VIETNAM NATIONAL UNIVERSITY, HANOI UNIVERSITY OF LANGUAGES AND INTERNATIONAL STUDIES ***** FACULTY OF POST–GRADUATE STUDIES NGUYEN THANH NGA DOCTOR TALK AT CONSULTANCY IN ENGLISH AND VIETNAMESE: AN INTERPERSONAL COMPARISON (Giao tiếp của bác sĩ trong tư vấn khám bệnh trong tiếng Anh và tiếng Việt: So sánh từ bình diện liên nhân) MAJOR: ENGLISH LINGUISTICS CODE: 9220201.01 A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Linguistics Supervisor: Prof. Hoang Van Van HANOI – 2018 i LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com DECLARATION I certify my authority of the study project report submitted entitled DOCTOR TALK AT CONSULTANCY IN ENGLISH AND VIETNAMESE: AN INTERPERSONAL COMPARISON In fulfillment of the requirements for the degree of Doctor of Philosophy in Linguistics at Vietnam National University, Hanoi Except where the reference is indicated, no other person’s work has been used without due acknowledgement in the text of the dissertation. Nguyen Thanh Nga, HANOI, 2018 ii LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com ACKNOWLEDGMENTS I would like to express my sincere gratitude to many people who have supported and helped me a great deal to complete this dissertation. I am especially grateful to all of the patients and the doctors who were generous enough to allow me to record their consultations.
To my supervisor, Prof. Hoang Van Van, I wish to thank him sincerely for his thorough and conscientious supervision that enlightened my inspiration in Systemic Functional Linguistics. I have benefited not only from his generosities of providing me with valuable materials, giving me edifying feedback as well as advice with regard to this dissertation but also from his patience, gentle and loving personality to encourage me to overcome my limited knowledge of systemic theory. I extend my warm thanks to all the lecturers and examiners for their enthusiasm and scholar knowledge, whose teachings and lectures I benefited from.
I am particularly indebted to Prof. Nguyen Hoa, Prof. Nguyen Quang, Assoc. Le Hung Tien, and Dr.
Huynh Anh Tuan who generously helped me by giving materials, feedbacks, critical comments, discussions and valuable advice with regard to this study. I would also like to thank all the staffs of VNU journal of foreign studies who provided me with invaluable feedback on my journal articles. I must not fail to express my sincere gratitude to Dr. Qasim Adam who provided me with rare materials and his dissertation copy.
I surely got much benefit and inspiration to complete this dissertation from his priceless academic resources. I wish particularly to thank all the personnel departments, administrators and military officers of Vietnam Military Medical University for their generosity of providing me time, financial supports, and permission to conduct this research. I take this opportunity to thank all the lecturers and my doctor students for their whole-hearted support, guidance and advice. Also, my great thanks to all of my friends and colleagues who have encouraged me to finish this study.
Last but not least, my special thanks and love go to my parents, my husband, Nguyen Đoan Ngoc and my two sons: Nguyen An Nguyen and Nguyen Khang Ninh who are certainly my greatest source of motivation to go through many hardships during my PhD study. I owe a debt of care to all of my family members as I had been very busy and spent less time taking care of them. Above all, I would like to say a great thank-you and wish you all good health and great success in your life. iii LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com ABSTRACT The language that doctors use during their consultations with patients has been the focus of increasing interest for many years.
A large number of contributors to this field of medicine, which include linguistic researchers, have explored this domain in various perspectives and in different languages. This thesis examined the issue of doctor talk, a subject that has been discussed by a large literature of medical communication. This thesis employed Systemic Functional Linguistics (hereafter SFL) as the theoretical and analytical framework. In particular, the study adopted the Mood system that includes two lexico-grammatical resources: mood and modality to compare proportions and realisations of interpersonal meanings as found in English and Vietnamese doctor talks at the time of consultations with patients.
The data of the study were collected and categorized into six groups of diseases: Cardiology, Endocrinology, Neurology, Gastroenterology, Oncology, and Otorhinolaryngology. Since the scope of this study is majorly on comparing interpersonal meanings between the two languages, it is unnecessary for the study to compare doctor talks across the selected diseases. However, comparisons of different patterns of interpersonal meanings in doctor talks across six selected groups of diseases were somehow provided. The aim is only to diversify the data source, to prove more cross-sectioned analyses and to ensure the current study’s reliability.
Descriptions, comparisons and interpretations of interpersonal meanings found in the two languages of consultation have been conducted by qualitative and quantitative processes and methods of content analysis. Research findings of this thesis showed that the use of mood and modality resources in English and Vietnamese corpora was remarkably different in the range of realisations compared with that of proportions. As regards proportions, doctors from the two corpora were seen to be more active in employing subtypes of mood and modality resources. These identical results of proportions in both doctor talks well reflect the natural instinct of doctor-patient consultation where the doctor always plays an active role.
As regards lexico-grammatical realisations, from a wide range of spontaneous patterns of doctor talks, this research shows that while English doctor talk is inclined to politeness, equality, friendliness and informativeness, Vietnamese doctor talk is prone to hierarchy, complexity and sophistication, directness and firmness. Comparisons of interpersonal features found in the two language of consultation indicate remarkable evidence supporting model of patient-centeredness in the English iv LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com consultations and a model of doctor-centeredness in the Vietnamese ones. This is suggestive of the possibility that English doctor talk was skewed towards patient- centeredness since the talk was scripted for educational purposes; the language used by the doctors can be idealized. In particular, this study is an attempt to make some pedagogical suggestions that enable medical educators to be more aware of the insufficiencies of healthcare communication training and of language teaching methods.
