کاربست روش «تحلیل مکالمه» در بازشناخت الگوی بیمار محور در تعامل پزشک- بیمار
محورهای موضوعی :
جامعه شناسی
سجاد ممبینی
1
,
علیرضا قبادی
2
1 - دانشجوی دکتری جامعه شناسی، دانشگاه خوارزمی، تهران، ایران (نویسنده مسئول) sajadmombeiny@yahoo.com
2 - استادیار گروه جامعه شناسی، دانشگاه خوارزمی، تهران، ایران
تاریخ دریافت : 1400/05/23
تاریخ پذیرش : 1400/08/10
تاریخ انتشار : 1402/06/01
کلید واژه:
الگوی بیمار ـ محور,
تحلیل مکالمه,
تعامل پزشک ـ بیمار,
چکیده مقاله :
پژوهش حاضر قصد دارد کاربست روش تحلیل مکالمه را در بازشناخت الگوی بیمار ـ محور در یک تعامل پزشک ـ بیمار، مورد کند وکاو قرار دهد. بدین منظور پژوهشی با رویکرد کیفی و به روش تحلیل مکالمه انجام گرفت. در این راستا چهار جلسۀ معاینۀ پزشکی میان چهار زوج بیمار-پزشک ضبط گردیده و بصورت متن پیاده سازی شد. بدنۀ اصلی متن ها انتخاب و با روش تحلیل مکالمه تحلیل گردید. در نتیجۀ تحلیل هایی که روی متون اعمال شد، 4 قاعدۀ اساسی (استقرار متناظر گفته ها، آشنایی سازی، انبساط کلام و نشانه گردانی) استخراج گردید. این قواعد که همگی مشخصه های یک تعامل شخصی و صمیمانه هستند، نشان دادند که تعامل پزشکیِ مورد مطالعه از نوع بیمار- محور بوده است. همچنین یک فرآیند سه مرحله ای به عنوان الگوی حاکم بر یک تعامل بیمار- محور، استخراج گردید. نتایج تحلیل نشان داد که روش تحلیل مکالمه به خوبی توانسته است از طریق تحلیل صوری متن، الگوی حاکم بر تعاملات پزشک ــ بیمار و نحوۀ برساخت آن را کشف نموده و توضیح دهد.
چکیده انگلیسی:
The present study intends to explore the application of conversation analysis method in recognizing the patient-centered pattern in a physician-patient interaction. For this purpose, a research was conducted with a qualitative approach and conversation analysis method. In this regard, four medical examination sessions between four patient-physician couples were recorded and implemented as a text. The main body of the texts was selected and analyzed by conversation analysis method. As a result of the analyzes applied to the texts, 4 basic rules (corresponding placement of utterances, familiarization, word expansion and marking) were extracted. These rules, which are all characteristics of a personal and intimate interaction, showed that the medical interaction studied was patient-centered. Also, a three-step process was extracted as a model governing a patient-centered interaction. The results of the analysis showed that the conversation analysis method was able to discover and explain the pattern governing physician-patient interactions and how to construct it through face-to-face text analysis.
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Nouri, M. (2010); "Ethnometodorology", Book of the Month of Social Sciences, No. 27, pp. 85-80.
Kalantari, S. et al (2009); "Discourse Analysis; Emphasizing critical discourse as a method of qualitative research ", Sociological Studies, No. 4, 7-28.
Blanchard, J., Lurie, N. (2004), Respect: patient reports of disrespect in the
health care setting and its impact on care, J FamPract, 53: 721–730.
Shafati, M. and Zahedi, M. J. (2012); "Study of biological, social and psychological patterns of physician-patient relationship: transition from biomedical model", Bioethics, No. 5, pp. 186-151.
6- Chien-Yu, CH. (2010), The analysis of communication problems andlanguage barriers between patients and physicians in California, Chung Shan Medical University, for the Degree Master of Science.
Masoudnia, I. (2005); "The effect of social class on patients' perception of rheumatoid arthritis symptoms and pain", Daneshvar, No. 13, 46-37.
Kalateh S., A., Iman, M. T. and Bagheri Lankarani, K. (2015); "Conversation Strategies in Physician Interaction with a Rival Patient", Razi Journal of Medical Sciences, Volume 22, Number 134, pp. 40-28.
Chavoshian, H. et al. (2015); "Formal power and methods of expressing resistance in everyday conversations in a teahouse by the method of critical dialogue analysis and semiotics", Journal of Social Sciences, Twelfth Year, No. 1, pp. 298-277.
Azizi, A. (2014); "Putting Culture in the Game of Power: A Study of the Manifestations of Power Relationships in Everyday Jokes in a Teahouse," Anthropology Journal, Volume 12, Number 20, pp. 137-113.
Hester S., Eglin P. (2019). Culture in Action: Studies in Membership Categorization Analysis, Washington, DC: International Institute for Ethnomethodology and conversation Analysis, and University Press of America.
Baker, C. (2018); “Locating culture in action: Membership categorization in texts and talk”. In A. Lee & C. Poynton (Eds.). Culture and text: Discourse and methodology in social research and cultural studies. 99-113.
Mohammadpour, A. (2013); Anti-method, Tehran: Sociologists.
Atkinson, P. (2008). Ethnomethodology: A Critical Review. Washington: University of Washington.
Weigert, A. (2011). Sociology of Everyday Life. New York: Longman.
Craib,I. (2013); Modern Social Theory, translated by Abbas Mokhber, Tehran: Ad.
Ritzer, G. (2016); Sociological Theory in Contemporary Times, translated by Mohsen Thalasi, Tehran: Scientific Publications.
Jalaeipour, H. and Mohammadi, J. (2015); Recent Sociological Theories, Tehran: Ney.
Flick, U. (2012); An Introduction to Qualitative Research, translated by Hadi Jalili, Tehran: Ney.
Bergmann, J. (2004). Conversation Analysis: A Companion to Qualitative Research. London: SAGE.
Silverman, D. (2014); Qualitative research method in sociology, translated by Mohsen Thalasi, Tehran: Sociologists.
Ten Have, P. (2012). Doing Conversation analysis: A Practical Guide. London: SAGE.
Foucault, M. (2014); The Will to Know, translated by Niko Sarkhosh and Afshin Jahan Dide, Tehran: Ney.
Masoudnia, I. (2015); Medical Sociology, Tehran: University of Tehran.
Armstrong, D. (1995). The Rise of Surveillance Medicine. Sociology of Health and Illness. 17: 393-404.
Lee S. J., Back A. L., Block S. D., Stewart S. K. (2002). Enhancing physician-patient communication. Hematology Am SocHematolEduc Program 1: 464–483.
Tongue JR., Epps HR., Forese LL. (2005). Communication skills for patientcentered care: Research-based, easily learned techniques for medical interviews that benefit orthopaedic surgeons and their patients, J Bone Joint Surg Am, 87: 652–658.
Klitzman H. (2006). Sexualization of the doctor-patient relationship: Is it
ethically permissible?, Journal of family practice, Vol.52.
Emanuel, j. & Emanuel, L. (2014). Four Models of the Physician- Patient Relationship. Journal of the American Medicine. N.16,p.p 5-13.
30- Cordella, M. (2007) Unveiling stories to the oncologist: a matter of sharing
and healing. Panace, Ix, (26), 230-238.
