Doctor Repeats of Patient Responses in Vietnamese Medical Consultations
DOI:
https://doi.org/10.17507/tpls.1304.01Keywords:
doctor repeats, patient responses, doctor-patient interaction, Vietnam, conversation analysisAbstract
This study examines doctor repeats of patient responses in medical interaction. These repeats lie at the third turn in a three-turn sequence: doctor question, patient response, and doctor follow-up utterance. The data were taken from 66 consultations held in the Consultation and General Practice Units of two public hospitals in Vietnam. Using a conversation-analytical approach, we reveal that doctor repeats in this specific cultural context serve to highlight the importance of the information provided by the patient for forming diagnostic hypotheses and recommending optimal treatment plans. In so doing, we also show that, in terms of function, doctor repeats differ in certain key respects from repeats in non-medical conversation.
References
Aarons, D. (2005). Doctor-patient communication in government hospitals in Jamaica: Empiric and ethical dimensions of a socio-cultural phenomenon (Unpublished doctoral dissertation). McGill University, Montreal, Canada.
Bickley, L. S., & Szilagyi, P. G. (2013). Bates’ guide to physical examination and history taking (11th ed.). Lippincott Williams & Wilkins.
Coulthard, M., & Ashby, M. (1976). A linguistic description of doctor-patient interviews. In M. Wadsworth & D. Robinson (Eds.), Studies in everyday medical life (pp. 69–88). Martin Robertson.
Cox, C. L., Turner, R., & Blackwood, R. (2004). History taking. In C. L. Cox & R. Turner (Eds.), Physical assessment for nurses (pp. 6–21). Blackwells.
Drew, P. (1992). Contested evidence in courtroom cross-examination: The case of a trial for rape. In P. Drew & J. Heritage (Eds.), Talk at work: Interaction in institutional settings (pp. 470–520). Cambridge University Press.
Enfield, N. J. (2012). Reference in conversation. In J. Sidnell & T. Stivers (Eds.), The handbook of conversation analysis (pp. 433–454). John Wiley & Sons.
Fancher, T. L., Tôn, H., Meyer, L. O., Hồ, T., & Paterniti, D. A. (2010). Discussing depression with Vietnamese American patients. Journal of Immigrant and Minority Health, 12(2), 263–266. https://doi.org/10.1007/s10903-009-9234-y
Farris, M. (2012). Lexical and grammatical properties of personal pronouns in Vietnamese: Deicticity and relationships. Rocznik Orientalistyczny, 65(1), 41–50. Retrieved September 18, 2022, from http://cejsh.icm.edu.pl/cejsh/element/bwmeta1.element
Gardner, R. (2001). When listeners talk: Response tokens and listener stance. John Benjamins.
Gardner, R. (2007). The “right” connections: Acknowledging epistemic progression in talk. Language in Society, 36(3), 319–341. https://doi.org/10.1017/S0047404507070169
Heritage, J. (1984). A change-of-state token and aspects of its sequential placement. In J. M. Atkinson & J. Heritage (Eds.), Structures of social action: Studies in conversation analysis (pp. 299–345). Cambridge University Press.
Hồ, T. Đ. (1997). Vietnamese-English bilinguals in Melbourne: Social relationships in code-switching of personal pronouns. Monash University Linguistics Papers, 1(1), 41-51. Retrieved September 18, 2022, from http://search.informit.com.au/documentSummary;dn=322250958933600;res=IELHSS
Huỳnh, T. Đ. (1989). Introduction to Vietnamese culture. San Diego State University.
Jefferson, G. (1984). Notes on some orderlinesses of overlap onset. In V. D’Urso & P. Leonardi (Eds.), Discourse analysis and natural rhetoric (pp. 11–38). Cleup Editore.
Jefferson, G. (2004). Glossary of transcript symbols with an introduction. In G. Lerner (Ed.), Conversation Analysis: Studies from the first generation (pp. 13–31). John Benjamins.
Kim, H. (2002). The form and function of next-turn repetition in English conversation. Language Research, 38(1), 51–81. Retrieved September 18, 2022, from http://s-space.snu.ac.kr/bitstream/10371/86198/1/3.%202225610.pdf
Lê, T. P. (2011). Transnational variation in linguistic politeness in Vietnamese: Australia and Vietnam (Unpublished doctoral dissertation). Victoria University, Melbourne, Australia.
