The Impact Of Doctor's Discourse On Patient's Attention In Doctor-Patient Communication: An Empirical Study

Over the last few decades, considerable attention has been paid to the study of doctor-patient communication and extensive systematic empirical research has been conducted, which has brought forth fruitful results. However, after a review of the literature, it is found that most studies were carried out from the sociological, linguistic or psychological perspective respectively. To make research on doctor-patient communication more meaningful, it is necessary to use multi-disciplinarily and interdisciplinary research approach so as to provide more clues about how to establish a good doctor-patient relationship. The present study, therefore, adopts real-life observation to investigate the doctor-patient conversations in outpatient department of Yilong Hospital. Linguistic material is obtained through tape-recording on the spot. And before the research is done, questionnaires concerning the study issue have been handed out to selected participants to collect data.The study, combining psychological studies on attention with linguistic studies on doctor-patient communication, addresses the following questions:(1) Does the discourse of doctor, namely, the length of conversation duration, questions in doctor-patient dialogue and the use of medical jargon have effects on patient's attention? (2) How does the discourse of doctor influence patient's allocating of attention? (3) How does such discourse affect patient's way of response?After analysis of the data by using both quantitative and qualitative methods, the thesis reached the following findings:(1) All of the three aspects of doctor's discourse have effects on patient's allocating of attention resources.(2) Skilled language use, requires the coordination of a number of cognitive abilities, while some language skills such as attending to a conversation, attending to changes in a linguistic environment (i.e., change in tone of voice; introduction of unexpected ideas), as well as inhibiting and selecting particular expressions cannot proceed smoothly as a result of the general short conversation duration. Different kinds of questions asked by doctor have different effects on the degree of patient's concentration of attention:some medical questions intensify the degree of patient's nervousness, which cause patient's attention to be mainly focused on his/her physical states; while conversational questions and psychosocial questions can calm down patient, thus he/she can better focus on the conversational information provided by doctor. And too many medical terminologies used by doctor increase attention load to patient.(3) Patient's way of responses may change due to the impact of doctor's discourse on patient's attention. In this process, the sustaining of attention on one object and shifting of attention from one object to another object make patient's response way often accompanied with "temporary stop", "repeat of questions" or even "body gestures". In this way, the whole medical conversation goes further.This dissertation consists of five chapters. The first chapter introduces the background to the study, purpose and significance of the study as well as organization of this thesis. Chapter Two critically reviews the development of the research on doctor-patient communication comprehensively and research on attention related. Chapter Three elaborates three important aspects of doctor's discourse in doctor-patient communication:namely, conversation duration, questions in doctor-patient dialogue and medical jargon. Chapter Four presents the research issue, participants, research procedure and methods, and analyses the results. Chapter Five makes a conclusion about the impact that doctor's discourse may have on patient as well as the influence it has on patient's way of response; then limitations and research implications of the study are presented and at last, it recommends further areas for future study.