School of Foreign Studies, University of Science and Technology Beijing.
Department of Sociology, University of York.
Health Commun. 2023 Oct;38(11):2470-2480. doi: 10.1080/10410236.2022.2077027. Epub 2022 Jul 22.
Research based on recordings made across numerous specialties and geographical locations has characterized doctors' solicitations of patients' reasons for the visit as normative. However, in our dataset of 132 audio-recordings of consultations in Chinese primary and secondary care, it was as common for patients to self-initiate giving the reason for their visit as it was for doctors to solicit these (n = 65 vs. n = 67 respectively). Based on a conversation analytic examination of our dataset, we show that doctors do not treat patient-initiated problem presentations as deviant. Whilst there are some contextual contingencies (related, for example, to the queuing-system) that might account for this novel finding, these are only partly explanatory. Instead, we argue that, relative to Western contexts, the participants in our data treat the medical consultation as akin to a service-encounter in which patients are entitled to ask for what they want. Implications for understanding medical openings and health outcomes are discussed.
研究基于在多个专业和地理位置的记录，将医生询问患者就诊原因的行为描述为规范。然而，在我们的 132 个中国初级和二级保健咨询音频记录数据集中，患者自行给出就诊原因的情况和医生主动询问这些原因的情况一样常见（分别为 n=65 和 n=67）。基于对我们数据集的会话分析检查，我们表明医生并不将患者主动提出的问题视为异常。虽然有一些语境因素（例如与排队系统有关）可以解释这一新发现，但这些因素只是部分解释。相反，我们认为，与西方语境相比，我们数据中的参与者将医疗咨询视为类似于服务接触，患者有权要求他们想要的服务。讨论了对理解医疗开场和健康结果的影响。
