门诊会话中医生和患者礼貌策略的对比分析

本文运用Brown和Levinson的面子理论研究门诊医患会话中的礼貌现象,研究发现医患双方都采用积极礼貌策略、消极礼貌策略以及间接礼貌策略来维护对方的面子以保证交际的顺利进行。通过将医生和患者的礼貌策略进行对比发现,在医患交际过程中,医生会使用直接礼貌策略,而患者则从未使用这一礼貌策略;医生多使用消极礼貌策略而患者多使用积极礼貌策略。分析显示,导致这一现象的根本原因在于医患之间的人际关系不对称。     

门诊会话中的礼貌策略研究

在Brown和Levinson面子理论的框架下考察了医患门诊会话中医生言语中的礼貌现象.发现了医生的一些不礼貌现象以及礼貌策略的特点,分析了导致这些不礼貌现象和礼貌策略特点的深层次原因,并总结了适应新型门诊医患会话特点的礼貌策略,以规范和指导实际的医患互动.     

医患模糊限制语的(不)礼貌分析

依据(不)礼貌理论框架,以真实的医患沟通音频语料为研究对象,应用话语分析法探讨医患模糊限制语的使用与(不)礼貌框架的关系。研究发现,医患交际中,模糊限制语的使用是把双刃剑,兼具积极和消极的双面功能:医患双方既可用它来实施礼貌策略,作为维护对方面子、建立良好医患关系的语言表达手段;模糊限制语亦可成为医患双方实施不礼貌的工具,在医患双方发生分歧、威胁对方面子时起强化作用。总结了医患模糊限制语的特点及使用理据,并探讨其正负作用以及对医患交际双方的启示。     

和谐医患关系中医生的言语礼貌策略分析

礼貌是人类社会普遍存在的现象,对于建立良好的人际关系和维护社会和谐起着重要的作用。语言是表达礼貌的重要手段,也是医患沟通最直接、最有效的方式。对在线咨询中好大夫的言语礼貌策略进行分析,有利于规范和指导医用语言,促进医患之间的理解、信任和沟通,从而建立平等、合作、和谐的新型医患关系。     

医患沟通对医生刻板印象表达的影响

从沟通频次与刻板印象传递性质的关系入手,以住院患者和尚未成为住院患者的大学生为被试,采用系列再生范式,利用10条4人再生链,探讨了医患沟通频次对医生刻板印象表达的影响。结果显示,与医生沟通频次高的住院患者在再生链的第2个位置传递医生的积极信息高于消极信息,但是经过4人的传递,住院患者对医生刻板印象信息的传递在积极信息与消极信息没有差异。而与医生沟通频次低的大学生在再生链的后期表现出传递医生消极信息的倾向。该结果表明：沟通频次能够调节有关医生的消极刻板印象的传递—与医生沟通频次高的群体在传递医生的刻板印象信息时,在传递的早期具有积极的倾向性;但经过多人传递之后,在效价方面已经没有倾向性;与医生沟通频次低的群体倾向于传递医生刻板印象的消极信息。     

基于自然语料的门诊会话分析

门诊会话是医患双方了解病情、分析病因、确定诊疗手段的最直接的对话方式.本文基于门诊会话的自然语料,对照以往的相关研究,分析了门诊会话中医生会话策略使用的特点以及医师、患者和语境互动的会话序列特征,旨在深化对医患互动过程的认知,进一步揭示现代中国医院语境中医患交流的社会文化符号特点.     

医患礼貌认知语用新解:关联期待信息量原则

回顾了国内外医患会话的礼貌研究,针对医患礼貌语言研究方面的不足,循着礼貌的认知语用研究进路,提出"关联期待信息量"原则。指出礼貌不仅事关医患双方"说了什么",还与双方"说了多少"有关。基于真实的门诊会话语料,对医患话语的礼貌性进行详细分析后发现,医患双方对信息量具有不同的关联期待:医生期待获取必要的病情信息,而患者期待获取充分的医学信息。双方不顾对方关联期待所致的话语欠关联或不关联,引起无意或有意不礼貌。因此,医患话语礼貌与否很大程度上取决于双方话语能否满足对方关联期待的信息量。     

双向促进患者参与临床决策的可行性调查与分析

我国医患关系紧张的状况逐渐受到社会各界的关注.本文结合现有医患关系的相关原始研究,分析造成医患关系紧张的可能原因,提出从医患双方积极促进患者参与临床决策,以寻求缓解医患关系紧张的有效途径.方法采用自拟问卷形式,对西南地区某三甲医院的563名患者和259名临床医生进行可行性调查与分析,为积极构建和谐医患关系提供循证依据.     

