论文题目：不同患者满意度的医生话语概念意义对比研究
摘要：医患会话作为机构性话语,有其特定的模式和特点。当前,国内外对医患会话的研究主要从语用学,会话分析,社会语言学以及系统功能语言学方面进行。在系统功能语言学中,研究者主要从语境、层次化、实例化、元功能,语类结构等方面对医患会话进行研究。然而,关于医生话语的概念意义的对比性研究以及概念意义建构与语类结构相结合的研究很少。因此,基于系统功能语言学中及物性过程的概念意义及语类结构潜势,结合定性与定量分析,本文试图探讨:1)患者满意度高的医生和患者满意度低的医生在及物性过程的使用上有哪些差异?2)在患者满意度高和患者满意度低的医生话语中,及物性过程在语类结构中的分布有何不同?结果表明:1)在及物性过程的使用中,关系过程和物质过程是两类医生话语中使用频率最高的过程类型,其次是心理过程和存在过程。这符合医患会话的特点,即描述疾病,告知患者应做的事或提出治疗方案。关于差异,患者满意度高的医生话语中言语过程最少,而患者满意度低的医生话语中行为过程最少,这表明通过运用行为过程,医生可以让患者感受到他所具有的同理心与责任心,从而拉近与患者的关系;2)就参与者而言,患者满意度高的医生话语中占比最多的为属性,这表明医生经常从客观和专业的角度向患者解释疾病的症状或特征。而在患者满意度低的医生话语中占比最多的为目标,这表明医生强调其权威并且在与患者对话时告知患者应做的事;3)在环境成分方面,两类医生使用最多的环境成分是位置和程度,这符合医患会话的特点,即从患者那里获得患病的时间、部位或程度等信息。不同之处体现在第三位,在患者满意度高的医生话语中,伴随使用最频繁;而在患者满意度低的医生话语中,使用最多的是方式。关于过程类型的使用与语类结构的结合,结果表明在病情探索阶段,患者满意度高的医生主要使用了关系过程,而患者满意度低的医生主要使用了物质过程。这表明在问诊过程中,医生可以尽可能多的使用关系过程来更好地了解患者的病情。这两类医生话语的共性体现在接下来的三个阶段。在诊断阶段,关系过程最多,体现了作为一个整体医生具有丰富的医学知识以及提供的客观诊断。在治疗阶段和最终安置阶段,这两类医生话语中的物质过程是最多的。表明这两个阶段的主要目的是向患者提供治疗方案和解决措施。
关键词：医生话语;及物性过程;概念意义;语类结构;患者满意度;对比分析
学科专业：外国语言学及应用语言学
Abstract
摘要
Chapter One Introduction
1.1 Research Background
1.2 Research Purpose
1.3 Research Significance
1.4 Structure of the Thesis
Chapter Two Literature Review
2.1 Previous Researches on Doctor-patient Interaction from Conversational Analysis
2.2 Previous Researches on Doctor-patient Interaction from Sociolinguistics
2.3 Previous Researches on Doctor-patient Interaction from Pragmatics
2.4 Previous Researches on Doctor-patient Interaction from Systemic Functional Grammar(SFG)
2.4.1 Ideational Meaning in Doctor-patient Interaction
2.4.2 Interpersonal Meaning in Doctor-patient Interaction
2.4.3 Comprehensive Researches in Doctor-patient Interaction
2.5 Research Gap
Chapter Three Theoretical Foundations
3.1 Systemic Functional Grammar(SFG)
3.2 Ideational Meaning and Transitivity Process
3.2.1 Material Process
3.2.2 Mental Process
3.2.3 Relational Process
3.2.4 Behavioral Process
3.2.5 Verbal Process
3.2.6 Existential Process
3.3 Generic Structure Potential(GSP)
Chapter Four Methodology
4.1 Research Questions
4.2 Participants
4.3 Instruments
4.3.1 UAM
4.3.2 Questionnaire
4.4 Procedures
4.4.1 Data Collection and Transcription
4.4.2 Employing UAM to Annotate Processes,Participants and Circumstantial Elements
4.4.3 Data Analysis
Chapter Five Results and Discussion
5.1 Transitivity Analysis Employed by Doctors with Higher Patient Satisfaction and Those with Lower Patient Satisfaction
5.1.1 Transitivity Processes Employed by Doctors with Higher Patient Satisfaction and Those with Lower Patient Satisfaction
5.1.2 Participants Employed by Doctors with Higher Patient Satisfaction and Those with Lower Patient Satisfaction
5.1.3 Circumstantial Elements Employed by Doctors with Higher Patient Satisfaction and Those with Lower Patient Satisfaction
5.2.Transitivity Processes and Generic Structure in Doctor’s Discourse with Higher Patient Satisfaction and Those with Lower Patient Satisfaction
5.2.1 Generic Structure in Doctor’s Discourse with Higher Patient Satisfaction and Those with Lower Patient Satisfaction
5.2.2 Transitivity Processes Distributed in Generic Structure in Doctor’s Discourse with Higher Patient Satisfaction and Those with Lower Patient Satisfaction
5.3 Summary
Chapter Six Conclusion
6.1 Major Findings
6.2 Limitations and Implications for the Future Research
References
Appendix A 患者满意度问卷(PSQ-III)
Appendix B Layers to Annotate Doctor’s Discourse
Acknowledgements