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Journal of Rural Medicine ›› 2025, Vol.2 ›› Issue (6) DOI:

• 指南解读 • 上一篇     下一篇

急诊科医患冲突性话语中的身份建构研究

张莉   
  1. 1 . 西安医学院医学语言与文化研究中心
  • 收稿日期:2025-06-01 03:31:36 发布日期:2025-09-17
  • 通讯作者:

  • 作者贡献:
  • 基金资助:
    西安医学院校级科研基金项目(项目编号:2021QN07)。

Research on Identity Construction in Doctor-patient Conflict Discourse in Emergency Department

ZHANG Li   
  1. Center for Medical Language and Culture Studies, Xi’an Medical University
  • Received:2025-06-01 03:31:36 Online:2025-09-17
  • Contact:

摘要: 本文以语用身份论及语言顺应论为理论框架,选取急诊科医患冲突性对话为分析语料,探讨了医患双方在冲突性话语情境下如何动态地建构与调整各自的身份,并进一步分析了这一构建过程所受的语境制约因素。结果发现,在急诊科医患冲突性话语中,医生建构了医学专家者、阐释者、同伴者、同情者、威胁者、质疑者身份,患方建构了请求者、挑战者、顺从者、质疑者身份。双方身份的建构与调整是顺应物理语境下冲突发展的不同阶段、心理语境下交际双方的情感表达和面子需求,以及社交语境下的权势关系和文化规范的结果。本文从语用身份的视角出发,揭示医患冲突性话语的互动特征,有助于医患审视和优化自己的言语行为,促进医患间的有效沟通和关系和谐。

关键词: 急诊科;医患交际;冲突性话语;身份建构

Abstract

Based on pragmatic identity theory and linguistic adaptation theory, this study, with data drawn from doctor-patient conflict discourse happened in the emergency department, explores how doctors and patients dynamically construct and adjust their respective identities in the context of conflict, and further analyzes the restricting contextual factors in the interaction. The result shows that in doctorpatient conflict discourse, doctors construct identities of the medical expert, the elaborator, the companion, the comforter, the threatener and the doubter; patients construct identities of the requestor, the defier, the submissive and the doubter. The construction and adjustment of the identities of both parties are the result of adapting to the different stages of conflict development in the physical context, the emotional expression and face-saving needs of communicators in the psychological context, as well as the power relation and cultural norms in the social context. This study reveals the interactive characteristics of doctor-patient conflict discourse from the perspective of pragmatic identity, which is helpful for doctors and patients to examine their verbal behavior and promote effective communication and harmonious relationships between doctors and patients.

Objective

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Key words: Emergency department; Doctor-patient communication; Conflict discourse; Identity construction

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