Conversational Implicatures in Medical Discourse: An Analysis of Doctor-Patient Dialogues in Amman, Jordan

Sally Mohammad Ali Darweesh, Rajai Rashid Al-Khanji
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Abstract

Effective communication is crucial in medical practice, and adherence to Grice's conversational maxims (quantity, quality, relevance, and manner) can improve communication between doctors and patients. In medical practice, doctors must provide clear and concise information while being honest about medical conditions and treatment options. It is also essential for doctors to communicate using simple language to ensure that the patients understand. This study analyses conversational implicature considering medical discourse in Amman. Twenty-six observations (tape-recorded doctor-patient dialogues) were randomly selected from private and government clinics in Amman, Jordan. The data was sorted and analyzed using the qualitative method of a six-phase framework. This study identifies the cooperative principles, their functions, and conversational implicature in doctor-patient discourse. Our results indicate the significance of all four conversational maxims in medical discourse, with manner being the most prominent aspect, followed by quality, relevance, and quantity. The function of cooperative principles observed in presenting the concepts of expression, direction, assertion, and declaration enhances the quality of medical discourse and promotes clarification in conversation. We observed that non-cooperative conversational implicatures are more frequently used in the doctor-patient dialogue, flouting Grice’s maxims. This flaw could lead to ineffective communication and negative health outcomes. In medical discourse, 66.7% of instances violated the Grice maxim, indicating non-cooperative conversation, while 33.3% involved cooperative implicature. The effective observance of the conversational maxims can positively impact doctors' communication with patients and promote better understanding of medical condition and treatment options that may lead to improved health outcomes.
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医学话语中的会话含义:约旦安曼医患对话分析
有效的沟通在医疗实践中至关重要,而遵守格莱斯的会话格言(数量、质量、相关性和方式)可以改善医患之间的沟通。在医疗实践中,医生必须提供清晰简洁的信息,同时诚实地告知病情和治疗方案。此外,医生还必须使用简单的语言进行交流,以确保患者能够理解。本研究分析了安曼医疗话语中的会话暗示。研究人员从约旦安曼的私人和政府诊所中随机抽取了 26 个观察对象(录制的医患对话)。采用六阶段框架的定性方法对数据进行了分类和分析。本研究确定了医患对话中的合作原则、其功能和会话含义。我们的研究结果表明,所有四项会话格言在医学话语中都很重要,其中方式是最突出的方面,其次是质量、相关性和数量。在表述表达、方向、断言和声明等概念时观察到的合作原则的功能提高了医学话语的质量,并促进了会话的澄清。我们观察到,在医患对话中,非合作性会话含意的使用频率较高,藐视格莱斯格言。这一缺陷可能导致无效沟通和不良的健康后果。在医学对话中,66.7%的情况违反了格莱斯格言,表明对话是非合作性的,而 33.3%的情况涉及合作性暗示。有效遵守会话格言可对医生与患者的沟通产生积极影响,促进患者更好地了解病情和治疗方案,从而改善健康状况。
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