Author: Jin, Ying
Title: Doctor-patient communication and patient satisfaction : an exploratory study of the similarities and differences between traditional Chinese medicine and western medicine practices in mainland China
Advisors: Tay, Dennis (ENGL)
Watson Bernadette (ENGL)
Evans, Stephen (ENGL)
Degree: Ph.D.
Year: 2019
Subject: Hong Kong Polytechnic University -- Dissertations
Discourse analysis
Physician and patient -- China
Medicine, Chinese
Department: Department of English
Pages: xiv, 259 pages
Language: English
Abstract: Communication is a fundamental component in medical interviews. It is believed (Bensing, 1991) to be a potent tool in improving the quality of medical care and thus a skill to be learned. Over the decades, scholars have made both theoretical and empirical contributions to knowledge of the medical encounter. While much is known about communication in western medical practice, what is left unknown is how people interact with each other in alternative medical practices, resulting in many unwarranted claims and suspicions. This thesis contributes to research on doctor-patient communication by exploring the communication behaviors in both western medical practice and traditional Chinese medical practice in Mainland China and the impact on patient evaluation of their medical care. In particular, communication outside the biomedical domains of medical interviews is chosen as a specific area for in-depth examination, focusing on where talk of this nature usually occurs in medical interviews, which topics are usually discussed, how participants encourage or discourage exchanges of information at this level, and what kind of interpersonal relationships are indexed by discourse at this level. In addition, this research also compares patient evaluations of their doctors' communication styles and global satisfaction. The research context on which this study was conducted is a first-grade level-three referral general public (三甲醫院) hospital (i.e. hospitals ranked highest) in Mainland China. The data comprises 69 audio recordings of medical interviews and post-consultation questionnaire surveys. Data includes medical interviews from both the western medical division and the traditional Chinese medical division. The data were translated into English for illustrative purposes. In the analysis of medical discourse, the Roter Interaction Analysis System codings were adapted to the interviews in both medical practices. The analytical frameworks in analyzing medical discourse include conversation analysis when analyzing the sequential turns and consequences and frame analysis when analyzing participants' orientation and understanding of the current discourse. Post-consultation patient evaluations were also collected adapting the relational communication scale to explore if variations in communication styles affect patient assessment of their medical consultation. In interpreting these variations, the social interaction theory was invoked to explain the relationship between the affective domains of communication and patient evaluations. Findings from this research suggest that compared with medical interviews in western medical practice, those in traditional Chinese medical practice feature a more patient-centered style of communication, with more doctor-patient interactions in non-biomedical domains of medical communication. Doctors in traditional Chinese medical practice also demonstrate more attentive listening, better attitude, lower dominance, and acquaintance with their patients, all of which are correlates of higher global patient satisfaction. The thesis argues that one possibility of these diverging features of medical discourse is the clinical differences in philosophy, pathology, and etiology.
Rights: All rights reserved
Access: open access

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