University of California, Berkeley, Institute of Human Development and Graduate School of Education, 2121 Berkeley Way, Berkeley, CA, 94720, USA.
University of Rome, La Sapienza, Department of Social and Developmental Psychology, Via Dei Marsi 78, 00185, Rome, Italy.
Soc Sci Med. 2019 May;228:211-222. doi: 10.1016/j.socscimed.2019.03.036. Epub 2019 Mar 23.
In this paper we examine how doctor and patient coordinate actions in interaction towards the smooth accomplishment of the medical visit. Such coordination entails primarily the management of time and praxis, i.e. the apportionment of time to the tasks to be completed during the visit; and it is not an easy enterprise, for a number of reasons: 1) the tasks to be carried out during the visit are not familiar in equal measure to doctor and patient; 2) the extent of attention to be devoted to each task cannot be fully determined in advance but requires ongoing judgment and calibration; 3) generally, the timeframe of the visit is relatively limited. Our ethnographic and conversation analytic study of oncological visits shows that doctor and patient rely on a range of semiotic resources to achieve mutual understanding and coordinated actions. In particular, our analysis has identified textual artifacts and metapragmatic utterances as key semiotic components in the coordination and negotiation of the temporal trajectories and courses of actions that constitute and traverse the oncology visit.
在本文中，我们研究了医生和患者如何在互动中协调行动，以顺利完成医疗就诊。这种协调主要涉及时间和实践的管理，即分配时间完成就诊期间的任务；这不是一件容易的事情，原因有以下几点：1）就诊期间要完成的任务，医生和患者熟悉的程度并不相同；2）对每个任务的关注程度不能事先完全确定，而是需要不断地判断和调整；3）一般来说，就诊的时间框架相对有限。我们对肿瘤就诊的人种志和会话分析研究表明，医生和患者依赖一系列符号资源来实现相互理解和协调行动。特别是，我们的分析确定了文本 artifact 和元语用话语作为在协调和协商构成和贯穿肿瘤就诊的时间轨迹和行动过程中关键的符号组成部分。
