Marshall R S
UC Berkeley/UCSF Joint Medical Program, San Francisco, New York, N.Y. 10040.
Cult Med Psychiatry. 1988 Jun;12(2):201-18. doi: 10.1007/BF00116858.
This paper discusses interpretation in doctor-patient interviews from a sociolinguistic perspective. A meaning-centered orientation to clinical practice calls for practitioners to create a clinical picture of the illness that is compatible with the patient's experience. This requires that appropriate interpretation of symptoms take place. Using transcripts of doctor-patient interviews, this paper demonstrates that another interpretive process, necessary to understanding illness, occurs at the level of conversation. Contrasting examples illustrate that without an adequate degree of "conversational cooperation," interpretation cannot take place. The results of poor conversational interpretation are the creation of an inaccurate clinical picture and the loss of clinically relevant information. The anthropological and sociolinguistic paradigms are linked by showing how differing perspectives on the illness affect conversational interpretation.
本文从社会语言学角度探讨医患面谈中的阐释问题。以意义为中心的临床实践取向要求从业者构建与患者经历相符的疾病临床图景。这需要对症状进行恰当阐释。本文通过医患面谈的文字记录表明,理解疾病所必需的另一种阐释过程发生在对话层面。对比示例说明,没有足够程度的“对话合作”,阐释就无法进行。糟糕的对话阐释结果是产生不准确的临床图景并丢失临床相关信息。通过展示对疾病的不同观点如何影响对话阐释,将人类学和社会语言学范式联系起来。