dc.description.abstract |
Doctor-patient consultation is a communicative situation which enables doctors to
understand patients’ health challenges in order to prescribe appropriate treatments. Earlier
works on doctor-patient interactions, particularly from linguistic and pragmatic perspectives,
have largely examined speech acts, conversational maxims and (im)politeness, with little
attention paid to the specific discourse devices and their pragmatic functions. Therefore, this
study was designed to examine doctor-patient verbal interactions in selected teaching and
general hospitals in Nigeria, with a view to determining the discourse devices deployed in
the interactions and their pragmatic functions.
Dan Sperber and Deidre Wilson’s Relevance Theory, complemented by M.A.K. Halliday’s
Systemic Functional Grammar, was used as the framework, while the descriptive design was
adopted. Data were sourced from 200 audio tape recordings and transcriptions of doctorpatient verbal interactions in two teaching hospitals (University College Hospital Ibadan
(UCH) (50), and University of Ilorin Teaching Hospital (UITH) (50)) and two general
hospitals (General Hospital Abeokuta (GHA) (50), and General Hospital Kabba (GHK)
(50)). The selected hospitals were chosen because they were well-patronised and were easily
accessible for data collection. Data were subjected to pragmatic analysis.
Thirteen discourse devices were dominant in the interactions: circumlocution, repetition,
counselling, modality, closing, direct question, indirect question, answering, phatic
communion, rapport expressions, language switch, Face Threatening Act (FTA) with redress
and FTA without redress. All of them were shared by the doctors and the patients across the
hospitals, with the exception of FTA with redress, FTA without redress and counseling,
which were doctor-specific. They performed the following pragmatic functions: phatic
communion, for opening consultations; direct and indirect questions, for seeking
information for diagnoses; code alternation, for explicitness, informativity and mutuality;
repetition, for confirmation, emphasis and clarification; rapport expressions, for cordiality
and solidarity; modality, for asymmetry of knowledge and power; counselling, for advising
the patients on their health; answer, to respond to questions; closing, for ending
consultations and circumlocution, for providing clues to diagnosis. Interrogatives were
employed for; eliciting information. Modality was deployed for expressing views and
expectations; FTA with and without redress, for correcting patients’ unwholesome health
practices and obtaining information for diagnosis tactfully; tact maxim, for expressing
compassion and granting permission; generosity maxim, for counselling and expressing
compassion; and sympathy maxim, for counselling and expressing empathy. Declaratives
were employed for providing information; imperatives, for giving directives; and
collocation, for connecting texts. The contributions reflected adjacency pairs in different
forms, showing cooperation amongst the interactants. There were variations in the
deployment of the discourse devices. The UCH and UITH doctors employed questions more
than those of GHA and GHK.
The discourse devices addressed specific communication and health challenges through
their pragmatic functions, thus underscoring the centrality of their knowledge to a better
comprehension of diagnostic discourse in doctor-patient consultations in the Nigerian
context. |
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