Positive Discourse Analysis Of Discursive Construction Of Nurse-patient Relationship In Hospital Wards

Over the past decade,the doctor-patient and/or nurse-patient relationship in our country has been deteriorating,which has even caused some violent conflicts.This has endangered the individual interest of doctors,nurses and the patients as well.Although it can be attributed to many reasons,such as medical negligence and incomplete medical system,the poor communication between doctors and/or nurses and patients can be seen as one of the leading factors.As a matter of fact,nurses spend more time with patients than doctors,and there can be more conversations occurring between nurses and patients.Therefore,conflicts are more likely to happen between nurses and patients.In this context,this thesis attempts to conduct an empirical research on the discursive construction of nurse-patient relationship in hospital wards.Three research questions are addressed: 1)What are the appraisal characteristics of nurse-patient conversations?2)How are appraisal resources distributed in nurse-patient conversations? 3)How can a harmonious nurse-patient relationship be constructed by conversations from the perspective of Appraisal System?This empirical study was conducted at the People's Hospital of Anyue County,Sichuan Province.All the data analyzed in this study were recorded with a digital voice recorder.Altogether,27 conversations were collected from 9 nurses,with 3 recordings for each nurse doing different tasks.All the materials were transcribed and annotated,and then analyzed in the framework of positive discourse analysis,focusing particularly on the Appraisal System.Methodologically,a combination of quantitative and qualitative study was employed in this project.Based on the data,the distribution patterns of Appraisal System and its three sub-systems in nurse-patient conversations were statistically analyzed,with an aim to reveal how appraisal resources are used to construct a harmonious nurse-patient relationship in hospital wards.The results of the quantitative and qualitative research indicate that: 1)The threesub-types of appraisal resources are distributed at the different frequency in nurse-patient conversations.Among them,Attitude resources account for 36.14%,Graduation resources occupy 34.70%,and engagement resources account for 29.16%.Within Attitude resources,positive expressions and negative ones account for 45.87%and 54.13% respectively;within Engagement resources,the Heteroglosses Contraction exceed the Heteroglosses of Expansion,accounting for 79.09% and 20.91% respectively;within Graduation resources,expressions of force are far more frequently used than expression of focus,for actually no resources of focus were found in this corpus.2)The expressions of Contraction are used to reduce the dialogic space,to present speakers' firm attitudes and stances,and to show authority when leaving some spaces for negotiating with the audience.3)A great number of force resources are adopted to strengthen the communicative effects.The findings of this study lends evidence to the discursive construction of nurse-patient relationship to some extent.This can help nurses to pay more attention to the interpersonal function of language and thus ameliorate the increasingly tense nurse-patient relationship in the healthcare context.Besides,the findings of the study is also expected to shed some light on medical ethics and medical sociology and provide some guidance for nurse training.