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|Title: ||Making medical decisions in pediatric consultations : a conversation-analytic study of sequences and actions of physician-parent interaction in a Chinese hospital|
|Other Titles: ||Er ke yi liao jue ce de hui hua fen xi|
|Authors: ||Wang, Nan ( 王楠)|
|Department: ||Department of Chinese, Translation and Linguistics|
|Degree: ||Master of Philosophy|
|Issue Date: ||2010|
|Publisher: ||City University of Hong Kong|
|Subjects: ||Communication in pediatrics -- China.|
Pediatricians -- China -- Language.
Conversation analysis -- China.
|Notes: ||CityU Call Number: RJ26.3 .W36 2010|
vi, 117 leaves 30 cm.
Thesis (M.Phil.)--City University of Hong Kong, 2010.
Includes bibliographical references (leaves 102-109)
|Abstract: ||This research investigates the physician-parent interaction when making medical
decisions. Specifically, it examines how the interaction during the making of
treatment and prescription decisions is accomplished through sequences of talks and
particular turn designs within the treatment recommendation stage. Conversation
Analysis (CA) is adopted as the methodology. Sixty video-recorded pediatric
consultations have been collected in a hospital in mainland China. Fifty were
transcribed and analyzed in considerable details. While studies on medical
interaction and shared decision making in China do exist, the present study is a first
attempt that approached the topic from CA's qualitative perspective.
The findings show that treatment decisions interactions are organized in a way that
parent acceptance is required to reach an agreement. The sequence structure
normally follows two paths: (1) it will be minimal if the physician's treatment
recommendation is followed by parent acceptance; and (2) it will be extended if the
parent resists the recommendation (because physicians normally pursue parent
acceptance until it is obtained). Parents and physicians' interactional resources for
negotiating treatment decisions are also identified and described. In responding to
physician's treatment recommendation, parents would either accept or resist with
passive or active devices. Physicians will either pursue their acceptance of the original recommendation in various ways or offer alternative plans contingent on the
patients' necessity, if parents resist their treatment recommendation.
Prescription decision is also investigated. The data show that in making prescription
decisions, physicians normally initiate a pre-prescribing sequence to see whether it is
warranted to produce the prescribing sequence. Parent responses to physician's
pre-prescribing questions are found consequential to the sequence trajectories. The
physician proceeds to issue a prescription recommendation if the parent gives a
'go-ahead' response; the physician withholds the issuance of a recommendation the
parent gives a 'blocking' response. The sequence will be truncated if the parent
provides a 'request' response to the pre-prescribing question; the sequence will be
expanded with insertion sequences or post-expansions, in which communication
problems of various kinds are dealt with. It is also possible for parents to initiate the
sequence for prescription decision.|
|Online Catalog Link: ||http://lib.cityu.edu.hk/record=b4086143|
|Appears in Collections:||CTL - Master of Philosophy |
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