a Department of Sociology , University of York.
Health Commun. 2018 Nov;33(11):1355-1365. doi: 10.1080/10410236.2017.1350912. Epub 2017 Aug 23.
Recommendations can be implied by asserting some generalisation about a treatment's benefit without overtly directing the patient to take it. Focusing on a collection of assertions in UK neurology consultations, this paper shows that these are overwhelmingly receipted as "merely" doing informing and argues that this is made possible by their ambiguous design: their relatively depersonalised formats convey that the neurologist is simply telling the patient what's available, but the link made between the treatment and the patient's condition implies that it will be of benefit. Thus, assertions, while stopping short of telling the patient what to do, are hearable as recommendation relevant. This delicates balance leaves it up to the patient to respond either to the implied or on-record action (recommending vs. informing). When treated as "merely" doing informing, assertions defer the decision point until the neurologist has done something more. Three main interactional functions of this are identified as follows: (i) indicating the existence of a solution to a concern, without making a decision relevant next; (ii) orienting to the patient's right to choose; and (iii) making "cautious" recommendations.
建议可以通过断言治疗的好处的一般性而不直接引导患者接受治疗来暗示。本文关注英国神经科会诊中的一系列断言，表明这些断言几乎都被认为只是在提供信息，并认为这是由于它们的模糊设计而成为可能：它们相对非个性化的格式传达了神经科医生只是在告诉患者有哪些治疗方法可用，但将治疗方法与患者的病情联系起来暗示它将是有益的。因此，虽然断言没有告诉患者该做什么，但它们可以被听到与推荐有关。这种微妙的平衡让患者可以选择对隐含的或记录在案的行动（推荐与告知）做出回应。当被视为“仅仅”提供信息时，断言会推迟决策点，直到神经科医生采取了更多行动。本文确定了这种情况的三个主要交互功能如下：（i）表明存在解决问题的方案，而不立即做出决策相关的行动；（ii）表明患者有选择的权利；（iii）做出“谨慎”的建议。
