본문 바로가기
HOME> 논문 > 논문 검색상세

논문 상세정보

의사-환자간 커뮤니케이션 행위에 대한 대화분석 연구 - 의사소통 문제의 유형과 해결방안을 중심으로
A Conversational Analysis of "Doctor-Patient" Communication - In Search of the Interpersonal Communication Problems and Solutions

이두원  
  • 초록

    이 연구는 휴먼 커뮤니케이션(human communication) 연구자의 시각에서 '의사-환자'간 커뮤니케이션 행위를 탐색하여, 다양한 의사소통 문제의 유형을 파악하고, 문제의 해결방안을 모색해 보고자 시도되었다. 의사소통의 의미적ㆍ표현적 오차가 오진(誤診)과 직결될 수 있다는 사실을 감안할 때, '의사-환자'간 커뮤니케이션 연구는 매우 시급하고 중요한 연구과제라고 할 수 있다. 이 연구에서는 대화분석의 방법론적 장점을 활용하며, '사회적 행위'로서 '의사-환자'간 커뮤니케이션의 상호행위를 관찰하고, 이 과정에 내재된 다양한 사회적 역할 및 관행의 실천과정을 분석해 보았다. 특히, 의사-환자간 대화 속에서 일관적ㆍ반복적으로 발견되는 의사소통 문제의 유형과 그 원인을 분석해 보고, 각 유형별 문제를 해결할 수 있는 방향을 '커뮤니케이션 전략' 차원에서 제시하고자 하였다.


    Communication between a doctor and a physician is largely consisted of a patient"s explanation of his/her symptoms and the doctor"s diagnosis. A patient orally reports his/her "physical condition" and the doctor tries to identify the illness on the basis of the patient"s oral report. Thus, for the better diagnosis, doctors become to depend upon the "oral report" presented by the patient him/herself who knows the "internal condition" best. However, most patients are not communicatively comfortable and competent enough to express his/her physical condition and feeling in everyday language. Thus, many patients in the meetings with their doctors tend to appeal their physical pains emotionally rather than explain their symptom step by step. Especially, in Korean medical culture, a feeling of awe and/or awfulness about a doctor exist in people"s mind and this fact itself becomes a major hindering factor for the effective communication between doctors and patients in Korea. A problematic context in human communication occurs when a doctor and patient meets. On one hand, the patient with physically "poor condition", thus having emotional attachment to the doctor who is expected to resolve the problem, is burdened with the task of "expressing" him/herself. On the other hand, the doctor with his/her medical education and training to detach his/her emotional or personal relation to a patient is burdened to diagnose the patient"s illness only on the basis of the medical symptoms. Thus, this context may be described as human communication between "warm heart (emotion-oriented)" and "cool head (logic-oriented)." This study is a conversational analysis of "doctor-patient" communication in Korea to identify those interpersonal communication problems and to build some guidelines overcoming those identified problems. The study results identify seven major problems of patients and doctors respectively. For doctors" problems, there were (1) semantic differentials with warm hearts (Patients), (2) authoritarian behavior and speech, (3) listening, (4) expression-jargons, information overload, ambiguity, and contradiction, (5) explaining about physical test, (6) the lack of feedback on the patient"s question, (7) the limit of time. For patients" problems, there were (1) semantic differentials with cool head (doctors), (2) the lack of the will of expression, (3) disorder and chaos in explaining. the symptoms, (4) exaggeration and ambiguity in the expression of symptoms, (5) the absence of the priority of the message, (6) discredit on doctor"s diagnosis or opinion, (7) lack of medical knowledge as commonsense. On the basis of the communicative problems, some guideline are designed for doctors and patients to make a more effective "doctor-patient communication." For doctors, the followings are recommended: (1) empathy for the warm heart, (2) symmetry relation of interpersonal communication, (3) listening skill training, (4) using everyday language to patients, (5) explanation of the physical tests, (6) two way communication model, (7) improving time-limitation. For patients, the followings are recommended: (1) reason and logical approach to doctor, (2) building will to express, (3) formal, systematic, and prepared explanation of symptoms, (4) acquiring the skill to express physical conditions and symptoms, (5) communication with semantic priority, (6) building credibility on doctors with their specialty, (7) acquiring some basis medical knowledge. In sum, people like to have doctors talk to them in an egalitarian way, listen, ask a lot of questions, answer a lot of questions, explain things in a simple way that the patient can understand, and allow patients to make decisions about their care. At the same way, doctors like to have patients talk to them step by


 활용도 분석

  • 상세보기

    amChart 영역
  • 원문보기

    amChart 영역

원문보기

무료다운로드
  • 원문이 없습니다.
유료다운로드

유료 다운로드의 경우 해당 사이트의 정책에 따라 신규 회원가입, 로그인, 유료 구매 등이 필요할 수 있습니다. 해당 사이트에서 발생하는 귀하의 모든 정보활동은 NDSL의 서비스 정책과 무관합니다.

원문복사신청을 하시면, 일부 해외 인쇄학술지의 경우 외국학술지지원센터(FRIC)에서
무료 원문복사 서비스를 제공합니다.

NDSL에서는 해당 원문을 복사서비스하고 있습니다. 위의 원문복사신청 또는 장바구니 담기를 통하여 원문복사서비스 이용이 가능합니다.

이 논문과 함께 이용한 콘텐츠
이 논문과 함께 출판된 논문 + 더보기