Affective-Discursive Practice in Online Medical Consultations in China

ISBN-13: 9789811926457 / Angielski / Miękka / 2023

Yu Zhang

Opis

This book provides readers with the latest research on the affective aspect of online interactions between doctors and e-patients in the context of China from a poststructuralist discourse analysis perspective. At the heart of this book is the presentation of four chapters which address (1) indirect negative emotional acts by e-patients and empathic acts by doctors (constituting “affective practice”), (2) the interactional discursive features involved in the affective practice, (3) discursive positions of e-patients and doctors within the affective practice context, and (4) power relations that are reflected in the positionings. This book sheds light on the importance of examining the affective facet of medical consultation, when it comes to identifying non-traditional positions and power relations in doctor-patient communication. It also provides the implication that e-healthcare platforms, especially those with an e-commercialized model for healthcare services, have potential to produce a type of neo-liberal discourse—the e-commercialized medical consultation discourse—in which patients and caregivers, who are acknowledged as the less powerful group in the traditional healthcare activities, are empowered and privileged.

Spis treści

List of Tables v

List of Figures v

Chapter 1 Introduction

Chapter 2 Online Space for Health Communication and the China Context

2.1 Online Space for Communicating Illness and Health

2.2 Internet Plus Healthcare in China

2.3 Communicative Problems in Healthcare and Research Gaps

2.4 Features of Online Affective Communication

Chapter 3 Affective Practice and A Poststructuralist Perspective

3.1 Affect and Affective Practice

3.2 A Poststructuralist Discourse Analysis Perspective

Chapter 4 Discourse Practice in Health Communication

4.1 Studies on Face-to-Face Medical Encounters

4.1.1 Linguistic attributes

4.1.2 Knowledge territory

4.1.3 Power asymmetry

4.1.4 The “sick role” of patients

4.2 Computer-Mediated Health Communication

4.2.1 Peer-to-peer interactions

4.2.2 Ask-the-experts online

4.3 Affective Communications in the Clinical Context

4.3.1 Emotional expression by patients

4.3.2 Empathic communication by doctors

Chapter 5 Research Sites and OMC Texts

5.1 Research Sites

5.2 Data Collection

Chapter 6 Emotional and Empathic Discursive Acts

6.1 E-Patients’ Indirect Emotional Acts (Indirect PEAs)

6.1.1 Presenting uncertainty

6.1.2 Narrating

6.1.3 Self-Repetition

6.1.4 Disagreeing

6.2 Doctors’ Empathic Acts (DEAs)

6.2.1 Understanding act

6.2.2 Reassuring acts

6.2.3 Agreeing act

6.2.4 Praising act

6.2.5 Self-disclosing act

6.2.6 Implications of DEAs

6.3 The Distribution of Empathic Acts in Response to Emotional Acts

6.4 Summary

Chapter 7 From Affective Discursive Acts to Affective Interaction

7.1 Sequences of Empathic Communication

7.1.1 Emotional act  immediate empathic act

7.1.2 Emotional act  non-empathic act  re-emotional act  empathic act

7.1.3 Emotional act  delayed empathic act

7.1.4 Emotional act  empathic act  re-emotional act  empathic act

7.1.5 Discussion of empathic communication sequences

7.2 Features of the Ineffective Empathic Response

7.2.1 Not addressing all the presented questions

7.2.2 Providing premature generalization

7.2.3 Giving no specific explanation

7.2.4 Using self-disclosure to delegitimize e-patients’ concerns

7.2.5 Discussion of ineffective empathic response features

7.3 Sequential positions of DEA within Empathic Response

7.3.1 Positioning empathic act after medical agendas

7.3.2 Positioning empathic act before medical agenda

7.4 Summary 122

Chapter 8 Discursive Positionings: Bucking the Traditional Roles

8.1 Poststructuralist Approach to Identity

8.1.1 A poststructuralist view on identity

8.1.2 Positioning theory

8.2 The Co-Construction of Positions – Emotional Support Seeker (ESS)/Giver     (ESG)

8.3 The Negotiation of Positions

8.3.1 From accuser/defender to ESS/ESG

8.3.2 From dissenter/justifier to ESS/compromiser

8.4 Doctor Initiated Construction of Positions

8.4.1 Online seller

8.4.2 Peer

8.4.3 Family member

8.5 Discussion and Summary

Chapter 9 Dynamic Power Relations Informed by Discursive Positionings

9.1 A Poststructuralist View on Power

9.2 The Dynamic Power Relations

9.2.1 Highlighting e-patients’ reward/coercive power

9.2.2 Softening doctors’ expert power

9.2.3 Negotiating expert power

9.2.4 Giving up legitimate power

9.3 Discussion and Summary

Chapter 10 Concluding Remarks

10.1 Practical Applications

10.2 Where is the E-Healthcare Culture Going?

10.3 Is the Degree of Sincerity of Empathic Expressions Important?

10.4 Limitations and Future Research

References

Appendix Ⅰ PRISMA Flowchart

O autorze

Yu ZHANG got her PhD degree from the Department of English at Hong Kong Baptist University in 2020. For her PhD degree, she studied discourse analysis in the context of online health communication. She currently holds a teaching position in the School of Foreign Studies at Beijing Information Science and Technology University. Her work has been published as articles in academic journals such as Health Communication, Applied Linguistics Review, Discourse and Communication, Chinese Journal of Communication, Communication & Medicine, and Journal of Foreign Languages (“外国语”). Her major research interest is discourse studies in the context of health communication.