Moreover, the study confirms a necessity of change towards a polite manner in doctor talk that helps student doctors establish solidarity, intimacy, and rapport in the doctor-patient relationship. v LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com TABLE OF CONTENTS Table of contents Abbreviations List of tables List of figures CHAPTER 1: INTRODUCTION. Statement of the problem. Aims and objectives of the study.
Significance of the study. Scope of the study. Research design and methodology. Structure of the thesis.
8 CHAPTER 2: LITERATURE REVIEW. Conceptual background of doctor talk at doctor-patient consultations. Concepts of doctor talk. Concepts of doctor-patient consultation.
Concepts of doctor-centeredness and patient-centeredness. Concepts of interpersonal communication at consultations. Different approaches to interpersonal communication in doctor talk:. Interpersonal communication in doctor talk.
Prominent linguistic approaches. An overview of SFL approach to interpersonal communication in doctor talk. Interpersonal meaning in doctor talk: The SFL approach. Advantages of SFL in finding interpersonal meanings of doctor talk.
23 CHAPTER 3: THEORETICAL AND METHODOLOGICAL FRAMEWORKS. Notions of interpersonal meanings in SFL. The pilot study – remarks. Descriptions of the corpus.
47 vi LUAN VAN CHAT LUONG download : add luanvanchat@agmail. 61 CHAPTER 4: DEPLOYMENT OF INTERPERSONAL RESOURCES. Summary of the English and Vietnamese data corpus. Summary of the English data corpus.
Summary of the Vietnamese data corpus. Summary of the English and Vietnamese data corpus. Deployment of IRs in English and Vietnamese doctor talks. Deployment of Mood resources in English doctor talk.
Deployment of mood resources in Vietnamese doctor talk. 100 CHAPTER 5: COMPARISONS OF INTERPERSONAL MEANINGS. Comparison of mood resources. Comparison of subject uses.
Comparison of declarative uses. Comparison of interrogative uses. Comparison of imperative uses. Comparison of interpersonal meanings of mood resources.
Concluding remarks of comparisons of mood. Comparison of modality resources. Comparison of congruent modality. Comparison of incongruent modality.
Comparison of interpersonal meanings of modality. Concluding remarks of comparisons of modality. Limitations of the study. Suggestions for further research.
185 vii LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com ABBREVIATIONS CA - Conversational Analysis C.A - corpus-based approach CDA - Critical Discourse Analysis Dr. - declarative IRs - Interpersonal resources interro. - imperative PA - Pragmatic Analysis Pt. - Patient SFL - Systemic Functional Linguistics SFG - Systemic Functional Grammar SLA - Socio-linguistic Analysis Subj.
- Subject VMMU - Vietnam Military Medical University viii LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com LISTS OF TABLES Table 3.1: Summary of the Vietnamese participants .2: Summary of the English participants .3: Grouping of English and Vietnamese doctor-patient pairs .1: Realisations of subject uses in English doctor talk.2: Realisations of declarative mood in English doctor talk .3: Realisations of interrogative mood in English doctor talk .4: Realisations of imperative mood in English doctor talk.5: Proportions of congruent modality used by English doctors & patients .6: Realisations of congruent modality uses in English doctor talk .7: Realisations of incongruent modality uses in English doctor talk .8: Realisations of subject uses in Vietnamese doctor talk .9: Realisations of declarative mood in Vietnamese doctor talk .10: Realisations of interrogative mood in Vietnamese doctor talk.11: Realisations of imperative mood in Vietnamese doctor talk .12: Proportions of congruent modality used by Vietnamese doctors & patients .13: Realisations of congruent modality uses in Vietnamese doctor talk .14: Realisations of incongruent modality uses in Vietnamese doctor talk .15: Modality Orientation and Manifestation used in Vietnamese doctor talk .1: Lexico-grammatical realisations of subject uses in English and Vietnamese doctor talks .2: Lexico-grammatical realisations of declarative uses in English and Vietnamese doctor talks .3: Lexico-grammatical realisations of interrogative uses in English and Vietnamese doctor talks .4: Lexico-grammatical realisations of imperative uses in English and Vietnamese doctor talks .5: Lexico-grammatical realisations of congruent modality in English and Vietnamese doctor talks .6: Lexico-grammatical realisations of incongruent modality in English and Vietnamese doctor talks. 151 ix LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com LISTS OF FIGURES Figure 3.1: The four strata of SFL language system.2: The Mood system network .3: Components of mood in clauses of English and Vietnamese doctor talks.4: Modal adjuncts found in Mood adjuncts of the Mood system .5: Relation of modality to polarity and mood .6: Types of modality.7: Three values of modality in English .8: Summary of the coding scheme .9: Types and subtypes of mood and modality in English and Vietnamese .10: The comparability of the corpora .11: Equivalence of the English and Vietnamese corpus .1: General summary of the English data corpus.2: General summary of the Vietnamese data corpus .3: The English and Vietnamese data corpus .4: Proportions of subject uses of English doctors and patient .5: Proportion of declarative mood used by English doctors & patients .6: Proportion of interrogative mood used by English doctors & patients .7: Proportion of imperative mood used by English doctors & patients .8: Proportions of modal auxiliaries and modal adjuncts in English doctor talk .9: Proportions of incongruent modality used by English doctors& patients .10: Proportions of subject uses of Vietnamese doctors and patients .11: Proportion of declarative mood used by Vietnamese doctors & patients .12: Proportion of interrogative mood used by Vietnamese doctors & patients .13: Proportion of imperative mood used by Vietnamese doctors & patients .14: Proportions of modal auxiliaries and modal adjuncts in Vietnamese doctor talk.15: Proportions of incongruent modality used by Vietnamese doctors& patients .1: Proportions of subject types in English and Vietnamese doctor talks .