A Pragmatic Study Of Echo Questions In Chinese Doctor-Patient Conversation

Echo questions are prevalent in verbal conversation, rather than a marginalized phenomenon. Researchers have increasingly realized the importance of echo questions in both daily life communication and institutional interaction. However, previous studies on echo questions are not sufficient and systemic. They mainly focus on linguistic features and functions of echo questions extracted from introspective examples or dialogues in literary works. Besides, interpretation of echo questions is mainly made under the framework of Relevance Theory. Few research have been conducted to investigate echo questions in naturally occurring conversation, with little attention paid to the dynamic features of echo questions in daily conversation or in institutional talk. Therefore, this study is aimed to investigate the linguistic and conversational characteristics of echo questions and their functions in doctor-patient conversation in outpatient departments of Chinese hospitals and to explore the dynamic process of echo questions and responses. Moreover, pragmatic interpretation of production and comprehension of echo questions is made under the framework of Adaptation Theory.In doctor-patient conversation, echo questions have the following five features. First, echo questions have the feature of question, ended with flat-rising or high-rising intonation, and feature of repetition, with the prior utterance repeated fully or partially. Second, echo questions repeat the whole utterance, or words, phases and clauses of the prior utterances. Third, most echo questions occur in the first position in a sequence and few in the second position and the third position. Fourth, the patterns of echo questions and responses are: echo question-response (EQ-R), echo question-response+assessment (EQ-R+A), echo question-assessment (EQ-A) and echo question-self-response (EQ-Rself). Fifth, echo questions mainly serve the following five functions:requesting confirmation, requesting clarification, preparing the next turn, expressing reception and feedback, and expressing emotions and attitudes.Under the framework of Adaptation Theory, echo questions and responses are the outcome of adapting to the contextual correlates that change from time to time so as to correspond to the participants’linguistic choices. The social, mental and physical factors affecting the production and interpretation of echo questions have been investigated. Social factors, such as institutional power and social position, play a constant role throughout the process of doctor-patient conversation. Doctors have more power and solidarity than patients in clinical settings while patients are always in lower institutional position with less power when confronted with doctors. Motivation is one mental factor that affects both doctors’and patients’linguistic choices. Doctors’ motivation in the communicative process includes task-oriented motivation and service-oriented motivation while patients’ motivation is much complex. Patients have considered both their own needs and doctors’ needs when using echo questions. Responses to echo questions are also the result of adapting to the mental world and social world that constitute the communicative context between doctors and patients. The production and interpretation model of echo questions has been constructed on the basis of Adaptation Theory. This study has enriched the research on echo questions and doctor-patient interaction and provided practical suggestions for establishing healthy and harmonious relationship between doctors and patients.