An Empirical Study On Inducing Conditions And Characteristics Of Elderspeak In Doctor-Patient Communication

The medical interaction mechanism of elderly patients is not only a significant problem faced by China after entering the aging society but also one of the crucial categories of geriatric linguistics.Since the government put forward the new service model of “combination of medical care and elderly care” for the elderly,various medical organizations have been committed to providing more comprehensive,intimate,and convenient services for elderly patients.In the doctor-patient interaction,health professionals often raise the volume,reduce the speed of speaking,and simplify the language style of sentence patterns to avoid the elderly being unable to hear and understand to promote communication.This particular discourse with distinctive characteristics is called elderspeak.However,relevant foreign studies have shown that although elderspeak can help some older people improve communication efficiency to a certain extent,it is often regarded as a manifestation of over-adaptation for the elderly with normal cognitive and hearing levels,which will damage their self-esteem and self-confidence.Based on this,through the combination of qualitative and quantitative research methods,taking rapport management theory of Helen Spencer-Oatey and multimodal interactional analysis of Sigrid Norris as the guiding framework,this study takes some health professionals,elderly patients,and their family members in hospitals of Shandong Province as the research objects.It is committed to solving the following two problems:1)How do health professionals view elderspeak,and what are the inducing conditions of elderspeak? 2)What are the salient features of the elderspeak often used by health professionals?This study found that:1)Overall,the ratings of health professionals on all questionnaire items were between 3.23 and 3.87,indicating that medical workers generally believed it is appropriate to use elderspeak.Specifically,among the internal characteristics of patients,the education level of elderly patients and their work before retirement were the main conditions inducing health professionals to use it.Secondly,in the external characteristics,the age,gender,and physiological characteristics of elderly patients(including vision,hearing,and whether they can walk independently)were the main inducing conditions.In the situational characteristics,the workload of doctors and the presence of leaders were also essential to evaluate its appropriateness.Furthermore,the degree of closeness between patients and doctors was also taken into account in the relationship characteristics.It is found that the more familiar patients were with doctors,the more doctors thought it was inappropriate to use elderly directional language.In addition,the demographic data of the questionnaire showed that regardless of the characteristics of patients,participants’ age,gender,working duration,and professional titles caused differences in the evaluation of the appropriateness of elderspeak.The last four open-ended questions of the questionnaire also proved that on relevant occasions,the use of elderly directional language was more frequent and often considered to be valid,which was helpful to improve communication efficiency.2)When using the elderspeak,health professionals tried to construct the interactive meaning through their verbal and non-verbal communication modes to meet the maintenance of the speaker’s face,the determination of social rights and obligations,and the realization of the communication purpose.From the perspective of the illocutionary domain,health professionals were more inclined to implement expressive speech acts,and directive speech acts for elderly patients.From the perspective of the discourse domain,elderspeak often showed the characteristics of information redundancy and particular responding words.From the perspective of the participation domain,the frequent participation of family members of elderly patients broke the traditional impression of binary doctor-patient interaction.The two leading roles of family members of elderly patients in doctor-patient communication were information provider and process facilitator.From the perspective of the stylistic domain,the use of slow rhythm,stress,honorific appellations,hedges,and the addition of modal particles at the end of sentences were distinctive characteristics.In addition to verbal communicative modals,health professionals actively chose and used their proxemics,posture,gaze,gesture,head movement,and other auxiliary nonverbal communicative modes.To sum up,this study opened a new perspective for the clinical application of Gerontology by analyzing of the inducing conditions and the characteristics of elderspeak in doctor-patient interaction.It provided relevant cases and references for scholars in multimodal research and doctor-patient interaction to arouse social language care for the elderly and build a harmonious society.