Lerner, G. H. (2004). Collaborative turn sequences. In G. Lerner (Ed.), Conversation analysis: Studies from the first generation (pp. 225–256). John Benjamins.
Ley, P. (1988). Communicating with patients: Improving communication, satisfaction, and compliance. Croom Helm.
Lương, H. V. (1990). Discursive practices and linguistic meanings: The Vietnamese system of person reference. John Benjamins.
Luu, N. T. K. (2010). A brief comparison of Vietnamese intonation and English intonation and its implications for teaching English intonation to Vietnamese EFL learners. VNU Journal of Science, Foreign Languages, 26, 171–180. Retrieved September 18, 2022, from https://js.vnu.edu.vn/FS/article/view/2554
Mishler, E. G. (1984). The discourse of medicine: Dialectics of medical interviews (Vol. 3). Greenwood Publishing Group.
Nguyễn, G. T., Barg, F. K., Armstrong, K., Holmes, J. H., & Hornik, R. C. (2007). Cancer and communication in the health care setting: Experiences of older Vietnamese immigrants, a qualitative study. Journal of General Internal Medicine, 23(1), 45–50. https://doi.org/10.1007/s11606-007-0455-2
Nguyễn, H. T. L., & Austin, G. (2018a). Follow-up visits in doctor-patient communication: The Vietnamese case. International Journal of Society, Culture & Language, 6(1), 18–30. Retrieved September 18, 2022, from http://www.ijscl.net/volume_4936.html
Nguyễn, H. T. L., & Austin, G. (2018b). On invoking third parties in Vietnamese medical communication. Theory and Practice in Language Studies, 8(7), 713–725. https://doi.org/10.17507/tpls.0807.01
Nguyễn, H. T. L., Austin, G., & Châu, D. D. (2018a). Treatment recommendation in Vietnamese medical consultations. PEOPLE: International Journal of Social Sciences, 3(3), 1010–1027. https://doi.org/10.20319/pijss.2018.33
Nguyễn, H. T. L., Austin, G., Châu, D. Đ., Nguyễn, H. Q., Nguyễn, K. H. B., & Dương, M. T. (2018b). Eliciting patients’ health concerns in consulting rooms and wards in Vietnamese public hospitals. International Journal of Applied Linguistics & English Literature, 7(2), 121–133. https://doi.org/10.7575/aiac.ijalel.v.7n.2p.121
Park, Y. (2011). The use of reversed polarity repetitional questions during history taking. Journal of Pragmatics, 43(7), 1929–1945. https://doi.org/10.1016/j.pragma.2011.01.004
Phạm, N. T. H. (2014). Linguistic and cultural constraints in Vietnamese general practitioners’ act of initiating clinical information-seeking process in first encounters with outpatients. Theory and Practice in Language Studies, 4(6), 1125–1131. Retrieved September 18, 2022, from http://www.academypublication.com/issues/past/tpls/vol04/06/04.pdf
Pomerantz, A. (1984). Giving a source or basis: The practice in conversation of telling ‘how I know’. Journal of Pragmatics, 8(5-6), 607–625. https://doi.org/10.1016/0378-2166(84)90002-X
Rabab'ah, G., & Abuseileek, A. F. (2012). The pragmatic functions of repetition in TV discourse. Research in Language, 10(4), 445–460. https://doi.org/10.2478/v10015-012-0004-x
Raymond, G. (2003). Grammar and social organization: Yes/no interrogatives and the structure of responding. American Sociological Review, 68(6), 939–967. https://doi.org/10.2307/1519752
Robinson, J. D. (2006). Soliciting patients’ presenting concerns. In J. Heritage & D. W. Maynard (Eds.), Communication in medical care: Interaction between primary care physicians and patients (pp. 22–47). Cambridge University Press.
Robinson, J. D. (2013). Epistemics, action formation, and other-initiation of repair: The case of partial questioning repeats. In M. Hayashi, G. Raymond, & J. Sidnell (Eds.), Conversational repair and human understanding (pp. 261–292). Cambridge University Press.