患者门诊话语中确认性问句的信息索取功能

确认性问句是门诊患者使用最多的向医生索取核心医学信息的间接方法.经考察这种兼有信息索取功能的确认性问句的功能、语言形式、内容、医生的答句各方面的特征,得出结论:这种确认性问句是病人综合考虑其目的和利益及其在医患角色关系中所处的地位、医生心理、语用原则、当前医患关系现状各因素后所选择的语言策略,医生应该认真对待.     

年轻医生面临的医患纠纷成因及沟通技巧

分析当前医患纠纷的成因,特别是年轻医生面临的人文背景知识、专业知识和价值观等内在因素,以及患方存在的社会矛盾、健康素养和潜在隐患.探讨纠纷的防范机制,提出有效沟通的步骤、方法和可能使用的沟通策略.防范医患纠纷,需认识自身不足,提高专业及人文知识,确实要做到以患者为中心,以“德”服患(者),让医疗回到本源.     

儿童Graves'病研究进展

Grave's病(GD)是导致儿童甲亢最常见的病因,其易感性80%决定于基因因素.ATD治疗是最常推荐的初始治疗手段,但长期缓解率仅为30%.ATD诱导儿童GD缓解的合适用药时间尚不明确.最佳治疗方式(ATD、RAI或手术)的选择还存在重大争议.药物治疗复发的预测非常重要,最近建立了一种复发风险评分,通过种族、年龄、诊断时FT4、TRAb水平、ATD预期治疗持续时间将GD儿童分成低中高三类风险人群,对其复发风险作出评估,对于确定GD儿童在初始治疗时选择何种方案更为适合意义重大.     

自伤青少年的冲动性

以自我报告、行为学和脑电为指标, 检验自伤青少年的冲动性。研究1, 对820名普通中学生和72名工读生进行问卷调查, 探讨自伤行为与情绪调节困难、冲动性的关系。结果表明, 冲动性能够预测自伤行为, 且预测效应量大于情绪调节困难。研究2, 采用Go/Nogo范式的ERPs实验, 检验自伤组与对照组冲动控制的行为学与脑电差异。结果表明, 自伤组Nogo正确反应的N2波幅显著高于对照组, N2潜伏期在部分电极点处高于对照组。脑电地形图显示两者的脑电差异主要体现在前额叶区。结论：自伤青少年的冲动性高于同龄普通青少年。     

Certification in Testing in Canada

This article presents a brief outline of a program developed by the Canada Employment and Immigration Commission (CEIC) for certifying employment counselors to use tests in Canada Employment Centres (CECs).     

Occupational Stress in Workers and Managers in Steelworks in China

Occupational stressors and strains of 121 Chinese steelwork employees and 122 managers were measured using the Chinese version of the Occupational Stress Indicator (OSI). It was found that factors intrinsic to the job, Type A behavior, logic, and organizational structure and climate were the main predictors of mental ill-health and physical ill-health in managers. Organizational structure and climate and relationships with other people were important predictors for workers. Management processes and organizational forces were the strongest predicting factors of job satisfaction in both samples. On certain OSI scales and subscales, managers scored statistically higher than workers. It is proposed that these results reflect the enormous economic and social changes currently taking place in China, together with certain features inherent in Chinese organizational and managerial processes.     

Sex differences in relational aggression in preschool children in Iran

The purpose of this study was to compare scores on a Relational Aggression Questionnaire for preschool boys and girls in Iran. The questionnaire was developed here, and its reliability and validity were assessed. Teachers' reports of relational aggression in 258 children ages 3 to 7 years was studied. Sex differences in relational aggression were not observed and was not significantly different across age groups.     

Evidence for sex differences in brain organization in recovery in aphasia

Ninety-one adult aphasics of both sexes were studied before and after a 3-month period of language therapy. Although no initial sex difference was found in severity of language disorders, females within the global aphasic group showed significantly greater improvement in three tests of language comprehension. It is suggested that more bilateral representation of language functions in the female brain may account for this greater improvement.     

Ethical Issues in Counselling in Education

It is suggested that there are two quite distinct Systems of ethics and practice in use by counsellors in education: the integrated model, which emphasises viewing the counsellor-institution relationship as theprimary ethical perspective; and the differentiated model, which emphasises the counsellor-client relationship as the starting point for an ethical understanding of the counsellor's role. The implications of these two perspectives for ethical issues relating to sources of referrai, issues of confidentiality, accountability for resources, the implications of role diffusion, and the outcomes of counselling, are examined. The ethical consequences of viewing the two Systems as reconcilable or incompatible are explored.