School of Foreign Studies, Nantong University, Nantong, China.
School of Languages and Cultures, University of Sydney, Sydney, Australia.
J Med Internet Res. 2022 Jul 8;24(7):e37403. doi: 10.2196/37403.
Given the growing significance of conversational agents (CAs), researchers have conducted a plethora of relevant studies on various technology- and usability-oriented issues. However, few investigations focus on language use in CA-based health communication to examine its influence on the user perception of CAs and their role in delivering health care services.
This review aims to present the language use of CAs in health care to identify the achievements made and breakthroughs to be realized to inform researchers and more specifically CA designers.
This review was conducted by following the protocols of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. We first designed the search strategy according to the research aim and then performed the keyword searches in PubMed and ProQuest databases for retrieving relevant publications (n=179). Subsequently, 3 researchers screened and reviewed the publications independently to select studies meeting the predefined selection criteria. Finally, we synthesized and analyzed the eligible articles (N=11) through thematic synthesis.
Among the 11 included publications, 6 deal exclusively with the language use of the CAs studied, and the remaining 5 are only partly related to this topic. The language use of the CAs in these studies can be roughly classified into six themes: (1) personal pronouns, (2) responses to health and lifestyle prompts, (3) strategic wording and rich linguistic resources, (4) a 3-staged conversation framework, (5) human-like well-manipulated conversations, and (6) symbols and images coupled with phrases. These derived themes effectively engaged users in health communication. Meanwhile, we identified substantial room for improvement based on the inconsistent responses of some CAs and their inability to present large volumes of information on safety-critical health and lifestyle prompts.
This is the first systematic review of language use in CA-based health communication. The results and limitations identified in the 11 included papers can give fresh insights into the design and development, popularization, and research of CA applications. This review can provide practical implications for incorporating positive language use into the design of health CAs and improving their effective language output in health communication. In this way, upgraded CAs will be more capable of handling various health problems particularly in the context of nationwide and even worldwide public health crises.
鉴于会话代理（CA）的重要性日益增加，研究人员已经针对各种技术和可用性问题开展了大量相关研究。然而，很少有研究关注基于 CA 的健康交流中的语言使用，以检验其对用户对 CA 的感知的影响及其在提供医疗服务方面的作用。
本综述旨在介绍医疗保健中 CA 的语言使用情况，以确定已取得的成就和有待实现的突破，为研究人员提供信息，特别是 CA 设计人员。
本综述按照 PRISMA（系统评价和荟萃分析的首选报告项目）2020 声明的方案进行。我们首先根据研究目的设计了搜索策略，然后在 PubMed 和 ProQuest 数据库中进行了关键字搜索，以检索相关文献（n=179）。随后，3 名研究人员独立筛选和审查了出版物，以选择符合预定义选择标准的研究。最后，我们通过主题合成对合格文章（N=11）进行了综合和分析。
在纳入的 11 篇出版物中，有 6 篇专门讨论 CA 研究中语言的使用情况，其余 5 篇仅部分涉及该主题。这些研究中 CA 的语言使用大致可分为六个主题：（1）人称代词，（2）对健康和生活方式提示的响应，（3）策略性措辞和丰富的语言资源，（4）三阶段对话框架，（5）人性化的巧妙对话，以及（6）符号和图像与短语的结合。这些衍生主题有效地吸引了用户参与健康交流。同时，我们根据一些 CA 的不一致响应以及它们在呈现有关安全关键的健康和生活方式提示的大量信息方面的能力不足，确定了需要改进的空间。
这是对基于 CA 的健康交流中语言使用情况的首次系统综述。在纳入的 11 篇论文中确定的结果和局限性可以为 CA 应用的设计和开发、推广和研究提供新的见解。本综述可以为将积极的语言使用纳入健康 CA 设计并提高其在健康交流中的有效语言输出提供实际意义。通过这种方式，经过升级的 CA 将更有能力处理各种健康问题，特别是在全国乃至全球公共卫生危机的背景下。
