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回避策略、知识与互动:在遗传咨询中医生和客户对医疗信息及客户体验的探讨。

Hedging, knowledge and interaction: Doctors' and clients' talk about medical information and client experiences in genetic counseling.

机构信息

Faculty of Philosophy, University of Vaasa, Vaasa, Finland.

出版信息

Patient Educ Couns. 2013 Jul;92(1):31-7. doi: 10.1016/j.pec.2013.02.005. Epub 2013 May 8.

Abstract

OBJECTIVES

The article starts from the observation that professionals in genetic counseling deploy the strategy of 'hedging'. It shows how hedging is used in a particular sequential position: doctors' responses to clients' presentations of personal information during information delivery sequences.

METHODS

The data consist of video-recorded sessions of genetic counseling. The methodology is based on ethnomethodological conversation analysis. The analysis identifies interactional patterns in the counseling sessions.

RESULTS

In their responses doctors display an orientation to different access to different kinds of knowledge. In particular, the doctors tread carefully when commenting on the situation of a particular client vis-á-vis the symptoms and prognosis of genetic conditions. Furthermore, the article shows that the doctors' responses and hedging devices in them are fitted to the form and function of the clients' presentations of personal experience.

CONCLUSION

While the focus of the article is narrow in that it concentrates on one type of an interactional sequence, its strength is that it shows how the doctor's talk can be intertwined with the client's contributions.

PRACTICE IMPLICATIONS

The results make it possible for genetic counselors to identify an interactional task they recurrently face and reflect on alternative ways of responding to it.

摘要

目的

本文从遗传咨询师运用“回避”策略这一观察出发。它展示了回避是如何在特定的顺序位置上使用的:在信息传递序列中,医生对客户呈现个人信息的反应。

方法

数据包括遗传咨询的视频记录会话。该方法基于民族方法论会话分析。分析确定了咨询会议中的互动模式。

结果

在他们的回应中,医生表现出对不同种类知识的不同获取方式的取向。特别是,医生在评论特定客户的情况时非常谨慎,这涉及到遗传状况的症状和预后。此外,本文还表明,医生的回应和回避手段与其说是针对客户对个人经验的呈现形式和功能,不如说是针对客户的回应和回避手段。

结论

虽然本文的重点很狭窄,只集中在一种类型的互动序列上,但它的优势在于它展示了医生的谈话如何与客户的贡献交织在一起。

实践意义

研究结果使遗传咨询师能够识别他们经常面临的一种互动任务,并反思应对它的替代方法。

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