google Scholar
2018 Orvosi kommunikáció a gyakorlatban [Medical communication in the praxis]. Budapest: Medicina.Google Scholar
Rounds, Carol
2001 Hungarian. An Essential Grammar. London, New York: Routledge.Google Scholar
Sára, Zoltán, Zoltán Csedő, Tamás Tóth, Józses Fejes. and Pörzse Gábor
2013 “A korszerű információtechnológiai megoldások szerepe az orvos-beteg kommunikáció javításában. [The role of advanced information technology solutions in enhancing doctor-patient communication].” Interdiszciplináris Magyar Egészségügy 12(4): 20–24.Google Scholar
Scarvaglieri, Claudio
2017 “ ‘Educational Landscaping’: A Method for Raising Awareness About Language and Communication.” Language Awareness 59 (5): 325–42. DOI logo.Google Scholar
Silverstein, Michael
2003 “Indexical Order and the Dialectics of Sociolinguistic Life.” Language and Communication 23 (3–4): 192–229. DOI logoGoogle Scholar
Tannen, Deborah, Heidi Ehernberger Hamilton, and Deborah Schiffrin
eds 2015 The Handbook of Discourse Analysis. Hoboken, NJ: Wiley Blackwell.Google Scholar
Vajda, Beáta, Sarolta Horváth, and Éva Málovics
2012 “Közös döntéshozatal mint innováció az orvos-beteg kommunikációban [Shared decision making, as an innovation in physician-patient communication]”. In Regionális innovációs képesség, versenyképesség és fenntarthatóság, ed. by Bajmócy, Zoltán., Lengyel, Imre. and Málovics, György. Szeged: JATE PressGoogle Scholar
Verschueren, Jef
1999 Understanding Pragmatics. London: ArnoldGoogle Scholar
2000 Notes on the Role of Metapragmatic Awareness in Language Use. Pragmatics 10 (4): 439–456. DOI logoGoogle Scholar
Volosinov, Valentin
1973 Marxism and the Philosophy of Language. New York: Seminar Press.Google Scholar
Warren, Ed
2006 B.A.R.D. in the Practice. A Guide for Family Doctors to Consult Efficiently, Effectively and Happily. Oxford: Radcliffe Publishing.Google Scholar