Communicative Strategies and Tactics in the Doctor's Speech in Dialogues About Self-Treatment

The article presents the results of the study of dialogues between the doctor and the patient about self-treatment in order to classify the speech strategies and tactics of the physician and evaluate their effectiveness in achieving mutual understanding with the patient. Fifty-five records of medical consultations were analyzed at semantic, lexical, lexical-grammatical and communicative-pragmatic levels and 34 fragments of dialogues relevant to the topic "self-treatment" were revealed. As a result of their analysis, the typical macrointentions in the doctor's speech were determined: to support (8 dialogues), to prohibit (17 dialogues), to ignore (9 dialogues). These communicative goals allowed to unite the material into appropriate groups of dialogues, in which specific speech strategies are implemented with the working names supporting, rejecting and ignoring. It has been established that these strategies are used both in authoritarian and collegial discourse, pursue common goals, but differ in tactical methods and techniques of language expression in the mentioned types of discourses. The supporting strategy is intended to approve patient's actions in situations when self-treatment is acceptable and justified. In authoritarian discourse, the goal is achieved through praise and verbal permission tactics, in collegial through verbal and non-verbal means of agreement with the words of the interlocutor. The most frequent is the rejecting strategy aimed at prohibiting independent actions of the patient. It is variable and presents a system of two sub-strategies that are realized through sub-tactics of constructive and destructive criticism, as well as tactics of emotional and rational effect. To establish the long-term compliance, the combination of sub-tactics of constructive criticism and rational effect is effective; it is used primarily in collegial communication between the doctor and the patient. The combination of sub-tactics of emotional effect and destructive criticism is carried out in authoritarian communication; it actively influences the patient's behavior, but is risky as it goes on the verge of conflicting and cooperative types of communication. The ignoring strategy realized through two tactical options, the annulling tactics and tactics of alternative, can testify both to cooperative and conflicting communication. Keeping silence, as the nuclear intention of strategy, leads to ambiguity, and, therefore, additional communicative acts in order to avoid undesirable consequences and ambiguity in establishing long-term compliance are required. The choice of an adequate speech strategy by the doctor in discussing self-treatment affects the type of communication development: cooperative or conflicting, the possibility of establishing a trusting relationship with the patient.

Keywords

Authors

References