Robinson, J. D., & Kevoe-Feldman, H. (2010). Using full repeats to initiate repair on others’ questions. Research on Language & Social Interaction, 43(3), 232–259. https://doi.org/10.1080/08351813.2010.497990
Sacks, H. (1987). On the preferences for agreement and contiguity in sequences in conversation. In G. Button & J. R. E. Lee (Eds.), Talk and social organisation (pp. 54–69). Multilingual Matters.
Sacks, H., Schegloff, E. A., & Jefferson, G. (1974). A simplest systematics for the organization of turn-taking for conversation. Language, 50(4), 696–735. https://doi.org/10.17323/1728-192X-2015-1-142-202
Schegloff, E. A. (1996). Confirming allusions: Toward an empirical account of action. American Journal of Sociology, 102(1), 161–216. https://doi.org/10.1086/230911
Schegloff, E. A. (1998). Reflections on studying prosody in talk-in-interaction. Language & Speech, 41(3-4), 235–263. https://doi.org/10.1177/002383099804100402
Schegloff, E. A. (2007). Sequence organization in interaction: A primer in conversation analysis I. Cambridge University Press.
Schegloff, E. A., Jefferson, G., & Sacks, H. (1977). The preference for self-correction in the organization of repair in conversation. Language, 53(2), 361–382. https://doi.org/10.1353/lan.1977.0041
Schegloff, E. A., & Sacks, H. (1973). Opening up closings. Semiotica, 8(4), 289–327. https://doi.org/10.1515/semi.1973.8.4.289
Schouten, B. C., & Meeuwesen, L. (2006). Cultural differences in medical communication: A review of the literature. Patient Education & Counselling, 64(1), 21–34. https://doi.org/10.1016/j.pec.2005.11.014
Silverman, J., Kurtz, S. M., & Draper, J. (2013). Skills for communicating with patients. Radcliffe.
Stivers, T. (2005). Modified repeats: One method for asserting primary rights from second position. Research on Language & Social Interaction, 38(2), 131–158. https://doi.org/10.1207/s15327973rlsi3802_1
Stivers, T., & Heritage, J. (2001). Breaking the sequential mold: Answering ‘more than the question’ during comprehensive history taking. Text - Interdisciplinary Journal for the Study of Discourse, 21(1-2), 151–185. https://doi.org/10.1515/text.1.21.1-2.151
Street, J. R. L. (2003). Communication in medical encounters: An ecological perspective. In T. L. Thompson, A. M. Dorsey, K. I. Miller & R. Parrot (Eds.), Handbook of health communication (pp. 63–89). Lawrence Erlbaum.
Tannen, D. (2007). Talking voices: Repetition, dialogue, and imagery in conversational discourse (2nd ed.).Cambridge University Press.
Todd, A. D. (1984). The prescription of contraception: Negotiations between doctors and patients. Discourse Processes: A Multidisciplinary Journal, 7(2), 171–200. https://doi.org/10.1080/01638538409544588
Trần, K. (2009). Examining conversational constraints in Vietnamese patient-doctor communication: A case study. Xulanexus: Xavier University of Louisiana’s Undergraduate Research Journal, 6(1), 3–20. Retrieved September 18, 2022, from http://xulanexus.xula.edu/textpattern/index.php?s=file_download&id=20
Trần, T. N. (2006). Tìm về bản sắc văn hóa Việt Nam [Tracing Vietnamese cultural identity] (5th ed.). Nhà Xuất Bản Tổng Hợp Thành Phố Hồ Chí Minh [Ho Chi Minh City General Publishing House].
Trần, T. Q. N. (2013). Refusal face-work strategies in intercultural communication: Refusals reported by Vietnamese speakers of EFL in intercultural workplaces (Unpublished doctoral dissertation). University of Queensland, Brisbane, Australia.
Wodak, R. (2002). Critical discourse analysis and the study of doctor-patient interaction. In M. J. Toolan (Ed.), Critical discourse analysis: Critical concepts in linguistics (pp. 340–364). Routledge.
Wong, J. (2000). Repetition in conversation: A look at “first and second sayings”. Research on Language & Social Interaction, 33(4), 407–424. https://doi.org/10.1207/S15327973RLSI3304_03
